Have you ever thought that once implant is inserted to the bone then what changes could be seen in the bone? How many days it takes for the changes to appear or will this change affect our treatment or not?
Today we will talk about the basic science in implant on which whole implantology depends. Now, we will talk about OSSEO INTEGRATION.
The word OSSEO INTEGRATION suggests its meaning itself. OSSEO means BONES and INTEGRATE means BECOMING A PART.
When we insert implant in the bones, it develops bones around it due to which implant doesn’t move. But there is no connection between bone and implant. There is a slight gap between bone and implant. We have always tried our best to cover up this space.
So, actually OSSEO INTEGRATION means to develop bones around implant so that it can do its work.
So, let’s start and see how this bone develops around implant.
When we drill in bone for implant then a lot of process starts inside the bone and bone starts repairing osteotomy site which we call as bone healing.
There are three phases of bone healing –
First phase is Inflammatory phase which remains from 1-10 days.
Second phase is Proliferative phase and it remains from 3-42 days.
And third phase is Maturation phase which starts from 28 days.
If you focus then you will know that inflammatory phase and proliferative phase overlaps from 3rdday to 10thday. This is because there is no distinction of these phases and these changes can take place soon in some and late in some.
These stages only give us idea that what we expect on implant site and we can take clinical decision.
Now, let’s go in detail of this process.
As you know that continuous bone deposition and resorption goes on in the bone and maintains a balance.
But when our bone drill makes hole in the bone then this balance becomes bad. A blood vessel which is present in trabecular bone, it is ruptured and implant side becomes full from blood.
After doing Osteotomy we place implant. And this time implant is only mechanically stable. It means implant drill is a little smaller than implant size. Because of this implant becomes tight after going in implant bones and this is called primary stability.
And after this thousand of changes occur in bone and bone implant develops between the threads and implant becomes more stable which we call as secondary stability. This process is known OSSEO INTEGRATION.
Just after bone drill one of the changes that occur that is hemostasis and this starts in few minutes.
Blood comes out from blood vessels and it splits all over. Serum protein implant in blood deposits on surface and platelet deposits on broken blood vessels. Platelets, collagen and other proteins make blood clot and blood loss stops.
Now, these platelets send messenger so that other process of bone healing could start. Like PDGF, Throwboxane, TGF-A, TGF-B.
After this our first stage is inflammatory phase.
Immune cells come inside the implant site whose work is to clean unwanted things like – small bone fragments, oral bacteria which come inside with implant.
Monocytes, leucocytes and macrophage combines together to clean the wounds so that healthy process could start.
Now you should know that inflammatory phase is very important and that is why we should limit anti-inflammatory drugs and we should avoid steroids too. Because we want inflammation for proper integration.
If you want to load implant then you should do it within 12 hours because in the next phase implant stability will be low.
Next stage is Proliferative phase which lasts from 3rd day to 42nd day.
Fibroblast comes in wound sites and they form a stabilizing matrix with the help of collagen and elastin.
Then, per-vascular cells start angio-generis and new blood vessels are formed on the wound site. After that osteo-cytes activate osteo-clast and osteo-clast is deposited on bone surface and bone starts resorption due to which primary stability decreases.
If implant fails then it fails in this stage only.
Then osteo-blast enters the wound site and new bone formation starts. The bones of this stage are un-mineralized and there is no strength in it. It is also called woven bone.
Next phase is Maturation phase which lasts from 28 days to 1 year.
The soft un-organized bone which was formed in the last phase, now mineralization will start in that and it will be orient perpendicular to implant surface.
It is also called bone remodeling. And osteo blast and osteo clast do it together.
Osteo clast resort the woven bone and osteo blast forms organized lamellar bones slowly. And this process mediates osteo-cytes.
New trabecular bone will be formed in this which will be according to new situation and OSSEO-INTEGRATION will be completed.
So, today we have learnt about Osseo-integration and bone healing.
If you also want to learn dental implant then GDS Academy welcomes you where you are taught to implant on the patient, where problem-solving is taught in actual and where you also lifetime support.
THANK YOU…
