Bone ingrowth on the surface of endosseous implants. Part 1: Mathematical model

Abstract

Osseointegration, understood as an intimate apposition and interdigitation of bone to a biomaterial, is usually regarded as a major condition for the long-term clinical success of bone implants. Clearly, the anchorage of an implant to bone tissue critically relies on the formation of new bone between the implant and the surface of the old peri-implant bone and depends on factors such as the surface microtopography, chemical composition and geometry of the implant, the properties of the surrounding bone and the mechanical loading process. The main contribution of this work is the proposal of a new mathematical framework based on a set of reaction–diffusion equations that try to model the main biological interactions occurring at the surface of implants and is able to reproduce most of the above mentioned biological features of the osseointegration phenomenon. This is a two-part paper. In this first part, a brief biological overview is initially given, followed by the presentation and discussion of the model. In addition, two-dimensional finite element simulations of the bone-ingrowth process around a dental implant with two different surface properties are included to assess the validity of the model. Numerical solutions show the ability of the model to reproduce features such as contact/distance osteogenesis depending upon the specific surface microtopography. In Part 2 [Moreo, P., García-Aznar, J.M., Doblaré, M., 2008. Bone ingrowth on the surface of endosseous implants. Part 2: influence of mechanical stimulation, type of bone and geometry. J. Theor. Biol., submitted for publication], two simplified versions of the whole model are proposed. An analytical study of the stability of fixed points as well as the existence of travelling wave-type solutions has been done with both simplified models, providing a significant insight into the behaviour of the model and giving clues to interpret the effectiveness of recently proposed clinical therapies. Furthermore, we also show that, although the mechanical state of the tissue is not directly taken into account in the model equations, it is possible to analyse in detail the effect that mechanical stimulation would have on the predictions of the model. Finally, numerical simulations are also included in the second part of the paper, with the aim of looking into the influence of implant geometry on the osseointegration process.