Histological response of anodized titanium implant

Abstract

Osseointegration is the essential biological basis of current dental implants. Osseointegration was initially defined on the light microscopic level as “a direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant”. Today, by definition, osseointegtation requires the absence of a fibrous layer and implies that the biological response of the bone is not one of inertness towards a foreign material but rather one of active integration of the material with the bone as part of the body. According to Giavaresi. et al. osseointegration is defined not only as the absence of a fibrous layer around the implant with an active response in terms of integration to host bone, but also as a chemical(bonding osteogenesis) or physico-chemical(connective tissue osteogenesis) bond between implant and bone. Endosseous integration can be deconvoluted into three distinct bony healing phases. The first, osteoconduction, relies on the migration of differentiating osteogenic cells to the implant surface. The second, de novo bone formation, results in a mineralized interfacial matrix equivalent to that seen in cement lines in natural bone tissue. Implant surface design will have a profound effect on osteoconduction, while the surface topography of the implant will play a critical role in bone bonding concomitant with de novo bone formation. The third healing phase, that of bone remodeling, will also, at