Before explaining what osseointegration is we would like to talk about dental implants. As you might know, this treatment has the purpose of replacing the whole structure of the tooth including the root. It is composed of three parts including the crown, abutment, and fixture. The fixture is made from titanium because it is biocompatible and will not be rejected from the body.
During the implant placement step, the main purpose is to become one with the bone and serve as the root of it. This process will take a while and after the healing period is done, thanks to osseointegration, the new implant will become stable and durable. This happens due to the fact that the jawbone cells will start to grow around the implant and grip it securely in place.
Depending on the position of the implants and the condition of the jawbone, osseointegration might take six weeks to six months. However, there is a possibility that the dentist will recommend putting fake teeth over the implant until it heals. Once the implants have been completely integrated, the final replacement teeth are placed on top of the implants or implant posts.
Because they offer a strong anchor and a supporting structure similar to a root, implants feel, look, and work just like natural teeth. Usually, the dental implant structure is made up of the three parts that we mentioned before. The titanium screw replaces the missing root in this area. This will be the foundation that will hold a single crown, bridge, or even a bigger set of teeth. The osseointegration process is very important in order to make this possible.
What Is Osseointegration?
Osseointegration is the process in which the bone and the gum tissue start to grow and heal around the artificial root of the tooth when it is placed on the jawbone. This is a necessary step since it makes sure it secures the screw in place. Once it is done the the crown can be attached securely and it won’t move.
Secure implants need successful osseointegration. A secure foundation for individual implants, bridges, and dentures is provided when the bone around the implant heals appropriately and is capable of handling this pressure. After the procedure is done, the patient will be able to speak, eat, and drink. As opposed to conventional dentures, this whole experience is much better.
How Does Osseointegration Work In Dental Implants?
Even the process of osseointegration on its own needs several stages to be completed. As soon as the dental implant is inserted into the jawbone, osseointegration takes place. Prior to implant implantation, the remaining tooth roots in the jawline must be extracted. This happens in certain teeth, particularly those removed due to dental disease, which remain loose and have not fully separated from the jawbone.
After the dental implant is placed in the surgical site, the osseointegration process begins two to three minutes later. This is referred to as the hemostasis stage and it occurs when a thick layer of blood surrounds the dental implant and acts as the starting point for the healing process.
A few hours following the procedure, the inflammatory stage occurs. This is the process by which microorganisms and surgical debris are removed by the gum line’s protective cells. In the Inflammation stage, peri-vascular cells heal and reestablish the microblood arteries that were broken during the Drilling stage.
The proliferative stage is the third step of osseointegration. Bone regeneration requires proliferation. Days after the implant device is inserted, the osteoblast cells begin to gradually proliferate. This is known as the proliferative stage. The creation of calcium phosphate and carbonate, which are essential for the growth of new bone, is attributed to osteoblast cells.
The Remodelling Stage is the final stage of osseointegration. It normally happens a few weeks or months following surgery. It is at this point that the osteocytes begin to rebuild. The dental implant starts to integrate with the surrounding tissues and bone. After the remodeling phase is over, the abutment placement and crown attachment are completed.
The healing process of dental implants also occurs in stages which will take some time especially when endosteal implants are used. It will take the patient at least two weeks to recover after the procedure is done. This is the most difficult part of the recovery process. After that, it will take another 3 to 6 months in order for the implant to fully integrate with the bone. This is the osseointegration process that we mentioned earlier. After this period is done, the patient should return back to the clinic so the abutment is implanted.
Another step of the process is the abutment placements. During this stage, a small device will be attached or connected to the dental posts. In order to do this, the gums need to be reopened surgically by the dentists for the connection to be possible. This will create another wound in the mouth which will need about two weeks to fully recover.
The final stage is the placement of the crown, which will be designed to look exactly like your natural teeth. After the placement is done the patient will be able to use their new teeth normally. In some cases when there are a lot of new teeth replaced, the dentist will recommend that you return to your diet gradually.
What Are The Benefits Of Osseointegration In Dental Implants?
The osseointegration process is very important when it comes to dental implants and it offers a lot of benefits. This is considered the heart of the procedure due to the weight that it carries. Among these benefits is the stimulation provided by the titanium alloy in the implant devices, which unites the gum line, the jawbone, and the dental device as a whole.
Osseointegration eventually gives the dental transplant more durability and strength. It supports maintaining the health of both the upper and lower arches together. Thanks to the osseointegration process the dental devices are supported by a strong and healthy base.
The ability of the jawbone to grow around the dental implant, however, is the most significant benefit of osseointegration in dental implants as it creates strong and long-lasting fundamental roots for the temporary teeth. Thanks to this process there are several additional advantages of dental implants.
What Are The Risks Of Osseointegration?
Besides the many benefits that the osseointegration process offers, there are also some risks associated with it that you must be aware of. Although the procedure itself is harmless, there are several complications associated with it that can prolong the process. These possible risks include infection, possible fracture, and failure of fixation.
Infection is expected to arise in the surgical site’s superficial and intense areas. The uppermost layer of skin as well as the subcutaneous tissues—where the bacteria are multiplying—are affected by superficial infections. On the other hand, severe or deep-seated infection affects more than only the surgery site’s subcutaneous tissues, they will spread near the implant and the bone.
The possible fracture of the area near the implant is another possible risk for patients who undergo implant procedures. It has to do with the broken bones surrounding the prosthesis. It often occurs during the implant insertion procedure or even during the healing phase. As soon as the operation is over, the bone around the implant becomes very sensitive and fragile, increasing its risk of fracture. A similar result is anticipated if implants are placed in the jawbone region.
Aseptic loosening is another possible risk associated with osseointegration. This issue occurs when, despite osseointegration’s assistance, the implant and the bone are unable to form a strong connection. Patients who experience it are thought to have incompatibility factors throughout the osseointegration process. When incompatible materials are present in the body, the patients will most likely suffer from aseptic loosening.
Usually, there are two types of osseointegration fears that most patients have. The first one is related to osseointegration surgical issues that include injury to the mandible bone, blood clotting, and alteration of neurosensory function. Another issue is that the process of osseointegration and the implant process has the potential to cause injury to the neurosensory nerves. When these nerves are affected, the patients can experience pain in their mouth and changes in the taste.
Hematoma, or blood clotting, is another known risk that patients may encounter during osseointegration. In fact, blood clotting is an indication sign of successful osseointegration, however, if they are formed in the gums they will have the opposite impact. The dental implant acts as a barrier to protect the bone nerve endings by causing blood clots to form when it is placed into the jawbone. Severe oral hemorrhage is prevented by blood clotting.
Another issue caused by osseointegration is injury to the mandibular bone. It is expected that there will be injury to the mandible or jaw bones either during or after the treatment. A weakening of the mandible or a reduction in blood flow to the surgical site are common causes. In terms of structure, implant fractures, denture retention problems, and incompatible prosthesis fractures are among the possible risks associated with osseointegration.
Is The Process Of Osseointegration Painful?
Yes, it is expected that the osseointegration process may cause some type of discomfort. this will not be a very pleasant situation since the mouth is still getting used to the new dental implant. The jawline becomes uncomfortable due to friction created by the bone that is developing behind the gums.
However, each dental patient’s individual tolerance to pain will determine how they will experience it. For some people, the whole process can be less painful; however, for others, it can be quite painful. the good thing is that during the procedure you won’t feel any pain since the process will be done under the effect of anesthesia.
Some levels of discomfort and pain will be more noticeable during the initial stage of recovery while the mouth is still getting used to the feeling of a foreign object. Because another incision needs to be made, pain is expected to intensify throughout the abutment insertion process. Gums that are more sensitive as a result of the cut are more responsive to various stimuli, including little movements. Pain is reduced or eliminated entirely during the abutment device installation process for the crown or artificial teeth. However, after you see the results you will understand that everything was worth it.
What Are The Factors That Affect Osseointegration?
Furthermore we have mentioned some factors that may affect the osseointegration process and how are they avoided by our professional dentists here at Dr. Roland Zhuka’s dental clinic.
Materials Used In The Implant
One of the most important factors that can affect the osseointegration process is the materials that will be used during the procedure. It is very important that the materials that will be used be compatible with the bone components, in order for the body to not reject it or to avoid any allergic reaction. To avoid these issues, most dental clinics use titanium, since it is one of the natural elements that is the most compatible with our bones.
Teeth implants have a high success rate because titanium is biocompatible with human bone. It contributes significantly to the formation of bone tissues and nerve connections by interacting with osteocytes in the jawbone. An essential function of osteocytes is to establish osseointegration. In the absence of suitable materials in the implant device, implantation cannot take place. Therefore, for dental implants to successfully create osseointegration, they must be titanium-based.
The Surgical Method Or Technique
The surgical method employed throughout the treatment has a great impact on the osseointegration process. During the first stages of osseointegration, this is among the factors that affect how firm the implant is.
That being said, the amount of time it takes for the bones and body tissues around the implant to recover can be affected by the type of surgical method used during osseointegration. Changing the surgical approach, as well as the design and surfaces of titanium implants, reduces the recovery time.
In the past, complicated and time-consuming procedures were used to place dental implants. In the early years of implant discovery, several bone structures are damaged and multiple drills are required to establish a dental implant. Over the years, a number of surgical techniques for dental implants have been developed to offer more stability with less harm to the gums and jawbone.
The “undersized drilling technique” is one of the practical solutions developed to deal with the issue. It is a surgical technique that involves indirectly compressing the bone tissue with a device known as an osteotome spreader. Through lateral compression, the undersized drilling technique increases bone density. It is well known to provide better implantation rates, which strengthens the dental implants’ attachment to the bone. This mentioned technique also makes it possible for the bone fragments to be uniformly distributed around the implant’s surface.
The even distribution of bone fragments promotes faster bone mending around the implant and strengthens the osseointegration remodelling stage. The majority of dental implant manufacturers advise using an undersized drilling method for inserting implants. Nonetheless, more research is being done to increase the effectiveness of the aforementioned surgical method.
Oral Hygiene
Oral hygiene is the last, although certainly not the least, factor influencing osseointegration. When it comes to osseointegration success, oral hygiene is the deciding factor. As we mentioned before the osseointegration process is what occurred during the recovery period. But how do we take care of the treated area and the teeth nearby?
Maintaining good dental hygiene throughout the healing process guarantees that osseointegration will be fully successful. If the patient practices good hygiene, there won’t be any unanticipated problems that interfere with the osseointegration process. In the end, it results in a quicker recovery, fewer dental issues in the future, and an overall greater success rate for the implant process.
If you dont take care of your mouth properly and dont have a regular dental cleaning routine, you will most likely suffer from gum disease in the future. This is an infection in the mouth that can be brought by oral bacteria and if left untreated it may cause issues in the gums which can spread to the teeth and even in the jawbone where the implant has been inserted.
If the jawbone is not in good shape the process of osseointegration will be at risk, which will eventually lead to the failure of the new implant. Keep in mind that good oral hygiene does not consist of only brushing the teeth, you should also use dental floss regularly and use mouthwash to protect your gums. These practices will also include changes in your diet and behavior. Do not use your teeth as tools to open things, and try quitting smoking and alcohol.
These practices are strictly advised for patients who are thinking of getting dental implants done. This is due to the fact that these habits lead to several dental issues in the mouth. Gum disease, tartar and plaque accumulation, tooth loss, and significant damage to the tooth structure are just some of them. As you now understand, good dental hygiene is an important factor in the effectiveness of osseointegration.
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