Perio: Osseointegration Lecture 1

intimate contact of vital bone and the implant surface WITHOUT intervening soft tissue

• 5 yrs: 97.2%
• 10 yrs: 95.2%

Survival 5 yrs for implant supported SCs: 96.3%

Survival 10 yrs for implant supported SCs: 89.4%

implant is still present in mouth, doesn't mean that the implant is in good health (success)

very hard to measure

66.4%

- incidence of complications usually increase w/ time

gingival margins for implant is more apical


Tooth: perio ligaments, CT fibers, long JE

Implant: direct contact of vital bone and implant surface, circumferental fibers that are parallel

tooth: supracrestal gingival fibers, network of CT fibers that are attached above bone to teeth to suppose tooth and tissue and protect against bacteria

implants don't have network of CT fibers

hemidesmosomal attachment to the implant

implant: keratinized mucosa, dense gingical fibers promote close adaptation of the mucosa around the implant resulting in gingival cuff (similar to sulcus in a natural tooth)

implant around non-keratinized lack circumferential gingival fibers and gingival cuff fails to form.

tooth: bone loss can be localized to one side of tooth  

vs.

implant:consistent circumferential bone loss

• 1. infection theory
• 2. biomechanical overload theory
• 3. additional factors (compromised healing)

• - host factors that influence healing
• - quality of surrounding bone
• - quality of surrounding soft tissue
• - trauma of surgical procedures
• - trauma from "other" post-tx incidents

anterior mandible

Posterior maxilla

1. thickness of cortical bone (most important)

2. quality (density) of trabecular bone

3. bicortical stabilization

load magnification = bone loss

causes load magnification around implant adjacent to the cantilever

tooth (periodontal): site specific bone loss and INFECTIOn driven

implant (peri-implant): CIRCUMFERENTIAL bone loss, biomechanical overload as well as infection driven