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Izvestia Journal of the Union of Scientists - Varna. Medicine and Ecology Series

Factors influencing the processes of osseointegration in intraosseous dental implants

Ivaylo Hristov


Osseointegration can be defined as a direct structural and functional link between bone and implant surface. Asymptomatic and rigid fixation of the alloplastic material in the bone is crucial for implant stability and long-term success of dental implant treatment. The connection between the implant and the surrounding tissue is extremely dynamic. This interaction is the basis for the formation of a new structure—the implant-tissue interface. The process of osseointegration is a combination of biological mechanisms as a result of which bone is formed on the walls of the osteotomy lodge growing to the implant surface (remote osteogenesis) and direct osteogenesis of bone on the surface of the implant (contact osteogenesis). The process is complex and there are a number of factors that affect the formation and maintenance of bone in the peri-implant space. The aim of the present study is to review the literature data on the factors influencing osseointegration in intraosal dental implants.


osseointegration, bone, implant, stability

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Пеев Ст. Приложение на дентални имплантати в условията на редуциран обем на наличната кост. Автореферат НС “Доктор на науките“, МУ-Варна, 2015

Попов Н., Пеев Ст., Йорданов Б., Абаджиев М., Йончева И. Зъбопротезна имплантология. Учебник и сптавочник за студенти, специализанти и специалисти. Под редакцията на акад. проф. д-р Н. Попов, София, 2012

Събева Е. Фактори повлияващи първичната стабилност на интраосалните винтови имплантати. Дисертационен труд, МУ-Варна, 2016

Albrektsson T, Branemark P-I, Hansson H-A, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52:155–170

Albrektsson Т., Albrektsson В. Osseointegration of bone implants: a review of an alternative mode of fixation Acta Orthop Scand, 1987, 58 (5), pp. 567-577

Albrektsson T., Chrcanovic B., Jacobsson M., Wennerberg A. Osseointegration of implants- a biological and clinical overview JSM Dent Surg, 2017, 2 (3), pp. 1022-1028

Aldahlawi S, Demeter A, Irinakis T. The effect of implant placement torque on crestal bone remodeling after 1 year of loading. Clin Cosmet Investig Dent. 2018 Oct 9;10:203-209

Baier RE, Natiella JR, Meyer AE, Carter JM. Importance of Implant Surface Preparations for Biomaterials with Different Intrinsic Properties. In: van Steenberghe D, Albrektsson T, Branemark P-I, Holt R, Henry P, Lidén C, Excerpta Medica, Amsterdam, 1986, p 13–40

Cameron HU, Pilliar RM, Weatherly GC. The effect of movement on the bonding of porous metal to bone. J Biomed Mater Res. 1973;7:301–311

CARMO, Luiz Carlos do, et al. Can implant surfaces affect implant stability during osseointegration? A randomized clinical trial. Brazilian oral research, 2018, 32

Coelho PG, Granjeiro JM, Romanos GE, Suzuki M, Silva NR, Cardaropoli G, et al. Basic research methods and current trends of dental implant surfaces. J Biomed Mater Res B Appl Biomater 2009;88:579-96

Daugaard H, Elmengaard B, Bechtold JE, Jensen T, Soballe K. The effect on bone growth enhancement of implant coatings with hydroxyapatite and collagen deposited electrochemically and by plasma spray. J Biomed Mater Res A 2010;92:913-21

Dimitriou R., Jones E., McGonagle D., Giannoudis PV. Bone regeneration: current concepts and future directions BMC Med, 9 May, 2011, S66

Dohan Ehrenfest DM, Coelho PG, Kang BS, Sul YT, Albrektsson T. Classification of osseointegrated implant surfaces: materials,chemistry and topography. Trends Biotechnol 2010;28:198-206

Dos Santos MV, Elias CN, Cavalcanti Lima JH. The effects of superficial roughness and design on the primary stability of dental implants. Clin Implant Dent Relat Res 2011;13:215-23

Elias CN. Factors affecting the success of dental implants (Internet). Rijeka: InTech (cited 2014 Apr 22). Available from:

Enkling N., Utz KH., Bayer S., Stern RM. Osseoperception: active tactile sensibility of osseointegrated dental implants. Int J Oral Maxillofac Implants, 2010, 25 (6), pp. 1159-1167

Eriksson RA. Heat-induced bone tissue injury. An in vivo investigation of heat tolerance of bone tissue and temperature rise in the drilling of cortical bone. Thesis. Sweden: University of Goteborg; 1984. pp. 1–112

Eriksson RA, Albrektsson T. The effect of heat on bone regeneration. J Oral Maxillofacial Surg. 1984;42:701–711

Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev. 2014 Jul 22;(7):CD003815

Gehrke SA, Treichel TLE, Aramburú Júnior J, de Aza PN, Prados-Frutos JC. Effects of the technique and drill design used during the osteotomy on the thermal and histological stimulation. Sci Rep. 2020 Nov 26;10(1):20737

GEHRKE, Sergio Alexandre, et al. New implant macrogeometry to improve and accelerate the osseointegration: an in vivo experimental study. Applied Sciences, 2019, 9.15: 3181

Gehrke S., Junior J., Treichel T., Dedavid B. Biomechanical and histological evaluation of four different implant macrogeometries in the early osseointegration process: An in vivo animal study. Journal of the Mechanical Behavior of Biomedical Materials, 2022, Vol. 125, 104935

Gehrke SA, Aramburú J Júnior, Pérez-Díaz L, do Prado TD, Dedavid BA, Mazon P, N De Aza P. Can changes in implant macrogeometry accelerate the osseointegration process?: An in vivo experimental biomechanical and histological evaluations. PLoS One. 2020 May 14;15(5):e0233304

Geng JP, Xu DW, Tan KB, Liu GR. Finite element analysis of an osseointegrated stepped screw dental implant. J Oral Implantol 2004;30:223-33

Georgieva, I; Peev, S. CBCT-Assessment of Morphological Characteristics of the Alveolar Bone in the Aesthetic Zone.International Journal of Science and Research (IJSR). 2016;5(2):2085-2089

Guan H, van Staden R, Loo YC, Johnson N, Ivanovski S, Meredith N. Influence of bone and dental implant parameters on stress distribution in the mandible: a finite element study. Int J Oral Maxillofac Implants 2009;24:866-76

Gupta A, Dhanraj M, Sivagami G. Status of surface treatment in endosseous implant: a literary overview. Indian J Dent Res 2010;21:433-8

Javed F, Ahmed HB, Crespi R, Romanos GE. Role of primary stability for successful osseointegration of dental implants: factors of influence and evaluation. Interv Med Appl Sci 2013;5:162-7

JIMBO, Ryo, et al. The combined effects of undersized drilling and implant macrogeometry on bone healing around dental implants: an experimental study. International journal of oral and maxillofacial surgery, 2014, 43.10: 1269-1275

Kan JY, Rungcharassaeng K, Kim J, Lozada JL, Goodacre CJ. Factors affecting the survival of implants placed in grafted maxillary sinuses: a clinical report. J Prosthet Dent 2002;87:485-9

Kumar K, Ramesh Bhat TR, Harish PV, Sameer VK, Gangaiah M. Nanobiotechnology approaches to design better dental implant materials. Trends Biomater Artif Organs 2011;25:30-3

Le Guéhennec L, Soueidan A, Layrolle P, Amouriq Y. Surface treatments of titanium dental implants for rapid osseointegration. Dent Mater 2007;23:844-54

Lee JH, Frias V, Lee KW, Wright RF. Effect of implant size and shape on implant success rates: a literature review. J Prosthet Dent 2005;94:377-81

Limmer A., Wirtz DC. Osteoimmunology: influence of the immune system on bone regeneration and consumption Z Orthop Unfall, 2017, 155 (3), pp. 273-280

Marquezan M, Osório A, Sant'Anna E, Souza MM, Maia L. Does bone mineral density influence the primary stability of dental implants? A systematic review. Clin Oral Implants Res 2012;23:767-74

Matos, G., Martins R. Surface roughness of dental implant and osseointegration. Journal of Maxillofacial and Oral Surgery, 2021, 20.1: 1-4

Meltzer AM. Primary stability and initial bone-to-implant contact: the effects on immediate placement and restoration of dental implants. J Implant Reconstruct Dent 2009;1:35-41

Mijiritsky E, Mazor Z, Lorean A, Levin L. Implant diameter and length influence on survival: interim results during the first 2 years of function of implants by a single manufacturer. Implant Dent 2013;22:394-8

Miteva, M.; Gerova, Ts. Bone Repair Materials Used in Guided Tissue Regeneration - Advantages and Disadvantages. International Journal of Science and Research. 2019;8(10):1490-4

NOBLES, Kadie P.; JANORKAR, Amol V.; WILLIAMSON, Randall S. Surface modifications to enhance osseointegration–Resulting material properties and biological responses. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 2021

Ong JL, Carnes DL, Bessho K. Evaluation of titanium plasma-sprayed and plasma-sprayed hydroxyapatite implants in vivo. Biomaterials 2004;25:4601-6

Palmquist A, Omar OM, Esposito M, Lausmaa J, Thomsen P. Titanium oral implants: surface characteristics, interface biology and clinical outcome. J R Soc Interface 2010;7(Suppl 5):S515-27

Roehling SK., Meng B., Cochran DL. Sandblasted and acid-etched implant surfaces with or without high surface free energy: experimental and clinical background A. Wennerberg, T. Albrektsson, R. Jimbo (Eds.), Implant surfaces and their biological and clinical impact, Springer, Berlin, Heidelberg, 2015, pp. 93-136

Sabeva, E., Peev, S. Miteva, M., Georgieva, M. Bone characteristics and implant stability. Scripta Scientifica Medicinae Dentalis. 2017;3(1):18-22

Samieirad S, Mianbandi V, Shiezadeh F, Hosseini-Abrishami M, Tohidi E. Tapered Versus Cylindrical Implant: Which Shape Inflicts Less Pain After Dental Implant Surgery? A Clinical Trial. J Oral Maxillofac Surg. 2019 Jul;77(7):1381-1388

Searson LJ. History and development of dental implants. In: Narim L, Wilson HF, eds. Implantology in general dental practice. London, Chicago: Quintessence Publishing Co; 2005:19-41

Seth S, Kalra P. Effect of dental implant parameters on stress distribution at bone-implant interface. Inter J Sci Res 2013;2:121-4

Shrivats AR, Mc Dermott MC., Hollinger JO. Bone tissue engineering: state of the union. Drug Discov Today, 2014, 19 (6), pp. 781-786

Simon Ziv, Philip A, Watson Biomimetic dental implants—new ways to enhance osseointegration. J Can Dent Assoc. 2002;68(5):286–288

Smeets R, Stadlinger B, Schwarz F, Beck-Broichsitter B, Jung O, Precht C, Kloss F, Gröbe A, Heiland M, Ebker T. Impact of Dental Implant Surface Modifications on Osseointegration. Biomed Res Int. 2016:6285620

Stanford CM. Surface modifications of dental implants. Aust Dent J 2008;53(Suppl 1):S26-33

Sullivan RM. Implant dentistry and the concept of osseointegration: a historical perspective. J Calif Dent Assoc 2001;29:737-45

Trindade R., Albrektsson T., Galli S., Prgomet Z., Tengvall P., Wennerberg A. Osseointegration and foreign body reaction: titanium implants activate the immune system and suppress bone resorption during the first 4 weeks after implantation Clin Implant Dent Relat Res, 2018, 20, pp. 82-91

Triplett RG, Frohberg U, Sykaras N, Woody RD. Implant materials, design, and surface topographies: their influence on osseointegration of dental implants. J Long Term Eff Med Implants 2003;13:485-501

Valente MLDC, Castro DT, Shimano AC, Reis ACD. Influence of an Alternative Implant Design and Surgical Protocol on Primary Stability. Braz Dent J. 2019 Jan-Feb;30 (1):47-51

Vidyasagar L, Apse P. Dental implant design and biological effects on bone-implant interface. Stomatologija 2004;6:51-4

Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: a systematic review. Clin Oral Implants Res 2009;20(Suppl 4):172-84

Yeo IL. Modifications of Dental Implant Surfaces at the Micro- and Nano-Level for Enhanced Osseointegration. Materials (Basel). 2019 Dec 23;13(1):89

Zarb GA, Albrektsson T. Osseointegration: a requiem for periodontal ligament? Int J Periodontal Restor Dent. 1991;11:88–91



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