Osseointegration

All clinical applications are rooted in the principles of Osseointegration, a term introduced by Professor Per-Ingvar Brånemark after his groundbreaking discovery in the 1950s. His findings revealed that bone has the ability to integrate seamlessly with titanium components, marking a pivotal advancement in modern medical practices. Adhering to these principles is paramount for ensuring successful outcomes in various medical procedures.

The process begins with the precise placement of a titanium screw-shaped implant, known as a fixture, into the bone. Remarkably, the typical genetic code that causes the rejection of foreign materials by bone remains inactive. Instead, nature facilitates the attachment of bone cells to the titanium surface, leading to a solid and enduring foundation for a prosthetic reconstruction.

Professor Brånemark aptly named his groundbreaking discovery "Osseointegration," derived from the Latin words "os" (meaning bone) and "integrate" (meaning to make whole or achieve interactive coexistence). This term encapsulates the harmonious relationship formed between bone and titanium, resulting in a successful and long-lasting integration of the prosthetic device.

Direct connection between anchoring element and living bone

After 6 years of function, metal fatigue occurred and specimen was removed by a trephine and cut longitudinally into two halves with a diamond disc, but with bone tissue still firmly – and inseparably – adhering to the titanium surface.

High resolution scanning electron micrograph of an osteoblast with its cellular process adapted to the surface of the fixture. Micrograph by Hans-Arne Hansson, 1985

Anatomy of Osseointegration. Compartment of anchorage composed of continuously remodeling and reorganizing interfacial tissue and titanium at the cellular as well as at the molecular level of dimensions.

Screw-connected components; fixture, abutment and center screw for the attachment of the prosthesis.

Osseoperception

Quality care encompasses not only the follow-up of implant and prosthetic stability, but also function. Osseoperception, which makes it possible for bone-anchored prosthetics to communicate with the mind via the patient´s central nervous system facilitates function in virtually every case.

If our ambition is restitutio ad integrum ( “to restore the original condition”) the need for sensory evaluation becomes self-evident.

P-I Brånemark, October 2010.