OSTEOINTEGRATION IN DENTAL IMPLANTS

Аннотация

The popularity of orthopedic treatment using the method of dental implantation causes the interest of researchers to study the integration of implants in bone tissue. Analysis of the literature shows that the improvement of research technology and interdisciplinary approach to the study of the phenomenon of osteointegration of dental implants has led to a change in traditional concept in recent years. This article summarizes information about the physiological processes and cellular interactions occurring on the border "implant-bone tissue" in various stages of integration. The results of studies indicate the need for revision notions of bio inertness of titanium implants and consideration of the integration process in the immunological aspect. Keywords: osteointegration, dental implantation, osteoblast, bone regeneration, contact osteogenesis. Introduction: Osteointegration of dental implants refers to the process of bone growing right up to the implant surface. No soft tissue connects the bone to the surface of the implant. No scar tissue, cartilage or ligament fibers are present between the bones and implant surface. The direct contact of bone and implant surface can be very fied microscopically. When osteointegration occurs, the implant is tightly held in place by the bone. The process typically takes four to six months to occur well enough for the implant dentist to complete the restorations. This article provides a comprehensive review of osteointegration in dental implants. Today, dental implantation is successfully used for orthopedic rehabilitation of patients with various types of dental defects. The relevance of this method of dental treatment is dictated by the high prevalence of partial and complete absence of teeth and the need for patients to effectively restore the integrity of the dental system in the conditions of increasing requirements for aesthetics and comfort. The world experience of using prosthetics based on dental implants demonstrates the ability to use this method in various clinical situations (both for fixed prosthetics and for improving the fixation of removable structures) and at the same time achieve predicted success in treatment. The steady growth in the popularity of dental implantation in recent decades has led to an increasing interest of researchers in studying the mechanisms of implant integration in bone tissue. Traditionally, the most favorable way of integration is considered to be osteointegration, which Per- Ingvar Branemark, the founder of modern dental implantology, defined as "obvious direct (direct) attachment or attachment of living bone tissue to the implant surface without introducing a layer of connective tissue". Its achievement is considered a necessary condition for the success of prosthetics based on implants in the long term. The phenomenon of osteointegration was discovered by p.-I. Branemark accidentally, when Japan, Osaka 346 Asian Journal of Research № 1-3, 2020 ISSN 2433-202x IMPACT FACTOR JOURNAL DOI 10.37057/2433-202x SJIF 6,1 www.journalofresearch.asia IFS 3,7 info@journalofresearch.asia studying microcirculation in bone tissue using a small optical camera surgically implanted in the tibia of a rabbit. Over the four decades following this discovery, an extensive scientific database describing the mechanisms of implant integration in bone tissue has been accumulated and continues to be updated. A. Kulakov et al. (2012) proposes to consider the integration of the implant into the bone tissue as a dynamic process of interaction between the living and non-living, provided that the balance of compensatory and homeostatic mechanisms is reached, which allows the living and the dead to coexist in a single system. The criteria for the success of this interaction are the absence of inflammatory, necrotic and allergic processes in peri-implant tissues, i.e. the absence of rejection reactions; formation of morphofunctional determinants of the integration process in the zone of contact between the implant and the surrounding tissue (in the case of dental implantation - osteoid or bone substance); relative stability of these determinants over time. According to the literature, there are the following ways of organizing tissues at the implant/bone border: - osteointegration, as defined by p. I. Branemark , is the direct contact of the bone with the implant surface; - fibroosteointegration implies the presence of a connective tissue layer between the actual bone and the implant, consisting of collagen-new fibers and coarse-fiber connective tissue; - connective tissue integration that occurs when the implant surface is surrounded by fibrous connective tissue. In the literature, the first two options are described as the normal reaction of the bone to implant insertion, and the latter is considered as its rejection. For a long time, the generally accepted theory of osteointegration remains the blood clot retraction theory. According to this theory, the first p