Titanium for Dental Applications (I)

Abstract

In the 60’s, commercially-pure titanium optical chambers were used to investigate the anatomy and pathophysiology of tissue injury under controlled experimental conditions [1]. These studies indicated the possibility of establishing a firm connection between titanium and bone, if titanium chambers were introduced into bone with minimal trauma. In fact, these chambers could not be removed from the surrounding bone once it had healed. It was believed, prior to these observations, that metals could not become integrated into bone. From this casual observation Professor Brånemark developed a new concept of “osseointegration” which led to oral implants with predicable success and long-term function. The concept of osseointegration stood in contrast to the leading principle of the time, “fibrointegration”, which aimed to encapsulate implants placed in bone with stratified connective tissue. The hypothesis behind the “fibrointegration” concept was that the soft-tissue interface surrounding an oral implant could resemble the highly vascular periodontal ligament of the natural dentition [2] with its shock-absorbing and sensory functions. This was not the case and the less than optimal clinical outcomes of “fibrointegrated” implants forced their abandonment in favor of “osseointegrated” implants. The concept of “osseointegration”, called ankylosis by others [3], revolutionized the practice of clinical dentistry in the 80s as well as other reconstructive disciplines. Oral implant therapy has improved the chewing ability of edentulous and partially dentate patients with all the related psychological implications.