In issue 3-2023 of the magazine implants, Dr Johann Lechner & colleagues are featured with a technical article on the topic of “Immune sustainability on titanium implants?”:

Bone-to-implant contact (BIC) is considered an essential requisite for implant stability and clinical success. The death of local bone marrow cells due to chronic stimulation as a result of unfavourable factors such as inflammation of the jawbone leads possibly to chronic osteoimmune dysregulation. Bone marrow defects of the jaw (BMDJ) surrounding dental titanium implants (Ti-Impl), in combination with impaired BIC, are difficult to detect in X-rays and have thus been little researched. Recent research shows that Ti-Impl can induce inflammation in the surrounding bone over time. Can alveolar bone decay possibly induce local osteoimmune reactions? In earlier publications we defined this chronic inflammatory process as fatty-degenerative osteonecrosis (FDOJ/BMDJ) connected to chronic overexpression of proinflammatory cytokine RANTES/CCL5. FDOJ/BMDJ is a lesion also primarily defined as “bone marrow edema” or as silent or subclinical inflammation without the typical signs of acute inflammation (Fig. 1). Is an undetected transition existing from diminished bone-to-implant contact (BIC) to hitherto neglected osteonecrosis? This opens up a new case in implantology:

The long-term immune sustainability of dental implants

Osseointegration, defined as “functional ankylosis” between implant and jawbone, is the primary treatment objective in implantology. Osseointegration is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant. Successful osseointegration occurs where new bone is deposited directly at the bone–implant interface and the implant exhibits mechanical stability. Figure 2 explains a diminished osseointegration in three steps: ideal theory, the radiographic display and the actual reduced BIC, converted to FDOJ/BMDJ.

The connection of incomplete BIC to osteoimmune inflammation

However, what if this BIC does not take place over the entire surface of the implant? In those areas where osseointegration is impaired, chronic inflammation may occur […]

The full article can be read HERE.