Osseointegration. Healing time

Last Updated: 10.01.2024

Author: George Ghidrai, MD  

For an implant to become permanently stable, the body must grow bone to the surface of the implant. This process is called osseointegration.

Osseointegration is defined as the formation of a direct interface between an implant and bone without intervening soft tissue.

Applied to oral implantology, this means that the bone grows right up to the implant surface without an interposed soft tissue layer.

When osseointegration occurs, the implant is tightly held in place by the bone. The process typically takes several weeks or months, but several factors can influence it:

• Implant material

  For osseointegrated dental implants, metallic, ceramic (zirconia), and polymeric materials, particularly titanium, have been used. Up to this day, titanium is the most favored material due to its remarkable ability to connect its surface with the alveolar bone.

  However, zirconia dental implants have recently emerged. Even though they are relatively new, there has been a considerable increase in the use of these types of implants.

  

  
  

• Loading time

  Loading time refers to the moment when the artificial teeth are attached to the implants.

  Refrain from confusing loading time with the timing of implants after teeth extraction.

  The first refers to when the artificial teeth are attached to the implants.

  The second refers to when the implants are placed after tooth extraction.

  Generally speaking, osseointegration can be damaged by prolonged adverse stimuli and overload, possibly resulting in implant failure. However, there are three valid options for when to attach teeth to dental implants:

  • Immediate loading procedure

    Immediate loading means that the artificial abutments and (sometimes) the prosthetic restoration are attached to the implants during the surgical placement procedure (or immediately after).

    This relatively new approach aims to shorten treatment time. Followers suggest that the initial stability of the implant in bone is a more important determinant of the success of implant integration rather than a certain period of healing time.

  • Early loading

    Early loading means that abutments and artificial teeth are attached to the implants one to twelve weeks after surgery.

    These two loading methods have certain limitations. Even in the event of early or immediate loading, many practitioners prefer to place temporary restorations for a specific time.

    Once the implants have had a chance to heal and have been tested for successful integration, the definitive restoration is manufactured.

  • Delayed loading

    It is the most prudent approach; three to six months of integrating time is allowed before placing the teeth on implants.

    Before connecting the artificial abutments, the implants are tested for successful osseointegration.

The fact is that the degree of osseointegration of implants is a matter of time. While the first evidence of integration occurs after a few weeks, the more robust connection is progressively achieved over the following months or years.

As a result, the osseointegration process continues well after the definitive restoration is secured to the implants.

That is one reason why the prosthetic phase requires equal technical expertise: a restoration that overloads one (or more) implants can damage the osseointegration process, which may result in implant failure.