Oseointegracion

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Presentacion sobre oseointegracion; historia, tecnicas, etc.

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Oseointegracion

  1. 1. osseointegration
  2. 2. History <ul><li>Osseointegration- founded by Professor Per-Ingvar Brånemark </li></ul><ul><li>1950s discovered that bone can integrate with titanium components </li></ul><ul><li>from the Latin word </li></ul><ul><li>os - bone </li></ul><ul><li>integrate - make whole. </li></ul>
  3. 3. HISTORY CONT’D <ul><li>wrought-iron found in a skull in a French cemetery. </li></ul><ul><li>X-rays of the skull </li></ul><ul><li>male believed to have lived about 1,900 years ago </li></ul>
  4. 4. PRINCIPLE <ul><li>A titanium screw-shaped implant (fixture) is carefully placed in the bone </li></ul><ul><li>amazingly enough - the genetic code that commonly makes bone reject a foreign material is not activated. </li></ul>
  5. 5. PRINCIPLE CONT’D <ul><li>attachment of bone cells to titanium surface results in firm anchorage for prosthetic reconstruction. </li></ul>
  6. 6. Davis's Law <ul><li>soft tissue and bone respectively heal according to the manner in which they are stressed. </li></ul><ul><li>Healing tissue responds to stress by reacting along the lines of the given stress. </li></ul><ul><li>For optimum healing, tissue must be stressed gradually to accept a given force. </li></ul>
  7. 7. Wolf's Law <ul><li>Making soft tissue accept this stress during rehabilitation leadS to strengthening tissue. </li></ul><ul><li>Wolf's Law states that the same principle applies to healing bone . </li></ul>
  8. 8. Bone Remodelling <ul><li>Bones are living, growing tissue. </li></ul><ul><li>bone is constantly being renewed. </li></ul><ul><li>The old bone is removed & the new bone is laid down </li></ul>
  9. 9. Resorption <ul><li>Cells called osteoclasts dissolve some tissue on the bone's surface, creating a small cavity. </li></ul><ul><li>takes place over a few days. </li></ul>
  10. 10. Formation <ul><li>osteoblasts fill cavities with new bone. </li></ul><ul><li>process takes place over a few months. </li></ul>
  11. 11. USES: <ul><li>replace missing teeth </li></ul><ul><li>ears and eyes. </li></ul><ul><li>attach bone-anchored hearing aids </li></ul><ul><li>joint replacements. </li></ul>
  12. 12. drawing of the principles of osseointegration
  13. 13.                                      
  14. 14. Bone Anchored Hearing Aids (BAHA) <ul><li>transmitted to the hearing apparatus in ear through air </li></ul><ul><li>transmitted through the bone skull through bone conduction . </li></ul>
  15. 15. 6 yrs after implant
  16. 16. Implant vs Osseointerception <ul><li>artificial tooth secured into the jawbone </li></ul><ul><li>allows wearer to eat and speak </li></ul>
  17. 17. Osseointerception <ul><li>tooth root substitutes surgically placed in the jawbone under gum tissue. </li></ul><ul><li>strong posts are attached to the implants to provide stable anchors for synthetic replacement teeth. </li></ul>
  18. 18. <ul><li>fixtures are inserted under controlled conditions </li></ul><ul><li>integrate during a 3-6 months healing period. </li></ul>
  19. 19. a bone cell attaching to titanium
  20. 20. Once osseointegrated <ul><li>fixtures connected to prosthetic replacement </li></ul><ul><li>bone responds by initiating a continuous process during which it remodels itself to a state of balance around the implants. </li></ul>
  21. 21. Osseoperception <ul><li>fixtures are inserted under controlled conditions </li></ul><ul><li>integrate during a 3-6 months healing period. </li></ul><ul><li>Once osseointegrated, the fixtures are connected to the prosthetic replacement </li></ul><ul><li>bone responds by remodels itself to a state of balance around the implants. </li></ul>
  22. 22. PROBLEMS <ul><li>INFECTIONS </li></ul><ul><li>WEAR AND TEAR </li></ul><ul><li>SURGICAL REMOVAL </li></ul>
  23. 23. Placement of 3 implants in the area of tooth #24, 25 and 26. Note the adequate amount of bone available.
  24. 24. 3 weeks postoperative staphylococci infection
  25. 25. 3 mobile implants removed
  26. 26. 8 yrs postop X-Ray: mesial abutment mobile due to a facture of implant head.
  27. 27. <ul><li>Clinical view of the fractured implant head </li></ul><ul><li>The apical portion of implant was osseointegrated </li></ul>
  28. 28. after removal of mesial implant placement of 6 mm diameter 3i implants
  29. 29. materials <ul><li>WROUGHT IRON </li></ul><ul><li>TITANIUM </li></ul>
  30. 30. biomimetic properties <ul><li>materials must first present cell adhesion motifs . </li></ul><ul><li>Another surface modification procedure of value in tissue engineering is the prevention of cell/protein/platelet adhesion to our biomaterial. </li></ul><ul><li>such interactions could lead to unfavourable events such as attachment of unwanted cell types and thrombus formation. </li></ul>
  31. 31. Integrins <ul><li>receptor proteins which : </li></ul><ul><ul><li>permit cells to bind & respond to the extracellular matrix. </li></ul></ul><ul><ul><li>are part of cell adhesion receptors involved in cell-extracellular matrix & cell-cell interactions. </li></ul></ul>
  32. 32. Functional integrins <ul><li>consist of 2 glycoprotein subunits </li></ul><ul><ul><ul><li>1.alpha </li></ul></ul></ul><ul><ul><ul><li>2. beta. </li></ul></ul></ul><ul><li>receptors contain 1 alpha chain & 1 beta </li></ul>
  33. 33. Cartoon of an integrin                                                          
  34. 34. Integrins vs cell-surface receptors <ul><li>integrins bind their ligands with a low affinity </li></ul><ul><li>usually present at 10-100 fold higher concentration on the cell surface. </li></ul><ul><li>can only bind their ligands when they exceed a certain minimal number @ focal contacts & hemidesmosomes. </li></ul>
  35. 36. OSSEOINT. BENEFITS <ul><li>Same-Day Teeth. </li></ul><ul><li>eliminates discomfort during a long healing period </li></ul><ul><li>fixtures are inserted in the morning and </li></ul><ul><li>the final prosthesis is anchored in the afternoon. </li></ul><ul><li>No rejection </li></ul>

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