Osseointegrated Titanium Implants:<i>Requirements for Ensuring a Long-Lasting, Direct Bone-to-Implant Anchorage in Man</i>
Tomas Albrektsson, Per‐Ingvar Brånemark, Hans‐Arne Hansson, Johan Lindström
Acta Orthopaedica Scandinavica
Abstract
A total of 2895 threaded, cylindrical titanium implants have been inserted into the mandible or the maxilla and 124 similar implants have been installed in the tibial, temporal or iliac bones in man for various bone restorative procedures. The titanium screws were implanted without the use of cement, using a meticulous technique aiming at osseointegration--a direct contact between living bone and implant. Thirty-eight stable and integrated screws were removed for various reasons from 18 patients. The interface zone between bone and implant was investigated using X-rays, SEM, TEM and histology. The SEM study showed a very close spatial relationship between titanium and bone. The pattern of the anchorage of collagen filaments to titanium appeared to be similar to that of Sharpey's fibres to