Osteointegration with implant and factors of it’s violation (literature review)


  • Stanislav Bondarenko




osteointegration, biomaterial, endoprosthetics


Biological fixation of the hip joint endoprosthesis today plays an important role in cementless total hip arthroplasty. The duration of stable fixation of endoprosthesis components largely depends on the osseointegration of bone tissue into the im­plant.

Objective: to determine the features of osseointegration around the implant and to identify the risk factors which affect this process.

Methods: more than 40 works from electronic databases PubMed, Medline, as well as abstracts, articles and other sources of scientific and medical information were analyzed.

Results: on the basis of the received information, the following issues were investigated: mechanisms and stages of osseointegration, factors affecting peri-implantation osteogenesis and osseointegration at arthroplasty. Osteointegration goes through the following stages: the inflammation, migration and differentiation of osteogenic cells, the formation of bone tissue, in which the surface of the implant is surrounded by an osteoid and a mineralized matrix; and bone tissue remodeling. Factors affecting peri-implantation osteogenesis and osseointegration in arthroplasty are also outlined. The following risk factors negatively influencing the process of osseointegration are highlighted: decrease in the amount or activity of osteoblasts, increase in the density of osteoclasts, imbalance between local and systemic factors affecting the formation and remodeling of the bone, violation of vascularization as a key factor affecting the differentiation of osteogenic cells.

Conclusions: it was established that the implant surface has a great importance in the process of osseointegration: its composition, technological characteristics, hydrophilicity or hydrophobicity in the biological environment, tropicity to cells and possibility to perform their main function — the expression of the products of genes forming a macromolecular environment between the implant and the bone, followed by mineralization and characteristic structure.

Author Biography

Stanislav Bondarenko

Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv 

PhD in Orthopaedics and Traumatology 



Van Grunsven W. Porous metal implants for enhanced bone ingrowth and stability: thesis submitted to the University of Sheffield for the degree of Doctor of Philosophy. 2014. 154 p.

Korzh NA, Radchenko VA, Kladchenko LA, Malyshkina SV. Implantation materials and osteogenesis. The role of induction and conduction in osteogenesis. Opthopaedics, traumatology and prosthetics. 2003;(2):150–7. (in Russian)

Korzh NA, Kladchenko LA, Malyshkina SV, Timchenko IB. Implantation materials and osteogenesis. The role of biological fixing and osteointegration in bone reconstruction. Opthopaedics, traumatology and prosthetics. 2005;(4):118–27. (in Russian)

Radchenko VO, Dedukh NV, Malyshkina SV, Bengus LM, Batura IO, Popov GF. Peculiarities of the osteoreparative process in implanting composites based on lactides and glycolids with different contents of tricalcium phosphate and hydroxyl apatite. Opthopaedics, traumatology and prosthetics. 2010;3(580):15–21. doi: 10.15674/0030-59872010315-21. (in Ukrainian)

Filipenko VA, Karpinsky MYu, Karpinska OD, Tankut VO, Mandus Akonjom, Bondarenko SE. The strength of bone-metal block for different types of implants surfaces under the conditions of normal bone and osteoporosis in rats. Opthopaedics, traumatology and prosthetics. 2016;(1):72–7. doi: 10.15674/0030-59872016172-77. (in Ukrainian)

Brеnemark PI. Osseointegration and its experimental. J Prosthet Dent. 1983;50:399–410.

Linder L, Albrektsson T, Brånemark PI, Hansson HA, Ivarsson B, Jönsson U, Lundström I. Electron microscopic analysis of the bone titanium. Acta Orthop Scand. 1983;54(1):45–52.

Albrektsson T, Johansson C. Osteoinduction, osteoconduction and osteointegration. Eur Spine. 2001;10:96–101.

Reddy KV. Osseointegration. International Dental & Medical Journal of Advanced Research. 2015;1:1–7. doi: 10.15713/ins.idmjar.23.

Mavrogenis AF, Dimitriou R, Parvizi J, Babis GC. Biology of implant osseointegration. J Musculoskelet Neuronal Interact. 2009;9(2):61–71.

Macha D, Koppolu P, Swapna LA, Bathini C. Osseointegration in іmplants: a review. J Res Adv Dent. 2014;3(3): 67–72. doi: 10.13140/RG.2.1.2306.2806.

Vaidya P, Mahale S, Kale S, Patil A. Osseointegration — a review. IOSR Journal of Dental and Medical Sciences. 2017;16(1):45–8. doi: 10.9790/0853-1601014548.

Osborn JF, Newesley H. Dynamics aspects of the implant bone. Dental implants — materials and systems. G. Heimke ed., Munich : Carl Hanser, Verlag, 1980. pp.111–23.

Franchi M, Fini M, Martini D, Orsini E, Leonardi L, Ruggeri A, Giavaresi G, Ottani V. Biological fixation of endosseous implants. Micron. 2005;36(7–8):665–71. doi: 10.1016/j.micron.2005.05.010.

Hosseini SH, Kazemian M, Ghorbanzadeh S. A brief overviewof cellular and molecular mechanisms of osseointegration. Int J Contemp Dent Med Rev. 2015:010415. doi: 10.15713/ins.ijcdmr.70.

Omar O, Lennerås M, Svensson S, Suska F, Emanuelsson L, Hall J, Nannmark U, Thomsen P. Integrin and chemokine receptor gene expression in implant-adherent cells during early osseointegration. J Mater Sci Mater Med. 2010;21(3):969–80. doi: 10.1007/ s10856-009-3915-x.

Thalji G, Gretzer C, Cooper LF. Comparative molecular assessment of early osteointegration in implant-adherent cells. Bone. 2013;52(1):444–53. doi: 10.1016/j.bone.2012.07.026.

Sollazzo V, Massari L, Pezzetti F, et al. Genetic effects of trabecular titanium on MG-63 cell line: a genetic profiling evaluation. ISRN Materials Scienc. 2011;2011:392763. doi: 10.5402/2011/392763.

Mengatto CM, Mussano F, Honda Y, Colwell CS, Nishimura I. Circadian rhythm and cartilage extracellular matrix genes in osseointegration: a genome-wide screening of implant failure by vitamin D deficiency. PLoS One. 2011;6(1):e15848. doi: 10.1371/journal.pone.0015848.

Nishimura I. Genetic networks in osseointegration. J Dental Res. 2013; 92(12 Suppl):109S-18S. doi: 10.1177/0022034513504928.

Omar O, Suska F, Lennerås M, Zoric N, Svensson S, Hall J, Emanuelsson L, Nannmark U, Thomsen P. The influence of bone type on the gene expression in normal bone and at the bone-implant interface: experiments in animal. Clin Implant Dent Relat Res. 2011;13(2):146–56. doi: 10.1111/j.1708-8208.2009.00195.x.

Omar O. Mechanisms of osseointegration: experimental studies on early cellular and molecular events in vivo: doctoral thesis. University of Gothenburg. 2010. 102 p.

Savich VV, Kiselev MG, Voronovich AI. Modern materials of surgical implants and instruments. UP Tehnoprint. 2003. 119 p. (in Russian)

Plecko M, Sievert C, Andermatt D, Frigg R, Kronen P, Klein K, Stübinger S, Nuss K, Bürki A, Ferguson S, Stoeckle U, von Rechenberg B. Osseointegration and biocompatibility of different metal implants — a comparative experimental investigation in sheep. BMC Musculoskeletal Disorders. 2012;13(32):1–12. doi: 10.1186/1471-2474-13-32.

Gotfredsen K, Berglundh T, Lindhe J. Anchorage of titanium implants with different surface characteristics: an experimental study in rabbits. Clin Implant Dent Relat Res. 2000;2(3):120–8.

Levine BR, Sporer S, Poggie RA, Della Valle CJ, Jacobs JJ. Experimental and clinical performance of porous tantalum in orthopedic surgery. Biomaterials. 2006;27(27):4671– 81. doi: 10.1016/j.biomaterials.2006.04.041.

Dedukh NV, Bondarenko SE, Filipenko VA, Batura IO. Morphological features osteointegration of porous tantalum implants in rats. Opthopaedics, traumatology and prosthetics. 2016;4(605):5–10. doi: 10.15674/0030-5987201645-10. (in Ukrainian)

Anil1 S, Anand PS, Alghamdi H, Jansen JA. Dental іmplant surface enhancement and osseointegration. I. Turkyilmaz (ed.). 2011. Available from : http://www.intechopen. com/books/implant-dentistry-a-rapidly-evolvingpractice/ dental-implant-surface-enhancement-and-osseointegration.

Donos N, Hamlet S, Lang NP, Salvi GE, Huynh-Ba G, Bosshardt DD, Ivanovski S. Gene expression profile of osseointegration of a hydrophilic compared with a hydrophobic microrough implant surface. Clin Oral Implants Res. 2011;22(4):365–72. doi: 10.1111/j.1600-0501.2010.02113.x.

Sakakura CE, Marcantonio E Jr, Wenzel A, Scaf G. Influence of cyclosporin A on quality of bone around integrated dental implants: a radiographic study in rabbits. Clin Oral Implants Res. 2007;18(1):34–9. doi: 10.1111/j.1600-0501.2006.01253.x.

Ouanounou A, Hassanpour S, Glogauer M. The influence of systemic medications on osteointegration of dental implant. J Can Dent Assoc. 2016;82:g7.

Fu JH, Bashutski JD, Al-Hezaimi K, Wang HL. Statins, glucocorticoids, and nonsteroidal anti-inflammatory drugs: their influence on implant healing. Implant Dent. 2012;21(5):362–7. doi: 10.1097/ID.0b013e3182611ff6.

Ribeiro FV, César-Neto JB, Nociti FH Jr, Sallum EA, Sallum AW, De Toledo S, Casati MZ. Selective cyclooxygenase-2 inhibitor may impair bone healing around titanium implants in rats. J Periodontol. 2006;77(10):1731–5. doi: 10.1902/jop.2006.060119.

Pablos AB, Ramalho SA, König B Jr, Furuse C, de Araújo VC, Cury PR. Effect of meloxicam and diclofenac sodium on peri-implant bone healing in rats. J Periodontol. 2008;79(2):300–6. doi: 10.1902/jop.2008.070301.

Ribeiro FV, Nociti FH Jr, Sallum EA, Casati MZ. Effect of aluminum oxide-blasted implant surface on the bone healing around implants in rats submitted to continuous administration of selective cyclooxygenase-2 inhibitors. Int J Oral Maxillofac Implants. 2009;24(2):226–33.

Kudo M, Matsui Y, Ohno K, Michi K. A histomorphometric study of the tissue reaction around hydroxyapatite implants irradiated after. J Oral Maxillofac Surg. 2001;59(3):293–300.

de Deco CP, da Silva Marchini AM, Marchini L, da Rocha RF. Extended periods of alcohol intake negatively affects osteointegration in rats. J Oral Implantol. 2015;41(3):44–9. doi: 10.1563/AAID-JOI-D-13-00111.

Koo S, König B Jr, Mizusaki CI, Allegrini S Jr, Yoshimoto M, Carbonari MJ. Effects of alcohol consumption on osteointegration of titanium implants in rabbits. Implant Dent. 2004;13(3):232–7.

Dvorak G, Fügl A, Watzek G, Tangl S, Pokorny P, Gruber R. Impact of dietary vitamin D on osteointegration in the ovariectomized rat. Clin Oral Implants Res. 2012;23(11):1308–13. doi: 10.1111/j.1600-0501.2011.02346.x.

Kwak HB, Kim JY, Kim KJ, Choi MK, Kim JJ, Kim KM, Shin YI, Lee MS, Kim HS, Kim JW, Chun CH, et al. Risedronate directly inhibits osteoclast differentiation and inflammatory bone loss. Bio Pharm Bull. 2009;32(7):1193–98.

Doaa Amr A, Heshmat Rostom, Ela AA, Abdalla MF. Effect of melatonin on osteointegration of immediate loading implant supported mandibular over denture: Randomized clinical trail. Int Dental Med J Advanced Res. 2016;2:1–5. doi: 10.15713/ins.idmjar.55.






Most read articles by the same author(s)

1 2 3 > >>