January 2015 Supplement

Introduction Osseointegration is defined as “a direct, structural and functional connection between ordered, living bone and the surface of a load-carrying implant” (Listgarten et al., 1991). Direct bone-to-implant contact was first described by Brånemark et al. (1969) and histologically demonstrated by Schroeder et al. (1978) as “functional ankylosis.” Albrektsson et al. (1981) described successful clinical treatment outcomes of 2895 threaded titanium screw implants placed using a strict surgical protocol. Subsequent animal studies showed that implants with various designs and surface configurations become osseointegrated, and analysis of numerous retrieved implants documented that osseointegration is also a reality in humans (Schenk and Buser, 1998). The temporal wound healing events leading to osseointegration were shown to involve coagulum formation, granulation tissue formation, the development of a provisional matrix, woven bone formation, parallel-fibered bone formation, and eventually lamellar bone formation (Berglundh et al., 2003).