Osseous Remodeling Around Dental Implants
Adequate bone remodeling may be a primary parameter for long-term successful complication-free dental implant treatment. A 1.8-mm osseous thickness around dental implants is thought to be the minimum thickness for adequate vasculature for osteocyte nutrition and function. A dental implant does not provide progenitor cells or angiogenic or osteogenic factors. Thus, the surrounding bone may need to have a 1.8-mm thickness to accommodate the vasculature necessary for nutrients for appropriate remodeling. Additionally, the 1.8-mm dimension may provide for mechanical load resistance. There is no evidence to illustrate the physiologic need for the 1.8-mm dimension. This dimension requirement is based on clinical outcome observations. Basic science research for bone survival around dental implants is needed.

Schematic of bone haversian system.

Photomicrograph of osseous cells.

Schematic of an osteon.

Lifestyle of osseous cells. Osteoblasts become trapped in the osseous matrix. Osteocytes maintain calcium and phosphorus levels for bone stability and strength. Osteocytes are stress sensors.

Implant placement parallel to the facial bone may not provide adequate bone thickness for long term success. An angled position parallel to the lingual or palatal bone my allow for a thicker facial bone.
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