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Oticon Medical Ponto 5 Family - April 2022

What are Factors that may Impact Osseointegration?

Courtney Smith, MA, CCC-A, FAAA, Aren Bezdjian, PhD

August 1, 2022

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Question

What are some factors that may impact osseointegration?

Answer

Osseointegration is a complicated process. It involves a cascade of cellular events. It actually starts with bone healing. Bone healing is what initiates osseointegration, and is an important component. What is important to note is for osseointegration to occur optimally, we need a rich blood supply. We need blood supply because if the blood is rich and if the access is there, then osseointegration will occur.

Bone healing requires blood cells that activate and release cytokines and other soluble growth and differentiating factors. Clot formation occurs on any percutaneous part of our body. This creates a scaffold around the implant, and this scaffold allows osteogenic cells to induce bone healing. Osteoblasts are found directly on the surface of the implant. Osteoblasts create osteoclasts, which is another type of cell that is involved in bone formation. It is very much a complex biological process that our body's natural ability allows us to do.

This allows the bone to accept the implant, and oftentimes, we have an extrusion of the implant, and it's this biological process that is impeded. Better osseointegration means better sound quality and better survival of the implant. We want to reduce adverse events, skin reactions, and implant loss. After that, we want to reduce the surgical duration. Surgical time is money and more exposure to anesthesia. The shorter duration of surgery, the better it is for everyone involved in the process. We recently launched devices that allow local anesthesia surgery as we don't need to go into the operating theater anymore. 

This Ask the Expert is an excerpt from Innovations in Bone Anchored Hearing Device Research.


courtney smith

Courtney Smith, MA, CCC-A, FAAA

Courtney Smith is a clinical audiologist with 18 years of clinical experience in hearing aids, cochlear implants, and bone-anchored hearing device solutions working in both medical and private practice settings.  She joined Oticon Medical as their Clinical Trainer in October of 2021. She completed her graduate training at the University of Iowa in 2003.


Aren Bezdjian, PhD

Aren Bezdjian, PhD is a clinical research manager at Oticon Medical LLC where he manages a portfolio of global clinical trials, investigator initiated & sponsored research projects. Prior to joining Oticon Medical, Aren held an affiliation in the Faculty of Medicine at McGill University and led research at an Auditory Sciences Laboratory where he conducted projects on ototoxicity and hearing rehabilitation through pharmacological and implantable solutions. Aren has published 36 peer reviewed scientific articles and is an active reviewer for journals in the fields of audiology and otolaryngology. He has taught in universities and frequently speaks at ENT conferences and organisation events including two appearances on the TEDx platform.


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