What are some factors that may impact osseointegration?
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.