Osseointegration in dental implants

Osseointegration refers to the direct structural and functional connection between living, organized bone and the surface of a load-bearing implant. It plays a vital role in implant stability and is regarded as essential for both implants loading and the long-term clinical success of endosseous dental implants. The implant–tissue interface represents a highly dynamic zone of interaction, involving not only issues related to biomaterials and biocompatibility but also changes in the mechanical environment. The process of osseointegration begins with an initial mechanical interlock between the implant and the surrounding alveolar bone, followed by biological fixation through ongoing bone growth and remodeling at the implant surface. Given its complexity, numerous factors affect both the formation and maintenance of bone at the implant interface. This review aims to evaluate the current understanding of clinical assessment methods and the key factors influencing the success and failure of osseointegrated dental implants.