Biologic determinants of bone formation for osseointegration: Clues for future clinical improvements

Statement of problem. Further improvement in and expansion of the application of dental implants requires control and improvement of bone mass for implant support. Purpose. Although osseointegration involves both the formation and the maintenance of bone at implant surfaces, the aim of this article is to identify cellular and molecular determinants of bone formation that may be used in clinical attempts to enhance or expand the application of endosseous implants for dental and craniofacial prosthetics. Methods. A review of bone biology and dental and orthopedic implant literature was performed using Medline and published monographs. Results. This spectrum of information indicates that molecular and cellular approaches to creating and maintaining bone mass may be used to expand the application of dental implants and to improve dental implant success in bone-deficient sites.