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J Dent Res. 2017 Jul;96(7):822-831. doi: 10.1177/0022034517700131. Epub 2017 Mar 22.

Relationships among Bone Quality, Implant Osseointegration, and Wnt Signaling.

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1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
3 Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
4 Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Chile, Santiago, Chile.
5 EA 2496, Orofacial Pathologies, Imaging and Biothérapies Laboratoire, L'Université Paris Descartes, Sorbonne Paris Cité, Montrouge, France.
6 Le Service d'Odontologie de Bretonneau, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique-Hôpitaux de Paris, Paris, France.


A variety of clinical classification schemes have been proposed as a means to identify sites in the oral cavity where implant osseointegration is likely to be successful. Most schemes are based on structural characteristics of the bone, for example, the relative proportion of densely compact, homogenous (type I) bone versus more trabeculated, cancellous (type III) bone. None of these schemes, however, consider potential biological characteristics of the bone. Here, we employed multiscale analyses to identify and characterize type I and type III bones in murine jaws. We then combined these analytical tools with in vivo models of osteotomy healing and implant osseointegration to determine if one type of bone healed faster and supported osseointegration better than another. Collectively, these studies revealed a strong positive correlation between bone remodeling rates, mitotic activity, and osteotomy site healing in type III bone and high endogenous Wnt signaling. This positive correlation was strengthened by observations showing that the osteoid matrix that is responsible for implant osseointegration originates from Wnt-responsive cells and their progeny. The potential application of this knowledge to clinical practice is discussed, along with a theory unifying the role that biology and mechanics play in implant osseointegration.


alveolar ridge; bone density; bone mineralization; dental implants; osteotomy; stem cell

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