Is osseointegration a requirement for success in implant dentistry?

The term 'osseointegration' was coined in 1977. This term gained popularity and has been extensively used, but with various and diverging meanings; therefore, there is a strong need to redefine it. We propose a definition of the concept of osseointegration grounded on a physical basis. Since bioactive biomaterials are more strongly integrated than inert ones (e.g. titanium or alumina), and since osseointegration is a word implying strong bonding, we propose to devote the use of the concept of osseointegration for materials which are most successfully integrated into bone, i.e. when the bone/implant interface is a diffuse interface with full chemical bonding, such as for bioactive biomaterials. If the bone/implant interface is a sharp one, the concept of osseointegration is no longer relevant and we propose use of the term 'osteal integration', i.e. for inert biomaterials, such as titanium and alumina. Based on this proposition, we assert that osseointegration is not a requirement for success in implant dentistry.