Bone dynamics of osseointegration, ankylosis, and tooth movement

Masticatory function challenges the strength and adaptive capability of supporting bone. When osseous tissue is loaded, it accumulates fatigue damage which must be repaired by bone modeling and remodeling. The three principal masticatory abutments (normal teeth, ankylosed teeth and osseointegrated implants) are a dynamic physiologic continuum relative to bone biomechanics. Implants are rigidly integrated units that can only be moved by fracturing the interface. Normal teeth and some ankylosed teeth can be moved using implants for orthodontic and orthopedic anchorage. Because orthodontic translation generates new bone and attached gingiva, it is a form of tissue engineering. Modern interdisciplinary practice requires a thorough knowledge of the principles of bone physiology and biomechanics.