Dental implants are placed into the alveolar bone, with the expectation that they become osseointegrated and that the periimplant mucosa will heal to the abutment surface and fulfill the primary functions of the periodontal tissues, which are attachment and protection of the soft tissue and the underlying bone.
This requires that the rather rigid ankylotic like connection between implant and bone replaces functionally the sophisticated suspension via the periodontal ligament as offered by the evolution and, that the structural framework of the periimplant mucosa matches the architecture of the gingiva.
The context of an understanding of the elicited host site interfacial healing response will be reiterated for the time period immediately following implant placement up to long term behavior. The role of the implants's surface and its macro-, and microscopic design features for osseointegration will be elucidated and the clinical implications explained.
In particular the biodynamics of the cascade of early wound healing beginning with the first interactions between modified rough implant surfaces, over inflammatory and proliferating phase up to the final osseointegration will be demonstrated and summarized in an animation video.
There are still many aspects of periimplant healing that need to be elucidated, but we can state that we understand today the principle healing patterns leading to osseointegration. There still is room, for improvement. There still is room to understand the benefit of new implant coatings, of improved implant designs and of new implant materials. There is no doubt at all that the hitherto exciting story about osseointegration will continue!