Ioan Sarbu, Cosmin Bida, Doriana Agop Forna, Sergiu Focsaneanu, Alina-Ramona Dimofte, Gabriela Stan, Kamel Earar
DOI: 10.62610/RJOR.2025.2.17.30
Abstract
Titanium dental implants are a durable therapeutic solution with a high clinical success rate due to their mechanical properties, corrosion resistance, and exceptional biocompatibility. This review analyzes the relationship between titanium, osseointegration, and local immune response, highlighting the decisive role of biological interactions in the long-term success of implants. The osseointegration process involves well-defined stages of inflammation, proliferation, and remodeling in which the implant surface plays a central role in the recruitment and differentiation of osteogenic cells. Simultaneously, the local immune response must be controlled and transient, being mediated mainly by macrophages, whose polarization towards the M2 phenotype supports bone regeneration. Although titanium is recognized for its favorable behavior in the biological environment, certain challenges persist: chronic inflammatory reactions, surface contamination, and the influence of the microbiome on integration. Current research explores functionalized, nanostructured surfaces and implant customization strategies to improve biological integration. An in-depth understanding of immunological and tissue mechanisms is essential for the development of predictable and personalized implant-prosthetic solutions.
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