PROSTHESIS-BONE INTERFACE

In this overview, which is based on selected books and reviews, the mi croscopic appearances of prosthesis-bone interfaces resulting from cli nically relevant implantation techniques are highlighted. The followin g techniques are distinguished to insert and attach prostheses in the recipient bone: impaction into bone, primary mechanical interlocking, cement fixation, bone ongrowth and secondary mechanical interlocking w ith bioinert materials, and enhanced bone ongrowth and bone bonding to bioactive materials. The resulting typical histomorphologies of ortho pedic and dental prostheses-bone interfaces are described and illustra ted from the author's studies employing light, fluorescence, and backs cattered electron microscopy, and corresponding microradiographs of un decalcified ground sections of bone and implants. Special emphasis is given to the mineralization-demineralization kinetics of the interfaci al bone matrix interacting with specific surface reactions of some imp lant materials. Consequently, the distinction between bioinert and bio active prosthetic materials is critically analyzed. (C) 1998 John Wile y & Sons, Inc.