Abstract

Continuous effort to safely apply occlusal load immediately, or as early as possible, led thru improved titanium surfaces to give more rapid osseointegration on a bigger implant surface (BIC). Around year 2000 increasing implant roughness became a key with a wish to inoculate active, bone growing factors in it. Surprisingly after few years a totally new phenomenon of progressive bone loss around implants was observed and coined ‘peri-implantitis’ as a parallel to ‘periodontitis’. Similar pathogens became a suspect however exposed rough surface is the main trigger. Retrospective studies of machined implants led to hybrid implant design on one hand and recommendations of subcrestal placement of fully rough implants on the other(Figure 1). Additionally, more emphasis has been put on surgical technique and timing.