In terms of patient selection for osseointegration, which factor is most critical?

Bone density and quality is the most critical factor in patient selection for osseointegration because these qualities directly influence the success of the implant. Osseointegration relies on a strong biological connection between the bone and the implant surface. Adequate bone density ensures that the implant can securely integrate into the surrounding bone tissue, providing stability and supporting the functional load of the implant.

When bone density is insufficient or of poor quality, the likelihood of implant failure increases as there may not be enough bone to achieve the required mechanical stability or the necessary biological response to facilitate integration. This is why assessments of bone quality, including factors like trabecular density and cortical thickness, are crucial prior to the procedure.

Other considerations, while important, do not have as direct an impact on the immediate success of osseointegration. While age can influence bone metabolism and healing, and a history of dental infections might suggest complicating factors, bone density and quality are the primary determinants in establishing a suitable environment for implants to integrate effectively. Nutritional status is relevant as well, but again, it is bone quality that primarily dictates whether osseointegration can — or will — occur.