Bone modelling in the implantation bed.

We consider results from tissue culture studies and the comparative histology of mineralized tissues and other natural tissue interfaces which may have some relevance in understanding the abnormal biology of the immediate environment of an implant in bone. We discuss factors influencing setting, colonization, and migration on natural and artificial substrates by various cell types which may make or remove matrix near the implant. A knowledge of mechanisms of mineral and organic matrix destruction by osteoclasts and other cells must be important in addition to an understanding of the interaction of local and systemic hormones with bone cells. More studies of the role of the immune system in implant failure are urgently required.