This is under physiology of dental implants. Why dental implants work? Now, if this is somewhat repetition to y’all but I said, there are, everything in Implantology pivots on four facts, if you know these four facts all the rules of implantology come from these four facts and every implant failure is because of violation of one or more of these fours. I think we covered it last time, did we? Hygiene? Yeah, yeah well it’s part of the implantology. Okay, so what are the four factors that all the implantology rules are based on and if you violate any of them you’ll get implant failure. Everything that we learn about implantology is based on making sure that these four factors are not violated. So in order for an implant to work there are four factors. We need , “Whats the first thing?” Patient selection? Okay, patient selection it goes, okay. Healthy bone, now we’re not we’re placing the implant in the bone so I would say okay healthy bone yes that’s one. What are the other? Clean surface? Clean, clean piece of titanium thank you. Not hygiene, clean piece of titanium. Hygiene is afterwards, so we need a healthy patient, healthy bone, we need a clean piece of titanium and then what? How they should be in respect to each other? Well, titanium is biovompatible, so as long as we’re choosing titanium we already have the biocompatibility. See there are four factors, we need to add a clean piece of titanium, in a healthy bone and can it be moving and wiggling around, so what’s the third factor? Immobility. Immobility, now if we keep it immobile for a day, would it work for several months? Okay, so what are the four factors? Lets revisit. Whats the first thing? Before that, let’s do it in the order. that is important. First, clean piece of titanium. See I’m very careful by saying clean piece of titanium because it really does not matter the brand you use or the design you use, okay? Body does not recognize brand I promise you that. When you put that implant there the body does not say oh okay that’s Straumann so I’m going to work at it or oh that’s a crappy Korean maker forget it, I’m not going to integrate. Not going to happen. Body cannot tell the brand, cannot tell the design If it’s clean titanium, the body goes to work in not seeing it. Remember, we said it works because what it doesn’t see. Where does the cleanliness come into the play? Because if it’s contaminated then there will be foreign body reaction but for it to work, we don’t want any reaction, we want this to be passing, so we call it clean piece of titanium. It could be a nail, it could be a plate, it could be a screw, it could be anything as long as it’s a clean piece of titanium that will do for body. Okay, second factor was which one?Healthy bone. Healthy bone, so healthy bone starts with a healthy patient. Okay, so how do we know that the bone is healthy?