**Luis Amengual-Peñafiel 1,\*, Manuel Brañes-Aroca 2, Francisco Marchesani-Carrasco 3, María Costanza Jara-Sepúlveda 3, Leopoldo Parada-Pozas <sup>4</sup> and Ricardo Cartes-Velásquez 5,6**


Received: 10 December 2018; Accepted: 22 January 2019; Published: 25 January 2019

**Abstract:** The permanent interaction between bone tissue and the immune system shows us the complex biology of the tissue in which we insert oral implants. At the same time, new knowledge in relation to the interaction of materials and the host, reveals to us the true nature of osseointegration. So, to achieve clinical success or perhaps most importantly, to understand why we sometimes fail, the study of oral implantology should consider the following advice equally important: a correct clinical protocol, the study of the immunomodulatory capacity of the device and the osteoimmunobiology of the host. Although osseointegration may seem adequate from the clinical point of view, a deeper vision shows us that a Foreign Body Equilibrium could be susceptible to environmental conditions. This is why maintaining this cellular balance should become our therapeutic target and, more specifically, the understanding of the main cell involved, the macrophage. The advent of new information, the development of new implant surfaces and the introduction of new therapeutic proposals such as therapeutic mechanotransduction, will allow us to maintain a healthy host-implant relationship long-term.

**Keywords:** oral implants; osseointegration; marginal bone loss; immunomodulation; mechanotransduction
