DENTAL

IMPLANT


PRESENTED BY:
M.ALI SHEIKH
HAREEM SATTAR

A prosthetic device or alloplastic material implanted into the oral
tissue beneath the mucosal or/and periosteal layer and/ or in the
bone to provide retention and support for the fixed and
removable prosthesis.
- GPT
What is an
Implant???
Classification of implants
I) Depending on the placement within the
tissues

Epithelial implants
Epiosteal / Subperiosteal implants
Endosteal implants
Transosteal implants


Epithelial implants
Implant is inserted into the oral mucosa


Disadvantages
painful healing


Endosteal Implants
within the bone
These implants are usually root
form or plate form and are made
either of metal, metal covered
with ceramic, or ceramic material.
They are placed within the
jawbone



through the bone
These implants are either a
metal pin or a U-shaped
frame that passes through
the jawbone and the gum
tissue, into the mouth.
Transosteal Implant
on top of the bone
These implants consist of a
metal framework that
attaches on top of the
jawbone but underneath
the gum tissue.

Epiosteal / Subperiosteal
Implant
http://dentalimplants.uchc.edu/a
bout/types.html
II) Depending on the materials used

METALLIC IMPLANTS
Titanium
Cobalt chromium
Stainless steel
Zirconium
Tantalum
Gold
Platinum


2. NON METALLIC
IMPLANTS
- ceramics
- carbon
Most commonly used



Commercially pure (CP) titanium
Titanium-aluminum-vanadium alloy
(Ti-6Al-4V) - stronger & used with
smaller diameter implants
latest research is going on zirconium
due to its better esthetic property.


PARTS OF DENTAL
IMPLANT:
Crown
GPT def.: An artificial replacement that restores
the missing tooth structure by surrounding part or
all of the remaining structure with a material such
as cast metal, porcelain or a combination of
materials such as metal and porcelain.

Abutment
It is a part of the implant which resembles a
prepared tooth, and which is screwed to the body
of the implant. It is the part which provides
support to the artificial crown, and lies between
the crown and the implant body.
The abutment provides retention to the
prosthesis.


Types of Abutment:


1. Screw retention



1. cement retention


2. for attachment
attachment device to retain a
removable prosthesis



Implant body or Fixture
This is the part of the implant which
is placed during the first stage of the
implant surgery, and which provides
the anchor or foundation for the
restoration. This part is fixed in the
jaw bone, and on this the abutment
is screwed in the next stage of the
surgery. The implant body can be
threaded or non-threaded.
Healing screw

This is a part of the implant which isnt
permanently placed, but is used during the
healing phase when the soft tissue over the
implant body is being healed. The healing
screw facilitates the suturing of the soft
tissue, and it also prevents the growth of
tissue over the edge of the implant.
Per mucosal extension / healing abutment
protrude through the gum tissue and
placed into the implant body.
http://dentistryforstudents.com/parts-of-
dental-implant/

OSSEOINTEGRATION

Definition of osseointegration: It is a histological
term used to determine the apparent direct
attachment or connection of osseous tissue to
an inert, alloplastic material without intervening
connective tissue.

Usually takes 4-6 months.
There are two well known theories:
Brnemarks theory of osseointegration
Weiss' theory of fibro-osseous integration

WEISS THEORY

fibro ossseous ligament formed
between implant and the bone
collagen fibers at bone implant
interface

ligament = periodontal ligament
In Gomphosis.

He interpreted it as the peri-implantal ligament with an
osteogenic effect

BRANEMARKS THEORY OF
OSSEOINTEGRATION

Bone is laid very close to the implant
material without an intervening
Connective tissue

the apparent direct attachment or
connection of osseous tissue
to an inert alloplastic material without
intervening connective tissue

- G.P.T.


IMPLANT should be left out of function
during the healing phase


INDICATIONS:
Fully edentulous
Partially edentulous
Single tooth
Orthodontic anchorage

Immediate implantation
Periodontal problems
Periapical pathology and resorption of roots
Agenetic elements ( by birth missing teeth)
Grossly Carious
Trauma.

CONTRAINDICATIONS:
Medical:
Pregnancy.
Uncontrolled metabolic disease(D.M)
Inability to restore with a prosthesis.
Immune diseases.
Use of corticosteroids.
Radiotherapy of head.
Dental:
Anatomy- nerves too close,sinus etc.
Local pathology- cyst
Poor oral hygiene


ADVANTAGES:
Preservation of bone
Improved function
Esthetic
Stability and support
Dental implants reduce the load on the
remaining oral structures/teeth by offering
independent Dental support and retention to
crowns, bridgework and overdentures.

Dental implants preserve natural tooth tissue by

avoiding the need to cut down adjacent teeth for
conventional bridgework.


EXPENSIVE
SURGICAL PRODURE
NEED PATIENT CO-OPERATION
LONGER DURATION OF TREATMENT
DISADVANTAGES:
Prosthesis fabrication

Impression is
necessary to transfer
the position and
design of implant or
abutment to the
master cast for
prosthesis fabrication

Transfer coping
used to position a
dye in an impression

Two types of transfer coping
1. direct transfer coping
2. indirect transfer coping
Laboratory fabrication

Analog
defined as something that is
analogous to something else

Analog is placed on the transfer coping
and the impression is poured
Prosthetic coping is a thin covering usually designed to fit the
Implant abutment for screw retention

It serves as a connection between abutment and prosthesis or
superstructure
Implant system broadly are of 2 types





Two stage One stage immediate
1. one piece implant system
implant body + prosthodontic
abutment

2. two piece implant system
implant system
prosthodontic abutment

Implant surgery

Implant surgery

Two stage surgery
1
st
surgery
- implant body placed below the soft tissue

after initial bone healing has occurred
2
nd
surgery
-soft tissue are reflected
- permucosal element or abutment is attached
One stage surgery
1
st
surgery
- implant and permucosal element placed
after initial bone healing has occurred -
abutment replaces the permucosal element without
reflection of flap

Implant body
First stage cover screw
Second stage permucosal extension
or healing abutment
Abutment
A) for screw retentin
B) for cement retention
C) for attachment
Hygiene screw
Transfer coping
A) direct
B) indirect
Analog
A)implant body
B) abutment
coping
Prosthesis screw