Classification and impression techniques of implants/ dentistry dental implants


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Classification and impression techniques of implants/ dentistry dental implants

  1. 1. Classification andClassification and impression techniques ofimpression techniques of implantsimplants INDIAN DENTAL ACADEMY Leader in continuing dental education
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  3. 3. ClassificationClassification ► Based uponBased upon 1.1. Placement within the tissuesPlacement within the tissues 2.2. Materials usedMaterials used 3.3. Attachment mechanismAttachment mechanism 4.4. Surface coatingSurface coating 5.5. ShapeShape 6.6. Surgical stageSurgical stage 7.7. Mode of insertionMode of insertion 8.8. Tissue response & systemic toxicity effects of implantsTissue response & systemic toxicity effects of implants
  4. 4. ►Subperiosteal implantsSubperiosteal implants Based upon the placement withinBased upon the placement within the tissuethe tissue
  5. 5. Subdivision of subperiosteal implantSubdivision of subperiosteal implant o UnilateralUnilateral o InterdentalInterdental o TotalTotal o circumferentialcircumferential
  6. 6. Unilateral subperiosteal implant Interdental subperiosteal implant
  7. 7. Total subperiosteal implant Circumferential subperiosteal implant
  8. 8. Transosteal implantTransosteal implant  Also known asAlso known as o Staple boneStaple bone o Mandibular stapleMandibular staple o TransmandibularTransmandibular
  9. 9. Transosteal implantTransosteal implant
  10. 10. Endosteal implantEndosteal implant
  11. 11. Root form Blade/plate form Ramus frame
  12. 12. Intramucosal insertsIntramucosal inserts
  13. 13. Endodontic stabilizer implant
  14. 14. Based upon materials usedBased upon materials used 1.Metallic implants-commercially pure titanium1.Metallic implants-commercially pure titanium Titanium alloyTitanium alloy Cobalt chromium molybdenumCobalt chromium molybdenum alloyalloy 2.Nonmetallic implants-Ceramics2.Nonmetallic implants-Ceramics CarbonCarbon
  15. 15. Ceramic and titanium alloy implants
  16. 16. Based upon the attachmentBased upon the attachment mechanismmechanism 1.Osseointegration 2.Fibro osseous integration
  17. 17. Based upon their surface coatingBased upon their surface coating o Titanium plasma sprayedTitanium plasma sprayed o Hydroxyapatite coatingHydroxyapatite coating o Grid blasting with TiOGrid blasting with TiO o SLA(sandblasted-largegrid-acidetched)SLA(sandblasted-largegrid-acidetched) o Acid etchedAcid etched o Machined surfaceMachined surface
  18. 18. Based upon the shapeBased upon the shape
  19. 19. Contd….Contd…. o Threaded,nonthreadedThreaded,nonthreaded o Tapered,parallelTapered,parallel o With vent holes,without vent holesWith vent holes,without vent holes o Hollow cylinder,solid screwsHollow cylinder,solid screws o Root form,blade formRoot form,blade form
  20. 20. Based upon the surgical stageBased upon the surgical stage Two stage implantsTwo stage implants One stage implant
  21. 21. Based upon mode of insertionBased upon mode of insertion 1.Axially inserted (crestal1.Axially inserted (crestal approach)approach)
  22. 22. 2.Laterally inserted(basal approach)
  23. 23. Based upon tissue responseBased upon tissue response &systemic toxicity effects of implants&systemic toxicity effects of implants o Biotolerant materials-polmethylmethacrylateBiotolerant materials-polmethylmethacrylate o Bioinert materials-titanium and aluminiumBioinert materials-titanium and aluminium oxideoxide o Bioactive materials-glass and calciumBioactive materials-glass and calcium phosphate ceramicphosphate ceramic
  24. 24. Components of implantComponents of implant Implant bodyImplant body
  25. 25. Cover screw Healing abutment
  26. 26. Healing cap Implant abutment
  27. 27. Impression posts
  28. 28. Laboratory analogs
  29. 29. IMPRESSION MATERIALS Ideal Requirements •Complete plasticity before cure •Fluidity to record fine detail •Ability to wet oral tissues •Dimensional accuracy •Dimensional stability •Complete elasticity after cure •Optimal stiffness
  30. 30. Materials Used o Alginate o Agar o Polysulphide o Polyether o Condensation Silicone o Addition Silicone
  31. 31. ALGINATE o Poor dimensional stability o Poor dimensional accuracy o Poor tear strength o Poor stiffness o Interferes with setting of gypsum
  32. 32. AGAR o Interferes with setting of gypsum o Dimensional instability o Elaborate equipment needed o Low tear resistance
  33. 33. Polysulphide o Base-polusulfide polymer, Catalyst- lead dioxide o High tear strength o Messy,unpleasant odour o Long setting time o Poor dimensional stability o Hydrophobic
  34. 34. Condensation silicone o Cheaper o Good tear strength, accuracy & elastic properties o Dimensional instability,due to loss of ethyl alcohol o Poured quickly
  35. 35. Addition silicone o Shorter setting time o Easy to mix- automatic mixing devices o Adequate tear strength o Extremely high accuracy o Dimensional stability even after 1 week o Least distortion on removal o Hydrophilic o Good compatibility with gypsum
  36. 36. Polyether o Good dimensional stability & accuracy o Short setting time o Material very rigid o Not available in all consistencies o Most expensive
  37. 37. Dispensed as : Manual mixing Automixing system
  38. 38. Manual mixing o Putty o Heavy body o Monophase o Light body
  39. 39.
  40. 40. Automixing equipment & materials
  41. 41. Two basic impression techniques for implants are 1. indirect technique or closed tray technique or pick-up or open tray technique.
  42. 42. Indirect impression technique
  43. 43. Contd…
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  47. 47. Contd…
  48. 48. Direct impression technique
  49. 49. Contd…
  50. 50. Contd…
  51. 51. Contd…
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  53. 53. Contd…
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  55. 55. Contd…
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  60. 60.
  61. 61. Indirect method
  62. 62. Direct method
  63. 63. Related articles Tautin(1985)presented a technique to accurately, transfer and reproduce the relationship between implant dentures , in which no preliminary impression or acrylic resin custom tray were needed. He used modeling compound to form a custom tray by adapting it over transfer copings,pressing the compound over the superior aspect of the coping so that its circular outline is seen through the compound.After trimming the outline of the coping showing through the top of the tray an impression plaster is used to record and transfer the coping to the impressions
  64. 64. Loos(1986)presented a detail technique for the fabrication of a fixed prosthesis supported by implants.His technique incorporated plugging the incisal end of the transfer coping with beading wax(to prevent impression material from flowing into it)splinting the transfer copings with orthodontic ligature wire and Duralay acrylic resin,use of a plastic perforated impression tray with incisal window to access the transfer coping and making the final impression with putty light body addition silicone.
  65. 65. Rasmussen(1987)presented a technique in which the existing denture is modified using tissue conditioning material is used instead of healing caps after second stage surgery ,eliminating the use of impression copings at the final impression.
  66. 66. Humphries et al (1990) evaluated the accuracy of implant master casts constructed from transfer impressions using three techniques.The techniques used were splinted square polymer copings,unsplinted square polymer copings and unsplinted hydrocolloid copings.Tapered hydrocolloid copings were more accurate than the other two methods.
  67. 67. Carr (1991) compared impression techniques for five implant mandibular model by both indirect and direct transfer coping techniques and found that for the models used ,the direct method produced more accurate working casts.
  68. 68. Vigolo et al(2000)evaluated the accuracy in transferring the position of the hexagonal head of a single implant to the working cast, and concluded that the sandblasting and coating the roughened surface of the impression coping with an impression adhesive will result in more accurate orientation of the implant replicas in the laboratory master casts in single tooth implant restorations.
  69. 69. Conclusion Success with implant prosthodontics requires a careful attention to each and every step from diagnosis and treatment planning. Several implant systems are available , selection of appropriate one is mandatory. The prosthesis fit can be accurate only if a proper impression is made. Thus usage of correct impression technique and material are important.
  70. 70. References 1. contemporary implant dentistry , Carl E. Misch 2. Implants in dentistry , Michael,John and Luis. 3. Implant prosthodontics Stevens & freidrickson 4. Dental implants- Fundamental & advanced laboratory technology , Robert Winkleman &Kenneth orth.
  71. 71. References contd… 5. Philip’s science of dental materials 6. Contemporary fixed prosthodontics, Rosentiel 7. Principles & practice of implant dentistry, Weiss 8. Theory & practice of ossteointegration, Hobo 9. Carr AB. Int J Oral Maxillofac Implants. 1991;6(4):448-55 10. Assif etal. Int J Oral Maxillofac Implants. 1999;14(6):885-88 11. Loos Larry G. J Prosthet Dent 1986;55:232-42 12. Rasmussen Eric J. J Prosthet Dent. 1987;57:198-203 13. Tautin Francis S. J Prosthet Dent. 1985;54:250-51 14. Vigolo etal. J Proshtet Dent. 2000;83:562-66
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