Endosteal implants / dentistry universities


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Indian Dental Academy: will be one of the most relevant and exciting

training center with best faculty and flexible training programs

for dental professionals who wish to advance in their dental

practice,Offers certified courses in Dental

implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic

Dentistry, Periodontics and General Dentistry.

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Endosteal implants / dentistry universities

  1. 1. www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. ENDOSTEALENDOSTEAL IMPLANTSIMPLANTS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. IntroductionIntroduction  The goal of modern dentistry is to restoreThe goal of modern dentistry is to restore the patient to normal contour, function,the patient to normal contour, function, comfort, esthetics, speech and health.comfort, esthetics, speech and health. www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4.  Factors effecting increased need and use ofFactors effecting increased need and use of implant related treatments:implant related treatments: 1)1) Increased in aged populationIncreased in aged population 2)2) Tooth loss related to ageTooth loss related to age 3)3) Anatomic consequences of edentulismAnatomic consequences of edentulism 4)4) Poor performance of removable prosthesisPoor performance of removable prosthesis 5)5) Psychological aspect of tooth lossPsychological aspect of tooth loss 6)6) Predictable long term results of implantPredictable long term results of implant supported prosthesissupported prosthesis 7)7) Advantages of implant supported prosthesisAdvantages of implant supported prosthesis www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5.  Advantages of implant supported prosthesis:Advantages of implant supported prosthesis: 1)1) Maintenance of boneMaintenance of bone 2)2) Maintenance of occlusal vertical dimensionMaintenance of occlusal vertical dimension 3)3) Tooth positioned for estheticsTooth positioned for esthetics 4)4) Proper occlusionProper occlusion 5)5) Improved psychological healthImproved psychological health 6)6) Regained proprioceptionRegained proprioception 7)7) Increased stabilityIncreased stability www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. 8)8) Increased phoneticsIncreased phonetics 9)9) Increased retentionIncreased retention 10)10) Reduced removable prosthesis sizeReduced removable prosthesis size 11)11) Improved success rate of prosthesisImproved success rate of prosthesis 12)12) Increased survival time of restorationIncreased survival time of restoration 13)13) Improved function of prosthesisImproved function of prosthesis 14)14) Maintenance of muscle of mastication &Maintenance of muscle of mastication & facial expressionfacial expression www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. DefinitionDefinition  According to GPT 8According to GPT 8 Dental implant is a biologic or alloplasticDental implant is a biologic or alloplastic material surgically inserted into soft ormaterial surgically inserted into soft or hard tissue of mouth for function andhard tissue of mouth for function and esthetic purposes.esthetic purposes. www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. ClassificationClassification Implants Totally buried Semi buried Sub periosteal Endosseous www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. Acc. To Weiss and WeissAcc. To Weiss and Weiss IMPLANTS ENDOSTEAL SUBPERIOSTEAL INTRAMUCOSAL INSERTS www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. Endosteal ImplantsEndosteal Implants  An alloplastic material surgically insertedAn alloplastic material surgically inserted into a residual ridge primarily asinto a residual ridge primarily as prosthodontic foundationprosthodontic foundation  Comprise broad category of implants theyComprise broad category of implants they are the most commonly applicableare the most commonly applicable abutment providing modality.abutment providing modality. www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11.  In mainstream casesIn mainstream cases endosteal implantsendosteal implants are placed within fullyare placed within fully or partially edentulousor partially edentulous alveolar ridges withalveolar ridges with sufficient residualsufficient residual ridge volumeridge volume www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12.  Advantages of endosteal implants:Advantages of endosteal implants: 1)1) A high degree of predictability inA high degree of predictability in attainment of osseo-integrationattainment of osseo-integration 2)2) Versatile surgical and prosthodonticVersatile surgical and prosthodontic protocolsprotocols 3)3) Design features that facilitate ease ofDesign features that facilitate ease of treatment & estheticstreatment & esthetics 4)4) A low complication rate & ease ofA low complication rate & ease of maintenancemaintenance www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13.  Success criteria (Albertsson et al:Success criteria (Albertsson et al: 1986)1986) 1)1) An individual, unattached implant isAn individual, unattached implant is immobile when tested clinicallyimmobile when tested clinically 2)2) A radiograph does not demonstrate anyA radiograph does not demonstrate any evidence of peri implant radiolucency.evidence of peri implant radiolucency. 3)3) Vertical bone loss is less than 0.2 mmVertical bone loss is less than 0.2 mm annually following implant’s first year ofannually following implant’s first year of serviceservice www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. 4)4) Individual implant performance isIndividual implant performance is characterized by an absence of persistentcharacterized by an absence of persistent and/or irreversible signs & symptoms such asand/or irreversible signs & symptoms such as pain, infection, neuropathies, parasthesia orpain, infection, neuropathies, parasthesia or violation of mandibular canalviolation of mandibular canal 5)5) In the context of the above, a success rate ofIn the context of the above, a success rate of 85% at the end of 5 year observation period &85% at the end of 5 year observation period & 80% at the end of 10 year period are minimum80% at the end of 10 year period are minimum criteria for successcriteria for success www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15.  According to Misch:According to Misch: 1)1) LongevityLongevity 2)2) PainPain 3)3) Rigid fixationRigid fixation 4)4) PercussionPercussion 5)5) Bone lossBone loss 6)6) Radiographic evaluationRadiographic evaluation www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. 7)7) Peri-implant diseasePeri-implant disease 8)8) Probing depthProbing depth 9)9) Bleeding indexBleeding index www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17.  Implant failureImplant failure:: 1)1) Horizontal mobility beyond 0.5 mm orHorizontal mobility beyond 0.5 mm or any clinically observed verticalany clinically observed vertical movement under less than 500gm forcemovement under less than 500gm force 2)2) Rapid progressive bone loss regardlessRapid progressive bone loss regardless of stress reduction & peri-implant therapyof stress reduction & peri-implant therapy 3)3) Pain during percussion or functionPain during percussion or function 4)4) Continued uncontrolled exudates inspiteContinued uncontrolled exudates inspite of surgical attempts at correctionof surgical attempts at correction www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. 5)5) Generalized radiolucency around anGeneralized radiolucency around an implantimplant 6)6) More than one half of the surroundingMore than one half of the surrounding bone is lost around an implantbone is lost around an implant 7)7) Implants inserted in poor position makingImplants inserted in poor position making them useless for prosthetic supportthem useless for prosthetic support www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. ENDOSTEAL IMPLANTS ROOT FORM PLATE/BLADE FORM ENDODONTIC STABILIZERS www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. ENDOSTEAL IMPLANTS BLADE FORM CYLINDRICAL SCREW SHAPED PINS DISC LIKE www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. Osseo-integrationOsseo-integration  ““direct bone anchorage to an implant bodydirect bone anchorage to an implant body which can provide a foundation to supportwhich can provide a foundation to support a prosthesis”a prosthesis”  ““at least some direct contact of living boneat least some direct contact of living bone with surface of an implant at lightwith surface of an implant at light microscope level of magnification”microscope level of magnification” www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22.  Factors effecting osseo-integration:Factors effecting osseo-integration: 1)1) BiocompatibilityBiocompatibility 2)2) Implant design –lengthImplant design –length -diameter-diameter -shape-shape -surface characteristics-surface characteristics www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. 3)3) Submerged and non submergedSubmerged and non submerged protocolsprotocols 4)4) Bone factorsBone factors 5)5) Loading conditionsLoading conditions 6)6) Prosthetic loading considerationProsthetic loading consideration www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. Root form implantsRoot form implants  It is major subcategory of endostealIt is major subcategory of endosteal implantsimplants  They are the most often used design formThey are the most often used design form  They are designed to resemble the shapeThey are designed to resemble the shape of natural tooth rootof natural tooth root  As a rule root form must achieveAs a rule root form must achieve osteointegration to succeedosteointegration to succeed www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25.  Most are 2 stage implantsMost are 2 stage implants  Can be placed any where in mandible orCan be placed any where in mandible or maxilla where there is sufficient availablemaxilla where there is sufficient available bonebone  Can be threaded, smooth, stepped,Can be threaded, smooth, stepped, parallel sided or tapered, with or withoutparallel sided or tapered, with or without coating, with or without grooves or ventcoating, with or without grooves or vent and can be joined to a wide varity ofand can be joined to a wide varity of components for prosthesis retentioncomponents for prosthesis retention www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. STEPPED CYLINDER MICRO THREADED TAPERED www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. PARALLEL SIDED WITH VENT www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. Components of root formComponents of root form implantimplant www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. Fixture / BodyFixture / Body - Surgically placed into- Surgically placed into the bonethe bone Cover screwCover screw –– placed on top of theplaced on top of the fixture to prevent invasion into thefixture to prevent invasion into the threaded internal area of the fixturethreaded internal area of the fixture www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. Second stage permucosal extensionSecond stage permucosal extension  Extends the implant above the softExtends the implant above the soft tissuestissues  Results in development of a permucosalResults in development of a permucosal sealseal www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. AbutmentAbutment  Portion of implantPortion of implant that serves to supportthat serves to support and/ or retain aand/ or retain a prosthesis or implantprosthesis or implant superstructuresuperstructure 20 degree 45degreewww.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. Transfer copingTransfer coping  Implant bodyImplant body copingcoping  Abutment transferAbutment transfer copingcoping  Direct transferDirect transfer copingcoping  Indirect transferIndirect transfer copingcoping www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. Direct impression coping www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. Indirect impression coping www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37. Implant Analog www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. CopingCoping PrefabricatedPrefabricated CastableCastable www.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. Healing Caps www.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. AbutmentsAbutments  Classified as:Classified as: Prefabricated – standardPrefabricated – standard - stock- stock - angulated- angulated Custom madeCustom made www.indiandentalacademy.comwww.indiandentalacademy.com
  41. 41. Abutment DesignAbutment Design  For cement retention:For cement retention: straight abutmentstraight abutment angled abutmentsangled abutments  For screw retention:For screw retention: www.indiandentalacademy.comwww.indiandentalacademy.com
  42. 42. Abutment for cement retentionAbutment for cement retention  Advantages :Advantages : 1)1) PassivePassive 2)2) Occlusal surface remains intactOcclusal surface remains intact 3)3) Loosens lessLoosens less 4)4) Improved estheticsImproved esthetics 5)5) Fewer occlusal porcelain fracturesFewer occlusal porcelain fractures 6)6) Can be easily correctedCan be easily corrected 7)7) Easy manipulation in posterior regionEasy manipulation in posterior region 8)8) Less expensiveLess expensive  Disadvantages:Disadvantages: www.indiandentalacademy.comwww.indiandentalacademy.com
  43. 43. Abutments for screw retentionAbutments for screw retention  Advantages:Advantages: 1)1) Greater prosthetic flexibilityGreater prosthetic flexibility 2)2) Permits use of short or low profile abutmentsPermits use of short or low profile abutments 3)3) Easy retreivabilityEasy retreivability  Disadvantages:Disadvantages: www.indiandentalacademy.comwww.indiandentalacademy.com
  44. 44. Attachment of abutments toAttachment of abutments to implantsimplants  For flat surfaced implantsFor flat surfaced implants  For implants with anti-rotational featuresFor implants with anti-rotational features External hexExternal hex Internal hexInternal hex Spline attachmentSpline attachment Morse taper (cold weld)Morse taper (cold weld) www.indiandentalacademy.comwww.indiandentalacademy.com
  45. 45. EXTERNAL HEX INTERNAL HEX www.indiandentalacademy.comwww.indiandentalacademy.com
  46. 46. Abutment TypesAbutment Types  Flat topped abutmentsFlat topped abutments  Tapered shouldered abutmentsTapered shouldered abutments  Direct gold copingsDirect gold copings  Overdenture abutmentsOverdenture abutments www.indiandentalacademy.comwww.indiandentalacademy.com
  47. 47. OVERDENTURE ABUTMENT STRAIGHT SCREW RETAINEDwww.indiandentalacademy.comwww.indiandentalacademy.com
  48. 48. Implant recommendation relatedImplant recommendation related to tooth anatomyto tooth anatomy  Cemento enamel junction minus 2mm is aCemento enamel junction minus 2mm is a good location to assess the average sizegood location to assess the average size of a tooth root and determine the optimalof a tooth root and determine the optimal implant size for replacing the toothimplant size for replacing the tooth www.indiandentalacademy.comwww.indiandentalacademy.com
  49. 49. Principles of implant positioningPrinciples of implant positioning  Vertical positioning – depthVertical positioning – depth  Buccolingual positioning – widthBuccolingual positioning – width  Mesiodistal positioning – lengthMesiodistal positioning – length  Trajectory or angleTrajectory or angle www.indiandentalacademy.comwww.indiandentalacademy.com
  50. 50. plate/ blade formplate/ blade form  Supplied as one-stage and two-stageSupplied as one-stage and two-stage  Can be tapered or parallel sidedCan be tapered or parallel sided  Can be used in combination with naturalCan be used in combination with natural tooth as co-abutmenttooth as co-abutment  Required bone:Required bone: >8mm of bone height>8mm of bone height >3mm of width>3mm of width >10mm bone length>10mm bone length www.indiandentalacademy.comwww.indiandentalacademy.com
  51. 51. PLATE./ BLADE FORM IMPLANTS www.indiandentalacademy.comwww.indiandentalacademy.com
  52. 52.  As with root form implants plate/bladeAs with root form implants plate/blade form implants can be placed anywhere inform implants can be placed anywhere in the mandible or maxilla wherever there isthe mandible or maxilla wherever there is sufficient bone available. Howeversufficient bone available. However because of the narrower buccolingualbecause of the narrower buccolingual width of blade/plate form, they are morewidth of blade/plate form, they are more applicable in wider range of available boneapplicable in wider range of available bone www.indiandentalacademy.comwww.indiandentalacademy.com
  53. 53.  AdvantagesAdvantages :: 1)1) Succeeds in both osteointegration & osteo-Succeeds in both osteointegration & osteo- preservation modepreservation mode 2)2) Low treatment costLow treatment cost 3)3) Low treatment timeLow treatment time 4)4) Low traumaLow trauma 5)5) Requires conventional prosthodonticRequires conventional prosthodontic proceduresprocedures 6)6) Easy to place and simple armamtariumEasy to place and simple armamtarium 7)7) Increased implant interfaceIncreased implant interface www.indiandentalacademy.comwww.indiandentalacademy.com
  54. 54.  Parts of blade/plate form implant:Parts of blade/plate form implant:  AbutmentAbutment  Safety stopSafety stop  NeckNeck  ShoulderShoulder  VentsVents  Shoulder set pointsShoulder set points www.indiandentalacademy.comwww.indiandentalacademy.com
  55. 55. www.indiandentalacademy.comwww.indiandentalacademy.com
  56. 56.  Prosthodontic related advantages of rootProsthodontic related advantages of root form implants compared with plate form:form implants compared with plate form: 1)1) Provide independent supportProvide independent support 2)2) Greater surface area for stress distributionGreater surface area for stress distribution 3)3) Permits better estheticsPermits better esthetics 4)4) Wide range of abutment optionsWide range of abutment options 5)5) Greater retention and resistanceGreater retention and resistance www.indiandentalacademy.comwww.indiandentalacademy.com
  57. 57. 5)5) Greater flexibilityGreater flexibility 6)6) Requires less skillRequires less skill 7)7) May be inserted at the level or below theMay be inserted at the level or below the crest of the ridgecrest of the ridge www.indiandentalacademy.comwww.indiandentalacademy.com
  58. 58. Endodontic stabilizerEndodontic stabilizer  They are used toThey are used to extend the functionalextend the functional length of an existinglength of an existing tooth roottooth root  Improve prognosisImprove prognosis and crown root ratioand crown root ratio www.indiandentalacademy.comwww.indiandentalacademy.com
  59. 59.  Parallel sided orParallel sided or taperedtapered  Smooth or threadedSmooth or threaded  ““sluice ways”sluice ways”  Nomenclature:Nomenclature: Major diameterMajor diameter Minor diameterMinor diameter PitchPitch www.indiandentalacademy.comwww.indiandentalacademy.com
  60. 60.  Functions in osteopreservation modeFunctions in osteopreservation mode  Need for atleast 5mm of available boneNeed for atleast 5mm of available bone beyond apex of the toothbeyond apex of the tooth www.indiandentalacademy.comwww.indiandentalacademy.com
  61. 61. Disk like implantsDisk like implants www.indiandentalacademy.comwww.indiandentalacademy.com
  62. 62. ConclusionConclusion www.indiandentalacademy.comwww.indiandentalacademy.com
  63. 63. bibliographybibliography 1)1) Contemporary implant dentistry – Misch 2 ednContemporary implant dentistry – Misch 2 edn 2)2) Principles & practice of implant dentistry –Principles & practice of implant dentistry – Weiss & WeissWeiss & Weiss 3)3) Atlas of oral implants - CraninAtlas of oral implants - Cranin 4)4) Dental implant- the art & science – BabushDental implant- the art & science – Babush 5)5) Implants in clinical dentistry – Palmer, Smith,Implants in clinical dentistry – Palmer, Smith, HoweHowe 6)6) Oral implantology - KakarOral implantology - Kakar www.indiandentalacademy.comwww.indiandentalacademy.com
  64. 64. For more details please visit www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com