Evolution ,components and classification of implants/ orthodontic practice

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  • 1. www.indiandentalacademy.com
  • 2. EVOLUTION CLASSIFICATION AND COMPONENTS OF IMPLANTS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 3. TABLE OF CONTENT: Introduction Historical background Classifications Endosteal implants Subperiosteal implants Intramucosal inserts Transosseous implants Components of root form implants Conclusion Bibliography www.indiandentalacademy.com
  • 4. INTRODUCTIONS- The goal of modern dentistry is to restore the patient to normal contour, function, comfort, esthetics, speech and health. www.indiandentalacademy.com
  • 5. Dental implants- A dental implants is a device of biocompatible materials placed within the mandibular or maxillary bone to provide additional or enhanced support for the prosthesis or tooth . www.indiandentalacademy.com
  • 6. EARLY HISTORICAL DEVELOPMENT The first history of implants dates back to 600 A.D. Archaeological findings show that ancient Egyptian experimented with reimplanting lost teeth with animal teeth or teeth carved from ivory . www.indiandentalacademy.com
  • 7. In 18th century lost teeth were replaced with extracted teeth of other human donor. www.indiandentalacademy.com
  • 8. In 1809, Maggiolo described a process of fabricating and inserting gold implants into fresh extraction socket . In 1887, Harris attempted the same procedure with platinum post instead of gold. www.indiandentalacademy.com
  • 9. In 1886 – Edmisids was the first person in USA to implant platinum disc into the jaw bone . In 1906- Greenfield described endosseous implant made of an iridium – platinum alloy. In 1939 – Strock succeeded in anchoring a vitallium screw and mounting a porcelain crown on it . www.indiandentalacademy.com
  • 10. In 1943 – Gustavo Dahl conceived the concept of subperiosteal implant . In 1948 – Goldberg and Gershkoff refined the subperiosteal implant with an extension of the framework . www.indiandentalacademy.com
  • 11. In early 1960 Orlay utilized vitallium posts for endodontically treated teeth with extension beyond apex. Linkow in the mid 1960s introduced the blade vent implant . www.indiandentalacademy.com
  • 12. in 1952 Branemark began extensive study on the microscopic circulation of bone marrow In 1965 human studies began, after 10year follow up, were reported in 1977 He defined the term osteointegration for the first time www.indiandentalacademy.com
  • 13. In 1980, Dr George a Jarb at the university of Toronto , Canada , began the clinical use of this system . In 1982 the Toronto conference on osteointegration in clinical dentistry laid down the first parameters on what is to be considered successful implant treatment within the stringent confines of the scientific community. www.indiandentalacademy.com
  • 14. In late 1960s Robert and Robert developed the ramus blade implant In early 1970s they designed the mandibular staple implant for the edentulous atrophic mandible. www.indiandentalacademy.com
  • 15. In 1970s ramus frame implant was designed . www.indiandentalacademy.com
  • 16. In early 1970s the use of Intramucosal inserts was popularized by Weiss and Judy. www.indiandentalacademy.com
  • 17. In early 1970 s Schroeder and his team designed a single stage implant system known as ITI implant system. In 1974 IMZ implant system was introduced . Elastic component is inserted between implant and superstructure . www.indiandentalacademy.com
  • 18. In early 1980s Niznick introduced core vent implant which is hollow implant with threaded component to engage bone. In late 1980s cylindrical plasma spray titanium and hydroxyapatite coated implant were introduced. www.indiandentalacademy.com
  • 19. In 1986 – The root form implants superceded the blade form implants as ‘the most frequently placed implant’. In 1984- Ct scan In 1987 – Sinus lift In 1988 – Nerve transposition In 1989 – Pterygoid implants In 1995 – Distraction osteotomies spilt ridge technique www.indiandentalacademy.com
  • 20. CLASSIFICATION OF DENTAL IMPLANTS www.indiandentalacademy.com
  • 21. IMPLANTS CAN BE CLASSIFIED AS - Implants Totally buried Semi - buried Sub periosteal implant Endosteal implant www.indiandentalacademy.com
  • 22. IN 1881 WILLIAM CLASSIFIED THE USE OF DENTAL IMPLANTS AS- For prosthetic treatment For endodontic stabilization For periodontal surgery For simulation of congenitally absent tissue For treatment of facial fracture www.indiandentalacademy.com
  • 23. CLASSIFICATION BASED ON IMPLANT POSITION - Endosseous Transoss eous Sub- periosteal www.indiandentalacademy.com
  • 24. ACCORDING TO WEISS AND WEISS - Endosteal Subperiosteal Denture enhancing intra mucosal inserts www.indiandentalacademy.com
  • 25. IN 1998 AFNOR CLASSIFIED ENDOSSEOUS DENTAL IMPLANT BASED ON THEIR MODE OF INSERTION- Crestally inserted dental implants(crestal approach ) Laterally inserted dental implant(basal approach) www.indiandentalacademy.com
  • 26. Osteotomy is initiated on the crest . This category includes root- form and blade form implant . Referred as Crestally inserted implants Axially inserted dental implants www.indiandentalacademy.com
  • 27. Osteotomy initiated on the buccal or lingual /palatal aspect of jaw . The entire osteotomy is performed laterally at the same initial depth. Laterally inserted dental implants www.indiandentalacademy.com
  • 28. ENDOSTEAL IMPLANTS An Alloplastic material surgically inserted into a residual ridge primarily as prosthodontics foundation. They are most commonly applicable abutment providing modalities. www.indiandentalacademy.com
  • 29. ENDOSTEAL IMPLANT CAN BE FURTHER CLASSIFIED AS – Root form Plate form Endodontic stabilizer www.indiandentalacademy.com
  • 30. ROOT FORM IMPLANTS- Designed to resemble the shape of a natural tooth root. Most commonly used dental implants. One stage /two stage implant. Placed in mandible and maxilla where sufficient bone are present. www.indiandentalacademy.com
  • 31. Available in four form – Threaded stepped tapered Parallel sided www.indiandentalacademy.com
  • 32. The primary types based on design – Cylinder or press fit Screw form combination www.indiandentalacademy.com
  • 33. PLATE / BLADE FORM IMPLANTS- The basic shape is similar to that of a metal plate or blade in cross–section. Combination of parallel and tapered sided. Supplied in one stage or two stage varieties. www.indiandentalacademy.com
  • 34. Maxillary and mandibular arch for partially or complete edentulous where adequate bone is present . Bone required- >8mm vertical bone height - >3mm bone bucco-lingually . - >10mm bone mesio-distally. www.indiandentalacademy.com
  • 35. RAMUS BLADE AND RAMUS FRAME IMPLANT- The ramus implant is a one piece blade . Use when insufficient bone exist in the body of jaw prosthetic option: overdentures Suitable arch : mandibular , completely edentulous. www.indiandentalacademy.com
  • 36. They features an external attachment bar that courses a few millimeters superior to the crest of the ridge from one side of the ramus to another side . Required bone- >6mm vertical bone height (symphysis and rami) >3mm bone width (buccal to lingual) www.indiandentalacademy.com
  • 37. ENDODONTIC STABILIZER IMPLANT- Endodontic stabilizers are used to extend the functional length of an existing tooth root. Improves prognosis and crown root ratio www.indiandentalacademy.com
  • 38. parallel sided or tapered Smooth or threaded Indication – mandible first molar and anterior to it . - - in maxilla first premolar and anterior to it www.indiandentalacademy.com
  • 39. SUBPERIOSTEAL IMPLANTS- Implant is placed under the periosteum rather than within the bone. Always custom made . Indicated - advanced alveolar ridge resorption . Required bone is >5mm www.indiandentalacademy.com
  • 40. Total subperiosteal implants Subperiosteal implants Circumferential implants Interdental implants Unilateral implants www.indiandentalacademy.com
  • 41. INTRAMUCOSAL INSERTS- They differ in form ,concept and function from the other modalities.  Mushroom shaped titanium projections . Attached to the tissue surface of a partial or complete removable denture in the maxilla.  Provide additional support and stability. www.indiandentalacademy.com
  • 42. Intramucosal inserts doesn’t contact bone . The mode of tissue integration is not osteointegration. Rather , the receptor sites in the tissue into which the inserts seat become lined with tough , keratinized epithelium. Indicated to patients who are poor medical risks. www.indiandentalacademy.com
  • 43. Prosthetic options-removable dentures, full or partial Suitable arch- maxillary , completely or partially edentulous: mandibular partially only Required bone – none ; required mucosa 2.2mm thick www.indiandentalacademy.com
  • 44. Types -single component , -multiple component -staple design Prosthetic options- overdentures , fixed bridge are rarely made Transosteal implants www.indiandentalacademy.com
  • 45. Required bone >6mm vertical bone height >5mm bone width Suitable arch-mandible anterior region, completely or partially edentulous www.indiandentalacademy.com
  • 46. COMPONENTS OF IMPLANTS- www.indiandentalacademy.com
  • 47. COMPONENTS OF ROOT FORM IMPLANTS- Body or fixture Cover screw Abutment and abutment screw Gold cylinder and screw www.indiandentalacademy.com
  • 48. Transfer coping Analog coping Coping or prosthesis screw www.indiandentalacademy.com
  • 49. BODY OR FIXTURE Divided into 3 parts Crest module Body apex www.indiandentalacademy.com
  • 50. FIRST STAGE COVER SCREW Placed into the top of the implant to prevent bone, soft tissue or debris from invading the abutment connection area during healing . www.indiandentalacademy.com
  • 51. PERMUCOSAL EXTENSION/HEALING ABUTMENT /GINGIVAL FORMER It extends the implant above the soft tissue and result in the development of a Permucosal seal around the implant. www.indiandentalacademy.com
  • 52. It can be straight, flared or anatomical to assist in the initial contour of the soft tissue healing . www.indiandentalacademy.com
  • 53. ABUTMENTS The portions of implants that support and retain a prosthesis or implant superstructure. www.indiandentalacademy.com
  • 54. TYPES OF ABUTMENT- Depending upon retention Abutment for screw retention Abutment for cement retention Abutment for attachment www.indiandentalacademy.com
  • 55. Abutment for cement retention single unit or one piece abutment Two piece abutment www.indiandentalacademy.com
  • 56. Advantages- Easier to obtain esthetic . Can join teeth and implant more readily. Minor discrepancies in fit. Disadvantages- Difficult to retrieve. Harder laboratory technique . Conventional impression can lead to errors in fit. www.indiandentalacademy.com
  • 57. Advantages- Easily retrieved Machined accurate component Disadvantages- Implant position and angulation is critical Potential of screw fracture and loosening Screw may spoil the appearance Abutment for screw retention BDJ VOL 187 NO 11 DEC 1999 www.indiandentalacademy.com
  • 58. Uses as attachment device to retain removable prosthesis Abutment for attachment www.indiandentalacademy.com
  • 59. www.indiandentalacademy.com
  • 60. Depending upon design Flat topped abutment Tapered shouldered abutment Direct gold coping abutment www.indiandentalacademy.com
  • 61. Placed over the abutment  Prevent debris and calculus from invading the internal threaded portion of the abutment Hygiene screw www.indiandentalacademy.com
  • 62. Analog www.indiandentalacademy.com
  • 63. Analog Abutment analog Implant analog www.indiandentalacademy.com
  • 64. Purpose-Fabrication of master cast to replicate the retentive portion of the implant body and abutment www.indiandentalacademy.com
  • 65. Use to position an analog in an impression . Transfer copings Implant body transfer coping Abutment transfer coping Direct transfer coping Indirect transfer coping www.indiandentalacademy.com
  • 66. Two basic type of impression for implant are Indirect or closed tray technique Direct or open tray technique www.indiandentalacademy.com
  • 67. Indirect or closed tray technique www.indiandentalacademy.com
  • 68. Transfer coping – abutment analog www.indiandentalacademy.com
  • 69. Transfer coping in abutment www.indiandentalacademy.com
  • 70. www.indiandentalacademy.com
  • 71. Transfer coping replaced in impression Transfer coping and analogues mounted in the impression www.indiandentalacademy.com
  • 72. Coping removed www.indiandentalacademy.com
  • 73. Direct or open tray technique Connect transfer coping with guide pins Block out the transfer coping with two thickness of base plate wax www.indiandentalacademy.com
  • 74. Resin tray is fabricated Head of guide pins is exposed www.indiandentalacademy.com
  • 75. Guide pin hole is enlarged www.indiandentalacademy.com
  • 76. Finished tray www.indiandentalacademy.com
  • 77. connect square transfer coping with guide pin www.indiandentalacademy.com
  • 78. www.indiandentalacademy.com
  • 79. www.indiandentalacademy.com
  • 80. Abutment analog connected to transfer coping www.indiandentalacademy.com
  • 81. Guide pins are unscrewed after setting of stone www.indiandentalacademy.com
  • 82. Cast with abutment analog www.indiandentalacademy.com
  • 83. Thin covering usually designed to fit the implant abutment for screw retention . It serves as the connection between the abutment and the prosthesis or superstructures . Prosthetic coping www.indiandentalacademy.com
  • 84. Prefabricated copings • Metal component machined precisely to fit the abutment Castable copings • Plastic pattern cast in the same metal as superstructures or prosthesis www.indiandentalacademy.com
  • 85. CONCLUSION The desire has always been to replaced missing teeth with something similar to root of a tooth and implant dentistry helps us to achieve that . Regardless of the implant system use the generic term is descriptive of function of components rather than its proprietary name . www.indiandentalacademy.com
  • 86. BIBLIOGRAPHY- Contemporary implant dentistry –Carl E Mish (third edition ) Atlas of oral implants – Cranin Principles and practice of implant dentistry – Weiss and Weiss Oral implantology – Kakar Implant and restorative dentistry –martin Dunitz BDJ 1999 BDJ 2006,2007 www.indiandentalacademy.com
  • 87. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com