Evolution ,components and classification of implants/ orthodontic practice


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Evolution ,components and classification of implants/ orthodontic practice

  1. 1. www.indiandentalacademy.com
  2. 2. EVOLUTION CLASSIFICATION AND COMPONENTS OF IMPLANTS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 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. 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. 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. 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. 7. In 18th century lost teeth were replaced with extracted teeth of other human donor. www.indiandentalacademy.com
  8. 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. 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. 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. 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. 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. 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. 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. 15. In 1970s ramus frame implant was designed . www.indiandentalacademy.com
  16. 16. In early 1970s the use of Intramucosal inserts was popularized by Weiss and Judy. www.indiandentalacademy.com
  17. 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. 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. 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. 20. CLASSIFICATION OF DENTAL IMPLANTS www.indiandentalacademy.com
  21. 21. IMPLANTS CAN BE CLASSIFIED AS - Implants Totally buried Semi - buried Sub periosteal implant Endosteal implant www.indiandentalacademy.com
  22. 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. 23. CLASSIFICATION BASED ON IMPLANT POSITION - Endosseous Transoss eous Sub- periosteal www.indiandentalacademy.com
  24. 24. ACCORDING TO WEISS AND WEISS - Endosteal Subperiosteal Denture enhancing intra mucosal inserts www.indiandentalacademy.com
  25. 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. 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. 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. 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. 29. ENDOSTEAL IMPLANT CAN BE FURTHER CLASSIFIED AS – Root form Plate form Endodontic stabilizer www.indiandentalacademy.com
  30. 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. 31. Available in four form – Threaded stepped tapered Parallel sided www.indiandentalacademy.com
  32. 32. The primary types based on design – Cylinder or press fit Screw form combination www.indiandentalacademy.com
  33. 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. 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. 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. 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. 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. 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. 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. 40. Total subperiosteal implants Subperiosteal implants Circumferential implants Interdental implants Unilateral implants www.indiandentalacademy.com
  41. 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. 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. 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. 44. Types -single component , -multiple component -staple design Prosthetic options- overdentures , fixed bridge are rarely made Transosteal implants www.indiandentalacademy.com
  45. 45. Required bone >6mm vertical bone height >5mm bone width Suitable arch-mandible anterior region, completely or partially edentulous www.indiandentalacademy.com
  46. 46. COMPONENTS OF IMPLANTS- www.indiandentalacademy.com
  47. 47. COMPONENTS OF ROOT FORM IMPLANTS- Body or fixture Cover screw Abutment and abutment screw Gold cylinder and screw www.indiandentalacademy.com
  48. 48. Transfer coping Analog coping Coping or prosthesis screw www.indiandentalacademy.com
  49. 49. BODY OR FIXTURE Divided into 3 parts Crest module Body apex www.indiandentalacademy.com
  50. 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. 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. 52. It can be straight, flared or anatomical to assist in the initial contour of the soft tissue healing . www.indiandentalacademy.com
  53. 53. ABUTMENTS The portions of implants that support and retain a prosthesis or implant superstructure. www.indiandentalacademy.com
  54. 54. TYPES OF ABUTMENT- Depending upon retention Abutment for screw retention Abutment for cement retention Abutment for attachment www.indiandentalacademy.com
  55. 55. Abutment for cement retention single unit or one piece abutment Two piece abutment www.indiandentalacademy.com
  56. 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. 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. 58. Uses as attachment device to retain removable prosthesis Abutment for attachment www.indiandentalacademy.com
  59. 59. www.indiandentalacademy.com
  60. 60. Depending upon design Flat topped abutment Tapered shouldered abutment Direct gold coping abutment www.indiandentalacademy.com
  61. 61. Placed over the abutment  Prevent debris and calculus from invading the internal threaded portion of the abutment Hygiene screw www.indiandentalacademy.com
  62. 62. Analog www.indiandentalacademy.com
  63. 63. Analog Abutment analog Implant analog www.indiandentalacademy.com
  64. 64. Purpose-Fabrication of master cast to replicate the retentive portion of the implant body and abutment www.indiandentalacademy.com
  65. 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. 66. Two basic type of impression for implant are Indirect or closed tray technique Direct or open tray technique www.indiandentalacademy.com
  67. 67. Indirect or closed tray technique www.indiandentalacademy.com
  68. 68. Transfer coping – abutment analog www.indiandentalacademy.com
  69. 69. Transfer coping in abutment www.indiandentalacademy.com
  70. 70. www.indiandentalacademy.com
  71. 71. Transfer coping replaced in impression Transfer coping and analogues mounted in the impression www.indiandentalacademy.com
  72. 72. Coping removed www.indiandentalacademy.com
  73. 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. 74. Resin tray is fabricated Head of guide pins is exposed www.indiandentalacademy.com
  75. 75. Guide pin hole is enlarged www.indiandentalacademy.com
  76. 76. Finished tray www.indiandentalacademy.com
  77. 77. connect square transfer coping with guide pin www.indiandentalacademy.com
  78. 78. www.indiandentalacademy.com
  79. 79. www.indiandentalacademy.com
  80. 80. Abutment analog connected to transfer coping www.indiandentalacademy.com
  81. 81. Guide pins are unscrewed after setting of stone www.indiandentalacademy.com
  82. 82. Cast with abutment analog www.indiandentalacademy.com
  83. 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. 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. 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. 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. 87. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com