Dental Implantology /certified fixed orthodontic courses by Indian dental academy


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Dental Implantology /certified fixed orthodontic courses by Indian dental academy

  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education
  3. 3. Classification of Implant According to Leonard. R.Rubin Classified according to the tissue into which they are embedded or on which they rest: Intraosseous implants: Receiving primary support from within bone Subperiosteal implants: resting on the bone beneath the periosteum Transosseous implants: stabilized by penetrating through both cortical plates Transcanal: support from an implant placed through the tooth root canal into the bone beyond the apex 
  4. 4. According to Charles. A.Babbush There are five main types: • Mucosal Inserts • Subperiosteal Implants • Endodontic Implants • Endosseous Implants • Transosteal Implants According to Dennis C. Smith, David.F.Williams • Buried: Metals Non-Metals Metals: Magnets placed in the superior aspect of the body of the mandible and another set placed in the lower denture 
  5. 5. Endodontic Stabilizers: Metal rods cemented into root canal of a natural tooth and extends beyond apex into the bone Non-metals: In ridge augmentation and facial recountouring procedures using proplast, ceramics and plastics Also in ridge maintenance efforts by placing implants made of carbon into recent extraction site root sockets • Semi-Buried: All true dental implants fall into this category Metals: Cobalt, Chromium, Molybdenum Non-metals: Ceramics, Bioglass, Carbons, Plastics
  6. 6. Classification of Implant Biomaterials According to Charles A.Babbush, Carl. E. Misch • Metals and Alloys • Ceramics and Carbon • Synthetic Polymers and Composites Metals and Alloys:  Titanium  Co-Cr-Mo based alloy  Iron-Chromium-Nickel based alloy  Other metals
  7. 7.  Tantalum  Platinum  Iridium  Gold  Palladium  Zirconium  Hafnium  Tungsten Ceramics: Bioactive and Biodegradable Ceramics based on Calcium Phosphates Metallic Oxide Ceramics:  Aluminium Oxides  Trocalcium Phosphates
  8. 8.  Calcium Aluminates  Zirconium Oxide (Zirconia)  Titanium Oxide (Titania) Synthetic Crystalline Structures like Hydroxyapatite Carbons :  Pyrolytic carbon  Polycrystalline Vitreous Carbon  Carbon-Silicone interstitial combination Synthetic Polymers:  Polyethylene Terepthalate (PET)  Polymethyl Methacrylate (PMMA)
  9. 9.  Ultra-high Molecular weight polyethylene (UHMW-PE)  Polypropylene  Polysulfone  Polydimethyl siloxane or silicone rubber  Polytetrafluoro ethylene Composites: Bioresorbable polymers like  Polyvinyl alcohol  Polyacids or glycosides  Cyanoacrylate
  10. 10. According to Stephen.D.Cook; Jeanette. E.Dalton (Based on Tissue Response and Systemic Toxicity) Biotolerant Bioactive Bioinert
  11. 11. Implant Systems  IMZ Dental Implant Systems  Innova Endopore Implant System  Nobel Biocare and 3i Systems  Sulzer-Calcitek Implant System  Friatec and Frialit  Oratronics Spiral  Implant Innovations incorporated
  12. 12. IMZ Dental Implant Systems
  13. 13.  It consists of a cylindrical, endosseous implant; a highly polished transmucosal implant extension (TIE), and a viscoelastic intramobile element (IME)  This has been in use since 1978  It is made of commercially pure titanium  The outer surface is titanium plasmasprayed with an electric arc, which gives rough texture and a large surface area  Apical end of implant contains vent for bone ingrowth
  14. 14.  They are available in 3.3, 4.0 and 4.25 mm diameter and in lengths of 8,11,13,15,17, and 19 mm  The Transmucosal Implant Extension (TIE) is an highly polished titanium sleeve that sits on top of the implant and extends up through the soft tissue  Designed to be easily cleaned in situ by patient and can be removed by dentist for extraoral cleaning  The Intramobile Element (IME) is made up of polyoxymethylene and provides a resilient connection between the implant and prosthesis
  15. 15. 4 mm implants in lengths 8,11,13 and 15 mm. placement head assemble, titanium healing screw, second-phase sealing screw and TIE, IME and TIE,
  16. 16.  They are developed by Interpore International, Irvine  Indicated in totally edentulous, partial edentulous, class I and II and single tooth edentulous space  IME is designed to minimize stress concentrations, by absorbing and distributing occlusal surfaces  Abutments systems are two: the conventional TIE and IME ; the intramobile connector (IMC)
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  18. 18. Completely edentulous patient rehabilitation  (1) custom tissue bar and clip-on overdenture
  19. 19.  (2) custom milled tissue bar and precision overdenture
  20. 20.  (3) implant supported, electively retrievable fixed prosthesis (bone-anchorage bridge)
  21. 21. For partially edentulous patients  Implant is rigidly connected to the natural tooth using an extracoronal screwstabilized attachment  Indicated for maxillary and mandibular posterior edentulous situations  It distributes load between the implant and the natural abutment  Possible if an semiprecision or telescopic attachment is used to connect teeth to implants
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  24. 24.  Single-tooth abutment has been designed for use with IMZ implant  In anterior regions of the mouth  This titanium abutment is a two-piece insert  Transmucosal section tightened against top of the implant body
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  26. 26.   Prefabricated ceramicor post and ring on the right designed so that when seated into abutment on left, post fits precisely over coronal aspect of abutment crown secured by using cement
  27. 27. Noble Biocare and 3i Systems  Both systems are similar  Packaged differently: glass tube and blister pack  Various coating like hydroxylapatite and titanium plasma spray are available  Diameters– 3.75, 4, 4.5, 5, and 5.5 mm  Branemark instrument names are used  Procedure begins with guide drill to half its diameter at propos implant site  2-mm twist drill to final implant depth
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  29. 29.  Counterbore to enlarge the coronal portion of osteotomy in preparation for 3-mm twist drill  3-mm twist drill  Counter-sink drill  Depth gauge  Screw tap  Insert implant attached to fixture mount  Wrench stabilizes fixture mount while fixation screw is removed  Cover screw inserter  Cover screw placement with small hexagon screwdriver
  30. 30. Seat Nobel Biocare implant so that its cover screw is flush with crest of bone
  31. 31. Sulzer-Calcitek Implant System  Available in 3.25, 4, and 5 mm diameters  Principles applied can be used for other press- fit endosseous cylindrical implants  Pilot drill for a depth of 8 mm  Rosette bur to half its diameter over the pilot osteotomy  Intermediate spade drill to enlarge pilot osteotomy for final depth preparation  Counter bore drill to enlarge coronal portion  Final spade drill  Implant body try-in
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  33. 33.    Seat implant with its plastic cap Tap implant into position Seat calcitek implants flush with crest of bone
  34. 34. Innova Endopore Implant  It has a surface macrostructure of sintered titanium beads  This design greatly increases surface area and encourages high levels of intraosseous retention  Technique for seating uses the classic bone enlargement drill, a steel try-in, and placement of implant in the press-fit mode
  35. 35. Pilot drill, implant bur, trial fit gauge, implant placement
  36. 36. Friatec and Frialit 2  These are stepped screw or press-fit TPS- coated implants designed to increase primary stability in poor-quality bone  Available in 3.8, 4.5, and 5.5 mm diameter  Primary purchase point with a round drill  Spade drill or twist drill used to full depth  Enlarge receptor site to its final diameter using stepped drill  Place implant into receptor site, first with finger pressure and then ratchet them into deeper threaded environment
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  38. 38. Omni-R  Guide drill at potential implant site  Pilot drill to full predetermined depth  Intermediate drill  R2 Hand auger  Seat implant in flush with crest of the bone
  39. 39. Oratronics Spiral  Guide drill used  Pilot drill or spade drill to its final pre- determined depth  Spiral tap is attached to hand ratchet  Enlarge the osteotomy to chosen length and width  Implant attached to titanium insert, placed in the hand wrench and rotated to its final seating position
  40. 40. SURGICAL PROCEDURES IN IMPLANTOLOGY  Stage I Surgery also known as fixture installation stage, is the procedure for installing Branemark system implants into bone. This procedure demands exacting, non-traumatic preparation of the recipient site and a specific insertion protocol. Variations in this procedure mainly depends on the quality and quantity of bone and also on the load demands on the final prosthesis
  41. 41. High speed hand piece geared up to run at high torque with a speed of 1500 to 2000 RPMs, and the slow speed hand piece at high torque with speed of approximately 15 to 20 RPMs
  42. 42. Drills used for bone preparation include: guide drill, 2 mm twist drill, pilot drill, the 3 mm twist drill, and countersink
  43. 43. Irrigation unit is used to deliver an even, steady flow of sterile water to the surgical site at all times during high and low speed preparation
  44. 44. Surgical guide stent is placed in the area to project the future position of the fixture
  45. 45. Guide drill is the first drill used in the bone preparation process. It is designed to penetrate the cortical layer of the bone
  46. 46. Initial penetration using surgical guide stent, is initiated using high speed guide drill at 1500 RPM. Copious saline irrigation used at all times
  47. 47. 2 mm twist drill is used second in the sequence to prepare the site to 2mm in diameter
  48. 48. Site is progressively enlarged to 2mm with a 2mm twist drill at 1500 RPM
  49. 49. Pilot drill is used next. Inferior portion of the drill is to engage the 2mm prepared site and superior portion begins the enlargement of the site
  50. 50. Final orientation and inclination of the fixture is by using the pilot drill at high speed, high torque. It has an 2mm non-cutting edge and a 3mm cutting edge
  51. 51. 3 mm twist drill is fourth drill in bone preparation. Its used to prepare bone to its final destination
  52. 52. Implant site is prepared to final length and width utilizing a 3mm twist drill operating at high speed
  53. 53. Countersink is the final drill used in the high speed drilling process. It is used to create a shelf in the prepared bony site
  54. 54. Crestal bone carefully prepared using countersink. Allows superior aspect of fixture to be placed crestally or sub-crestally, to avoid premature loading of the fixture during stage I healing
  55. 55. Bone tap is the first in the series of slow speed bone preparation. Made of titanium and used to thread the bone prior to implant placement
  56. 56. Receptor site is tapped utilizing a titanium tap operating at 15 to 20 RPMs along with copious irrigation
  57. 57. Fixtures are composed of commercially pure titanium and range in length from 7 to 20 mm and width of range 3.75 and 4.0 mm
  58. 58. Thank you Leader in continuing dental education