INTRODUCTIONINTRODUCTION
TOTO
DENTAL IMPLANTSDENTAL IMPLANTS
www.indiandentalacademy.com
• SUCCESS CRITERIA
• BASIC GUIDE TO OSSEOINTEGRATION
• Biocompatibility and implant design
• Bone factors
• Loading condit...
Basic terminology in implantBasic terminology in implant
dentistrydentistry
OSSEOINTEGRATION:
A direct structural and func...
www.indiandentalacademy.com
IMPLANT ABUTMENT:
The component which attaches to the
dental implant and supports the prosthesis.
A transmucosal abutment ...
Ball abutments
Abutments in ‘single tooth restorations’
Conical shaped abutments
Cylindrical healing abutments
www.indiand...
SINGLE STAGE IMPLANT SURGERY:SINGLE STAGE IMPLANT SURGERY:
surgical placement of a dental implant which is
left exposed to...
Single stage implant surgery
Two stage implant surgery
www.indiandentalacademy.com
www.indiandentalacademy.com
1. An individual, unattached implant is immobile when tested
clinically.
2. Radiographic examination does not reveal any P...
• However, some of the criteria apply to the overall
requirements of an implant system, but are not
useful when judging th...
• It is also difficult to stipulate what level of change in
an individual implant over a given period of time
would consti...
www.indiandentalacademy.com
• Biocompatibility and implant design
• Bone factors
• Loading conditions
• Prosthetic considerations
www.indiandentalacad...
Biocompatibility and implantBiocompatibility and implant
designdesign
• Successful clinical results are reported in
implan...
Implant designImplant design
• Has a great influence on initial stability and
subsequent function.
• The main design param...
Implant lengthImplant length
• Generally available in lengths from about
6mm to as much as 20mm.
• Most common lengths emp...
Implant diameterImplant diameter
• Most implants are approx. 4mm in diameter.
At least 3.25mm in diameter is required to
e...
ImplantImplant
shapeshape
• Hollow-cylinders, solid-cylinders, hollow screws or
solid screws are commonly employed shapes....
Branemark /
nobel biocare implant Astra ST implant
ITI straumann solid
screw implant
www.indiandentalacademy.com
Surface characteristicsSurface characteristics
• The degree of surface roughness varies
greatly between different systems....
Machined surface Blasted surface (Tio-blast)
Plasma sprayed surfacewww.indiandentalacademy.com
BONE FACTORS
• Radiographic determination of bone quantity and quality
should be considered.
• The most favourable quality...
www.indiandentalacademy.com
Factors which compromise bone quality
are…
• Infection
• Irradiation
• Heavy smoking
• The effects of the latter two are a...
LOADING CONDITIONSLOADING CONDITIONS
• Following installation of an implant it is important
that it is not loaded during t...
• Bone quality can be assessed by measuring
the cutting torque during preparation of the
implant site.
• The stability of ...
• Some systems employ a single stage
approach in which the implant is installed so
that it protrudes through the overlying...
Prosthetic considerationsProsthetic considerations
• Carefully planned functional occlusal loading will
result in maintena...
The type of prosthetic reconstructionThe type of prosthetic reconstruction
• This can vary from a single tooth replacement...
The occlusal schemeThe occlusal scheme
• The lack of mobility in implant supported fixed prostheses
requires provision of ...
The number, distribution, orientationThe number, distribution, orientation
and design of implantsand design of implants
• ...
The design and properties of implantThe design and properties of implant
connectorsconnectors
• Multiple implants are join...
Dimensions and location of cantileverDimensions and location of cantilever
extensionsextensions
• Cantilever extensions ha...
Patient parafunctional activitiesPatient parafunctional activities
• Great caution should be exercised in treating
patient...
There are great many factors to take into
account to ensure predictable successful
implant treatment.
There is no substitu...
www.indiandentalacademy.com
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.com
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Introduction to dental implants / online orthodontic courses

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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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Introduction to dental implants / online orthodontic courses

  1. 1. INTRODUCTIONINTRODUCTION TOTO DENTAL IMPLANTSDENTAL IMPLANTS www.indiandentalacademy.com
  2. 2. • SUCCESS CRITERIA • BASIC GUIDE TO OSSEOINTEGRATION • Biocompatibility and implant design • Bone factors • Loading conditions • Prosthetic considerations www.indiandentalacademy.com
  3. 3. Basic terminology in implantBasic terminology in implant dentistrydentistry OSSEOINTEGRATION: A direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant. (Albrektsson et al. -1981) ENDOSSEOUS DENTAL IMPLANT: A device inserted into the jaw bone (endosseous) to support a dental prosthesis. It is the ‘tooth root’ analogue and is often referred to as a ‘fixture’. www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. IMPLANT ABUTMENT: The component which attaches to the dental implant and supports the prosthesis. A transmucosal abutment (TMA) is one which passes through the mucosa overlying the implant. - a temporary or healing abutment may be used during the healing of the Peri-implant soft tissue before the definitive treatment is chosen. ABUTMENT SCREW:ABUTMENT SCREW: A screw used to connect an abutment to the implant. www.indiandentalacademy.com
  6. 6. Ball abutments Abutments in ‘single tooth restorations’ Conical shaped abutments Cylindrical healing abutments www.indiandentalacademy.com
  7. 7. SINGLE STAGE IMPLANT SURGERY:SINGLE STAGE IMPLANT SURGERY: surgical placement of a dental implant which is left exposed to the oral cavity following insertion. • This is the protocol used in non-submerged implant systems. TWO STAGE IMPLANT SURGERY:TWO STAGE IMPLANT SURGERY: Initial surgical placement of a dental implant which is buried beneath the mucosa and then subsequently exposed with a second surgical procedure some months later. • This is used in submerged implant systems. www.indiandentalacademy.com
  8. 8. Single stage implant surgery Two stage implant surgery www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10. 1. An individual, unattached implant is immobile when tested clinically. 2. Radiographic examination does not reveal any Peri- implant radiolucency. 3. After the first year in function, radiographic vertical bone loss is less than 0.2mm per annum. 4. The individual implant performance is characterised by an absence of signs and symptoms such as pain, infections, neuropathies, paraesthesia, or violation of the inferior dental canal. 5. As a minimum, the implant should fulfill the above criteria with a success rate of 85% at the end of a 5yr observation period and 80% at the end of a 10yr period. Albrektsson et al. IJOMI 1986;1:11 www.indiandentalacademy.com
  11. 11. • However, some of the criteria apply to the overall requirements of an implant system, but are not useful when judging the success of individual implants. • The ideal bone level is usually judged against a specific landmark on the implant and it may differ therefore between implant systems. • The bone levels are usually more or less stable, and small changes such as 0.2mm per annum are impossible to measure with conventional radiographs. www.indiandentalacademy.com
  12. 12. • It is also difficult to stipulate what level of change in an individual implant over a given period of time would constitute failure. • A rapid change in bone level may be followed by a long period of stability. • On the other hand progressive or continuous bone loss is a worrying sign of impending failure. • Implants placed in the mandible have a higher success rate than the maxilla. 95% - mandible (after 5yrs of loading) 85%-90% - maxilla www.indiandentalacademy.com
  13. 13. www.indiandentalacademy.com
  14. 14. • Biocompatibility and implant design • Bone factors • Loading conditions • Prosthetic considerations www.indiandentalacademy.com
  15. 15. Biocompatibility and implantBiocompatibility and implant designdesign • Successful clinical results are reported in implants, made up of commercially pure titanium, titanium alloys, hydroxyapatite coated implants, and few others like niobium. • More recently resorbable coatings have been developed for improving initial rate of bone healing against the implant surface and then resorb within a short time frame to allow establishment of a bone to metal contact. www.indiandentalacademy.com
  16. 16. Implant designImplant design • Has a great influence on initial stability and subsequent function. • The main design parameters are… • implant length • Implant diameter • Implant shape • Surface characteristics www.indiandentalacademy.com
  17. 17. Implant lengthImplant length • Generally available in lengths from about 6mm to as much as 20mm. • Most common lengths employed are between 8 and 15mm which correspond quite closely to normal root lengths. www.indiandentalacademy.com
  18. 18. Implant diameterImplant diameter • Most implants are approx. 4mm in diameter. At least 3.25mm in diameter is required to ensure adequate implant strength. • Important in the distribution of loads. • Up to 6mm are available, which are considerably stronger, but they are not so widely used because sufficient bone width is not so commonly encountered.www.indiandentalacademy.com
  19. 19. ImplantImplant shapeshape • Hollow-cylinders, solid-cylinders, hollow screws or solid screws are commonly employed shapes. • Are designed to maximize the potential area for osseointegration and provide good initial stability. • Screw shaped implants also offers good load distribution characteristics in function. www.indiandentalacademy.com
  20. 20. Branemark / nobel biocare implant Astra ST implant ITI straumann solid screw implant www.indiandentalacademy.com
  21. 21. Surface characteristicsSurface characteristics • The degree of surface roughness varies greatly between different systems. • Surfaces which are machined, grit-blasted, etched, plasma sprayed and coated are available. • By increasing the surface roughness there is the potential to increase the surface contact with bone but this may be at the expense of more ionic exchange and surface corrosion.www.indiandentalacademy.com
  22. 22. Machined surface Blasted surface (Tio-blast) Plasma sprayed surfacewww.indiandentalacademy.com
  23. 23. BONE FACTORS • Radiographic determination of bone quantity and quality should be considered. • The most favourable quality of jaw bone for implant treatment is that which has a well formed cortex and densely trabecular medullary spaces with a good blood supply. • cortical bone – initial stability, but easily damaged by overheating during drilling. (especially sites more than 10mm in depth) • Thin Cortical layer and sparse trabeculation – poor initial stability & fewer cells with good osteogenic potential to promote osseointegration. www.indiandentalacademy.com
  24. 24. www.indiandentalacademy.com
  25. 25. Factors which compromise bone quality are… • Infection • Irradiation • Heavy smoking • The effects of the latter two are a result of a diminution of the vascular supply to the bone which compromises the healing response. www.indiandentalacademy.com
  26. 26. LOADING CONDITIONSLOADING CONDITIONS • Following installation of an implant it is important that it is not loaded during the early healing phase. • Movement of the implant within the bone at this stage results in fibrous tissue encapsulation rather than osseointegration. • Currently there is no accurate measure which precisely determines the optimum period of healing before loading can commence. www.indiandentalacademy.com
  27. 27. • Bone quality can be assessed by measuring the cutting torque during preparation of the implant site. • The stability of the implant and increasing bone-to-implant contact has been quantified using Resonance frequency analysis. • This non-invasive research tool measures stiffness of the implant at the bone interface. www.indiandentalacademy.com
  28. 28. • Some systems employ a single stage approach in which the implant is installed so that it protrudes through the overlying mucosa (i.e non-submerged), although evidence of early loading is equally critical. • Following the recommended healing period, abutments are connected to the implant to allow construction of the prosthesis. www.indiandentalacademy.com
  29. 29. Prosthetic considerationsProsthetic considerations • Carefully planned functional occlusal loading will result in maintenance of osseointegration and possibly increased bone to implant contact. • In contrast, excessive loading may lead to bone loss and/or component failure. • Clinical loading conditions are largely depend upon : • The type of prosthetic reconstruction • The occlusal scheme • The number, distribution, orientation and design of implants • The design and properties of implant connectors • Dimensions and location of cantilever extensions • Patient parafunctional activities www.indiandentalacademy.com
  30. 30. The type of prosthetic reconstructionThe type of prosthetic reconstruction • This can vary from a single tooth replacement in the partially dentate case to a full arch reconstruction in the edentulous individual. • Implants which support overdentures may present particular problems with control of loading as they may be largely mucosal supported, entirely implant supported or a combination of the two. www.indiandentalacademy.com
  31. 31. The occlusal schemeThe occlusal scheme • The lack of mobility in implant supported fixed prostheses requires provision of shallow cuspal inclines and careful distribution of loads in lateral excursions. • With single tooth implant restorations it is important to develop initial tooth contacts on the natural dentition and to avoid guidance in lateral excursions on the implant restoration. • Loading will also depend upon the opposing dentition which could be natural teeth, another implant supported prosthesis or a conventional removable prosthesis. www.indiandentalacademy.com
  32. 32. The number, distribution, orientationThe number, distribution, orientation and design of implantsand design of implants • The distribution of load to the supporting bone can be spread by increasing the number and dimensions (diameter, surface topography, length) of the implants. • The spacing and 3-dimensional arrangement of the individual implants will also be very important. • The so-called ‘tripod’ arrangement of three implants is recommended in situations of high load, such as replacement of molar teeth in the partially dentate individual.www.indiandentalacademy.com
  33. 33. The design and properties of implantThe design and properties of implant connectorsconnectors • Multiple implants are joined by a cast or milled framework. • A rigid connector provides good splinting and distribution of loads between implants. • It is equally important that the connector has a passive fit on the implant abutments so that the loads are not set up within the prosthetic construction. www.indiandentalacademy.com
  34. 34. Dimensions and location of cantileverDimensions and location of cantilever extensionsextensions • Cantilever extensions have the potential to create high loads, particularly on the implant adjacent to the cantilever. • The extent of the leverage of any cantilever should be considered in relation to the anteroposterior distance between implants supporting the reconstruction. • The cantilever extension should not exceed this length and cross sectional design should be adequate to prevent flexing. www.indiandentalacademy.com
  35. 35. Patient parafunctional activitiesPatient parafunctional activities • Great caution should be exercised in treating patients with known parafunctional activities. • Excessive loads may lead to loss of marginal bone or component fracture. www.indiandentalacademy.com
  36. 36. There are great many factors to take into account to ensure predictable successful implant treatment. There is no substitute for meticulous attention to detail in all of these areas. Failure to do so will result in higher failure rates and unnecessary complications. www.indiandentalacademy.com
  37. 37. www.indiandentalacademy.com
  38. 38. For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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