Dental implants

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Dental implants

  1. 1. -Dental implants (features and materials). -Medical and dental evaluation before implant placement. -Techniques of implant placement. -Surgical and post-surgical complications. -Providers of implant supported prosthesis.
  2. 2. Features of the ideal implants :Implants have to • Induce healing and bone formation . • Be easily removed if needed . Have appropriate reactions with • surrounding living tissues (biocompatibility) . • Resist the acting loads and probable overloads . Resist the long-term actions like fatigue,• ..corrosion, etc • Be easily sterilized .
  3. 3. Possible problems upon using the implant materials: - Inflammation - Infection - Rejection
  4. 4. First Implant Design by Branemark   All the implant designs are obtained by the modification of this design.
  5. 5. Dental implant materials Titanium / Alloys �Easily available. �Lightweight, corrosion resistant, easily milled into different shapes, while maintaining its strength. �Forms layer of titanium oxide, which is a stable and reactive interface that becomes coated with plasma proteins. �Ti-6Al-4V was alloyed to create a biocompatible material with added strength.
  6. 6. Dental implant materials (cont.) . Zirconium � An inert material with very low allergic potential. � Has outstanding physical and mechanical qualities. � Zirconia implants have proven high level of osseointegration and bone-toimplant contact.
  7. 7. Dental implant surface treatment Dental implants with rough surfaces have been designed to improve early healing, especially in areas of poor bone or insufficient bone quantity � Acid-etching. �More threads. �Coating implant surface with different materials that can enhance the healing: -Plasma. -hydroxyapatite. -Bone morphogenic protein. -Osteoprotein.
  8. 8. Implant thread Bone
  9. 9. .Astra Tech ITI Bicon More than 350 implant systems and 145 manufacturers
  10. 10. 1- Having no disease or condition that interferes with proper healing after implant surgery. 2- Having enough amount and density of jaw bone, to secure the implants.
  11. 11.  Cardiovascular  Respiratory  Renal  Musculoskeletal  Neurological  Endocrine Surgical or anesthetic ? contraindications
  12. 12.        Diabetes. Coronary artery disease. Alcoholism. Drug therapy - anticoagulants. - anti epileptics. - antidepressants. - others. Osteoporosis. Smoking. Pregnancy.
  13. 13.    Bone Quantity Bone Quality Associated structures - inferior alveolar nerve - mental nerve - maxillary antrum - nasal floor - incisive canal  Pathology - periapical pathology - cysts - other pathology
  14. 14. - OPG Lateral Cephalogram Periapicals - AxialCT Scan Coronal 3D reconstruction Dentascan MR - -
  15. 15. Bone quantity Bone width Bone height
  16. 16. Bone quality D1 DD DD D D2 D3 D4 Bone Quality relates to the degree of bone density present. Type 1 is dense bone, which provides great cortical anchorage, but limited vascularity. Type 2 bone is the best bone for osseointegration of dental implants. It provides good cortical anchorage for primary stability, yet has .better vascularity than Type 1 bone .Types 3 and 4 are soft bone textures with the least success in type 4 bone
  17. 17. Implant placement Surgical timing There are different approaches to place dental implants after tooth extraction. The approaches are: Immediate post-extraction implant placement. Delayed immediate post-extraction implant placement (2 weeks to 3 months after extraction). Late implantation (3 months or more after tooth extraction).
  18. 18. Implant placement .( (cont Surgical procedure: - Two - stage technique. - One - stage technique. Surgical approach: - Raising a mucoperiosteal flap. - Flapless technique.
  19. 19. Placement of implants by raising a mucoperiosteal flap INITIAL SURGERY INITIAL INITIAL SURGERY
  20. 20. Two-stage implant placement procedure Stage one Stage two
  21. 21. One- stage implant placement 1111 5 222 2 4 3 6 7 8
  22. 22. One- stage implant placement .( cont )
  23. 23. Flapless technique A surgical approach of implant placement without raising a mucoperiosteal flap. .
  24. 24. Advantages: -Shorter and faster surgical treatment procedure of implant placement, and by that, less time is needed for the complete implant-prosthetic restoration. . -Minimal bleeding and postoperative discomfort for the patient. - Possibility of immediate loading of the inserted implant. -
  25. 25. Immediate implantation An implant can be placed on the same day as an extraction if good amount of bone is available and if there is no any infection around the existing . tooth When teeth are lost, bone will shrink in several dimensions. Placing an implant immediately can reduce this bone loss and provide a .. better esthetic result
  26. 26. Surgical and post-surgical complications - Bleeding and bruising - Post-surgical pain Post-surgical infection -Chronic painDelayed healing - HematomaAbscess -GingivitisOsteomyelitisSequestrum - Local or systemic infection- Bone fracture - Loss of alveolar ridgeFistula to nose or sinus -Temporary speech problemsTransient or permanent damage to the nerves in thejaw
  27. 27. Success Rates
  28. 28. Who can provide implant supported dental prosthesis ? The general dentist is usually the first resource for this service. The key is the implant dentist’s training, experience and credentials Competent dentists include periodontists, prosthodontists and oral surgeons who perform surgical and/or restorative procedures.

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