o Introduction! o Importance of Teeth in Early Civilizations! o History of Methods for Tooth Replacement !o Implants! o Definition of Implants! o History of Implants! o Types of Implants (2 main classifications)!o Uses of Implants in Dentistry!o Procedural Steps.!o Indications and Contraindications!o Advantages and Disadvantages!o Implant Systems in the Market Today!!o Recent Advancements in Implant Tx Planning (3D Imaging).!
o Replacing teeth and having proper alignments have been a significant concern since the creation of human kind.!o The importance of teeth has been documented by many civilizations. !o Sound, healthy teeth were highly valued by the early Hebrews. !
" Ancient people of southern North America went to “dentists”- among the earliest known-to beautify their teeth with notches, grooves and semi-precious gems.!" !" !" ! 2500 years ago!" They were not marks of social class!! But instead meant for pure decoration… !
" !o Both the value and beauty of teeth were identified in the Old Testament book, Song of Solomon (Chapter 4, Verse 2),! " “Your teeth are white as sheep’s wool, newly shorn and washed, perfectly matched, without one missing.” !" These words express the esthetic concepts of color, evenness, alignment, bilateral symmetry, and completeness. They also convey the value and appreciation placed upon teeth.!
" !" Several dental treatments for infected and carious teeth have been documented in the ancient ages;!o Dental Drills; (As early as 5500 B.C)! Have been existing since! 9000 yrs ago!! Small bow used to drive! the flint drill tips into! the patient’s teeth, to! prepare the cavity and ! form a perfect hole.!
" !o Open-Mouse Surgery; (As early as 2600 B.C)! Ancient Egyptians believed! that mice warm blood cures! and relieves pain.! A procedure of opening a ! live mouse body to drain ! and place its blood over the! infected/painful tooth.!
" !" Over the centuries, several methods by different civilizations have been used for tooth replacement;!o Sea-Shells; They were hammered into the jaw to replace missing teeth.!o Ivory.!o Tooth Implantation.!o Tooth Transplantation.!
" !" !o Early Dentures; (As early as 700 B.C)! were purely cosmetic and ! not until the 1700s that ! dentures were made in ! such a way to be functional ! as well as cosmetic.!
" " Implants are endosteal alloplastic biocompatible material, that is surgically inserted into the edentulous bony ridge to restore form and function.!! OR:"" " It is a prosthetic device or alloplastic material implanted into the oral tissues beneath the mucosal or/and periosteal layer, and/or within the bone to provide retention and support for a fixed or removable prosthesis. Definition of the Glossary of Prosthodontic Terms.!
Brånemark;!During the 1970s implantologygrew.!At this time Branemark wasdeveloping an extraordinarystudy in Sweden. He wasinterested in micro-circulationduring bone healing.!He accidentally discovered thatthe titanium was incorporated inliving bone in an unexpected way(biocompatible).!
Brånemark;!He realized at that time that there isformation of a layer that acts as anattachment b/w the bone and thetitanium, leading to complete healing ofbone around the implant.!He termed this layer of interface as“Osseointegration”.!During the 1980s, Brånemark broughthis research to the United States where itwas presented.!It was considered as an overwhelmingimprovement. In return they quicklyadopted these principles.!
o Osseointegration has two main definitions;! o Histological Definition:! " Direct structural and functional connection between ordered living bone and the surface of the load carrying implant.! o Clinical Definition:! " A process whereby clinically asymptomatic rigid fixation of alloplastic materials is achieved and maintained in bone during functional loading.!
According to the Surgical According to the Surface Procedure Treatment
There are 3 main categories of implants: (According to the surgical approach)!1- Subperiosteal Implants;!" This type of implant is non-osseointegrated framework that rest on the surface of the jaw. It simply lays over the bone BUT under the gums. Used in cases where there is severe bone resorption in the mandible.!2- Transosseous Implants;!" Through-and-through implants.!3- Endosseous Implants; (Blade, Root/Screw and the Cylinder form) !" Within bone implants. Those implants are the widely and most commonly used type. They are manufactured with a variety of lengths and widths to suit the patients’ conditions.!
Another classification is according to the Implant surface treatment;! Commercially pure titanium Machined Ti-Al-Vanadium Hydroxyapatite (HA) Coated/Added Rough TPS Uncoated/Subtracted Acid Etched TiO2-Blast SLA Sandblast
" !1- For replacement of a single missing tooth;!" !
3 steps:!1- Surgical placement of the fixture into the bone, that is done by special implant handpiece and under L.A.!
" A sufficient healing time is required for proper osseointegration (usually 3-6 months).!
2- A minor surgical exposure of the fixture takes place here. A post is placed, which will act as an attachment for the prosthetic crown. Also done under L.A.!
3- This final stage is the prosthetic one. Where a crown will be fabricated in the laboratory for this implant. In order to restore a natural-looking appearance.!
o Implants are indicated as a treatment option available for any patient regardless of age or gender.!
o Relative Contraindications;! o Pathology of the hard or soft tissue.! o Patients with drug, alcohol or chewing tobacco abuse.! o Patients with chronic diseases; Diabetes, high blood pressure.!o Absolute Contraindications;! o Hematological system disorders; Hemophilia.! o Patients undergoing radiotherapy.! o Patients with psychiatric issues/problems.!
" Overall there are 8 suppliers for implant systems, where only 7 are approved by the ADA.!