classification of implants

2. IMPLANTS
Presented by
Dr.ABBASI BEGUM
PG - DEPT.OF PROSTHODONTICS
Narayana Dental College and Hospital

3. COMPONENTS &
CLASSIFICATION OF
IMPLANTS

4. content
Introduction
Definitions
Implant components
Classification of implants

5. Introduction
Implant dentistryImplant dentistry is a boon for
restoration of missing teeth
It overcomes many disadvantages of
other conventional methods of
restorations i.e with removable
prosthesis & with fixed prosthesis.

6. DEFINITION OF IMPLANT
A substance or other tissue, which
partially or completely inserted or
grafted into the body for therapeutic,
diagnostic, prosthetic or experimental
purposes.

7. Implantology
Study of art & science concerned
with the surgical insertion&
restoration of material & devices
restoring the partially or totally
edentulous patients to function
or
The study or science of placing &
restoring dental implants- GPT

8. Dental implants
A prosthetic device made of
alloplastic material(s) implanted into
the oral tissues beneath the mucosal
on/or within the bone to provide
retention & support for removable or
fixed dental prosthesis ;a substance
that is placed into or/and upon the
jaw bone to support a removable or
fixed dental prosthesis.

9. INDICATIONS FOR IMPLANTS
1. For completely edentulous patients
with advanced residual ride
resorption, where it is difficult to
obtain adequate retention.
2. For partially edentulous arches
where RPD may weaken the
abutment teeth & also provides
reduced masticatory efficiency.
3. For single tooth replacement
4. Patient’s desire.

10. Advantages
To overcome the drawbacks of
removable prosthesis
Bone maintenance of height & width
Ideally esthetic tooth positioning
Improved psychological health
Increased stability in chewing
Increased retention
Eliminates need to involve adjacent
teeth

11. Parts

12. Parts
1. Implant body
2. Healing screw
3. Healing caps
4. Healing abutment or per mucosal
extension
5. Abutment
6. Hygienic screw
7. Prosthesis retaining screw

13. 1. Implant body
• The component that
is placed within the
bone during first
stage of surgery
• It could be threaded
or non threaded
• Threaded implants
are available in
commercially pure
titanium or as
titanium alloys
• The Ti or Ti alloys
may be with or
without a
hydroxyapatite
coating.

14. First stage cover screw or healing
screw
First stage :
Cover is placed
into the top of
the implant to
prevent bone
,soft tissue or
debris from
invading the
abutment
connection area
during healing

15. Functions of healing screw
Facilitates suturing of soft tissues
Prevents growth of the tissues over
the edge of the implant
3)Healing caps
Dome shaped screws placed over the
healing screw after 2nd
stage of
surgery & before insertion of
prosthesis.

16. Length ranges from 2-10mm
They project through the soft tissues
into the oral cavity
They function to prevent overgrowth
of tissues around the implant….

17. Permucosal extension :healing
abutment
After a prescribed healing period sufficient to
allow a supporting interface to develop a
second stage procedure is performed.
To expose the implant or to attach a
transepithelial portion
It is called Permucosal extension because it
extents the implant above the soft tissue &
results in development of Permucosal seal
around the implant.

18. Also called as healing abutment
because ;
Stage 2 uncovery surgery often uses this
device for initial soft tissue
healing…….

19. Implant abutment
Implant abutment is the
intermediate
connector between the
implant and the
restoration, it may
extend above the
tissue. In some
instances is
subgingival, to provide
a more esthetic
restoration.

20. Implant abutment
supports or retains a prosthesis or
implant super structure
Defined as: a metal framework that fits
the implant & provides retention for a
removable prosthesis
OR
Provides the framework for a fixed
prosthesis.

21. Categories of implants
Depending on method by which the
prosthesis is retained to abutments
1. Abutment for screw retention
2. Abutment for cement retention
3. Abutment for attachment
Uses an attachment device to retain
a removable prosthesis such as o-
ring attachment
Used for CD & or partial dentures.

22. Hygienic cover screw
An abutment for screw retention uses
a hygienic cover screw placed over
the abutment;
To prevent debris & calculus from
invading the internally threaded
portion of abutment during prosthesis
fabrication.

23. Transfer coping:
A metallic, acrylic resin, or other
covering or cap used to position a dye
in an impression
to position an analog in an
impression
It is defined by portion of implant it
transfers to master cast.
1. Implant body transfer coping or
2. the abutment transfer coping

24. Transfer technique
Two technique
• Indirect
• Direct
Indirect– impression material requires
elastic properties.
Indirect transfer coping is screwed
into abutment or implant body
remains in place when set
impression is removed from
mouth..

25. Parallel sided or slightly tapered
To allow ease in removal of impression
Flat sided or smooth undercuts
To facilitate reorientation in the impression
after removal
Direct technique
Direct transfer coping consists of hollow
transfer component, often square & a long
screw to secure it to abutment or implant
body.
Used as pick up impression coping
They remain within the impression until
master model is poured & seperated.

26. Impression post
It is a small stem that facilitates the
transfer of te intraoral location (of the
implant or the abutment )to a similar
position on the cast
They are placed over the implant
body during impression making.

27. Impression posts
27

28. Analog
Used in fabrication of master cast
To replicate the retentive portion of
implant body or abutment
1. Implant body analog
2. Implant abutment analog
After master impression the analog
is attached to transfer coping & the
assembly is poured in stone to
fabricate master cast.

29. These are machined structures ,which
represent the body of implant
Placed on laboratory cast in order to
fabricate an implant supported prosthesis
During surgery, after the implant body is
inserted into the prepared bone cavity,the
impression post is placed over it.
An impression is made & the analogue
impression post complex gets attached to
impression & comes away with it.
When the impression is poured ,the
impression post analogue complex will get
embedded to the cast.

30. Laboratory analogs
30

31. A prosthetic coping
A thin covering to fit implant abutment
for screw retention & serve as
connection between abutment & the
prosthesis superstructure.
Prefabricated coping
A castable coping
A prosthetic screw;
a screw retained prosthesis is secured
to implant body or abutment with a
prosthetic screw…

32. 32
Classification of implants
1. Based on placement within the
tissue
A)endosteal a)ramus frame
b)root form
c)blade form
B)Subperiosteal
C)Transosteal
D)Intramucosal

33. 33

34. Subperiosteal implants

35. Subperiosteal implant
Derive primary support by resting on
the bone
Indicated when there are several
missing teeth or when there is no
enough jaw bone width & height
can easily fit over the jaw bone &
provide root for multiple teeth

36. Endosteal implant
36

37. Endosteal implants
It is the most common & successful dental
implant today.
Placed directly into the bone & works like a
natural tooth.
Made up of metal, ceramic, or polymeric
material
3 types root form
blade form
ramus frame form

38. Root form Implant
Used over a vertical
column of bone
Available in different forms
i.e cylinder or press fit
form, screw root form &
combination root form
Cylinder root form
depends on microscopic
retention
It is tapped or pushed into
the prepared bone site
Screw root forms have
threads & have
macroscopic retention
which provides superior
bone fixation

39. Blade form implant
Also known as plate form implant
Less common type of implant
indicated: when the jaw bone is too
narrow & not suitable for bone
grafting

40. Ramus frame
Indication: when pt
has no enough
bone or thin bone
It is a metal bar to
provide root to
replace missing
teeth

41. 41
Transosteal implant
Penetrates both cortical plates &
passes through the entire thickness
of the alveolar bone

42. Mucosal inserts
42

43. Intramucosal implants
Used with removable dentures
Have mushroom shaped design
It will attach to the gum side of the
denture
Help to increase the chewing
efficiency

44. 2)Based on attachment mechanism
of implants
1. OSSEOINTEG
RATION
2. FIBRO
INTEGRATION

45. FIBROINTEGRATION
Proposed by Dr. Charles Weiss
Complete encapsulation of the
implant with soft tissues
Soft tissue interface could resemble
the highly periodontal fibers of mature
dentition.

46. Osseo-Integration
Direct contact between the bone &
the surface of the loaded implant
Described by BraneMark
Bioactive material that stimulate the
formation of bone can be used

47. 3)Based upon materials used
1.Metallic implants- Commercially pure
titanium
Titanium alloy
Cobalt chromium
molybdenum
2.Nonmetallic implants- Ceramics
Carbon
47

49. Cylindrical dental implant
In the form of cylinder
Depends on coating or surface
condition to provide microscopic
retention & bonding to the bone
Pushed or tapped into the prepared
bone site
Straight, tapered or conical

50. Threaded Implant
The surface of the implant is threaded
to increase the surface area of
implant
This results in distribution of forces
over a greater peri- implant bone
volume

51. Perforated dental implant
The implant of inert micro porous
membrane (MIXTURE OF
CELLULOSE ACETATE)in intimate
contact with & supported by the layer
of perforated metallic sheet material
(pure titanium)

52. Solid dental implant
Circular cross section without vents or
hollow in the body

53. Vented dental implants
In the hydroxyapatite coated cylinder
implant patented vertical grooves
connecting to the apical vents were
designed to facilitate seating & allow
bone ingrowth to prevent rotation

54. Hollow dental implant
Hollow design in the apical portion
Systemically arranged perforations on
the sides of the implants
Increased anchoring surface…..

55. Cylindrical Screw shaped implants.
Threaded Non threaded.
55

56. 5)Classification based on surface of
implants
Smooth surface
Machined
Textured
coated

57. Smooth surface implants
Has very smooth surface
Prevents microbial plaque
retention
Machined surface implants
For the purpose of better
anchorage of implant to the bone,
the surface of the implant is
machined….

58. Textured implant
The implant of increasing surface area
to which the bone is bond
Coated
The implant surface is covered with a
porous coating
The material used for coating are
1. Hydroxyapatite
2. titanium

59. Hydroxyapatite coatings

60. 6)Based upon their surface coating
1. Titanium plasma sprayed
2. Hydroxyapatite coating
3. Grid blasting with TiO
4. SLA (sandblasted-large grid-acid
etched)
5. Acid etched
6. Machined surface

61. Titanium plasma sprayed coating
(TPS)
6-10 times increase surface area.

62. Sand blasting large grid Acid
etching
Decrease in contact angle by 100 –
better cell attachment.
Acid etching with 1% HF and 30%
NO3 after sand blasting – increase in
osseointegration by removal of
aluminum particles (cleaning).

63. Based on implant material
Metallic
Ceramic
Polymer
Metallic :most popular material used is
titanium
Other materials are-stainless steel
-cobalt chromium
molybdenum alloy
-vitallium

64. Ceramic & ceramic coated implant
These materials are also used to coat
the metallic implants
These ceramics can either be plasma
sprayed or coated to produce bio-
active surface
Non reactive ceramic material are
also present

65. Polymeric material
In the form of polymethylmethacrylate
& poly tetrafluroethylene
Have only been used as adjuncts
stress distribution along with implants
rather than used as implants by
themselves.

66. Based upon the surgical stage
Two stage implants One stage implant
66

67. Two stage implant
Multi component implant system is used
During the first stage ,the implant body is seated
in the bone & completely covered with
mucoperiosteal flap
The fixture is allowed to heal with bone
(osseointegration)
The second stage is done 6 weeks after the first
surgery
During the second surgery the implant fixture is
uncovered so that the prosthetic component can
be placed over the implant

68. Advantage:
• Direct observation of crestal bone
volume before osteotomy
• Direct observation during osteotomy
preparation
• Ability to bone graft the site at the
time of implant placement
• Implant body healing at or below the
crest of bone, which reduces the
risk of early loading during initial
bone healing

69. Local hygiene issues or anaerobic bacterial
infiltration are not critical factors during
initial healing
The ability to deliver a soft tissue –borne
transitional appliance in the esthetic zone
During second stage
The crestal & the facial region may be
directly evaluated &
Minor defects corrected before beginning
the prosthetic reconstruction
The facial plate of bone may resorb during
initial healing & may be grafted during the
second surgery

70. One stage implant
The implant fixture is placed such that
the prosthetic post of the implant
extends into the oral cavity
They are usually stabilized by inter
implant splints to avoid the action of
excessive loading forces on the
implant during healing phase
At the conclusion of the surgery ,a
Permucosal Healing Element (PME)
is placed into the implant body

71. Implant body is usually placed slightly
above the crest of the bone
Soft tissue is then placed around the
PME

72. Based upon tissue response
o Biotolerant materials-
polymethylmethacrylate
o Bioinert materials-titanium and aluminium
oxide
o Bioactive materials-glass and calcium
phosphate ceramic
72

73. References
1. Atlas of oral Implantology-
2. Contemporary implant dentistry –
Carl.E.Misch
3. Prosthodontic treatment for
edentulous patients-complete
dentures & implant supported
prosthesis-Zarb -Bolender

74. Thank
you