NOWADAYS osseointegrated implants are used, which have been proven to be totally biocompatible.
Dental implant: is a "root" device, usuallymade of titanium (or may use zirconium),used in dentistry to support restorationsthat resemble a tooth or group of teeth toreplace missing teeth.Osseointegration: is a process refers to thedirect fusion between mental implantsurface and the healthy surrounding bone.
• PARTS OF IMPLANT1. Implant body2. Healing screw3. Healing caps4. Abutments5. Impression post
• CLASSIFICATIONA. Depending on placement within the tissue Endosteal implant subperiosteal implant transosteal implant
B.Depending on materials used Metallic ex: Non metallic ex: titanium ceramicC. Depending on design : screw shaped
3. Measurement of bone and mucosal thickness.using sterile needle with verniarubber stop X-ray ruler
1. Width and height of available bone.2. Soft tissue condition.3. Smile line.4. Color of teeth.5. Symmetry.6. Position of the implant.
SMILE LINEsmile line is defined as the relationship between theupper lip and the visibility of the gingival tissue andteeth. Its imaginary line following the lower margin ofthe upper lip and usually has a convex appearance ;it could be classified in to: high average low
• The other line is formed by the bottom edge of the upper teeth. Ideally this line should follow the curvature of the lower lip.• A straight flat line is less pleasing.• A reverse curve where the front teeth appear to be shorter than the canines gives a look of aging and wear and can be quite unattractive.
Preoperative measures Flap less and Flap Designs Crestal flap 3 sided flap
For single tooth replacement, and If there is sufficient boneavailable also for esthetic reasons the mucoperiosteal flapshould leave a 1mm margin of sound interdental papillatissue to insure that it maintain fine . length ofmucoperiosteal must not exceed two times its width inorder not to compromise the blood supply.
Dr. PAUL A. FUGAZZOTTO (1998) noted the preciseﬂap design should be governed according eachindividual situation, and not by an overall generic ﬂapdesign. He categorized implant sites for single-toothmaxillary anterior placement as follows:Class I: Minimal or no ridge atrophy buccolingually orapicocoronally.Class II: Minor buccolingual atrophy with noapicocoronally .Class IIA: Both minor buccolingual and apicocoronallyatrophy.
Class III: Moderate buccolingual ridge atrophy withno apicocoronal deﬁciency dehiscence and/orfenestration.Class IIIA: The same as Class III, accompanied bymoderate apicocoronal ridge atrophy.Class IV: Moderate-to-severe buccolingual ridgeatrophy with or without an apicocoronal component;as a result, the hard tissue atrophy precludes idealimplant positioning and necessitates hard tissueaugmentation prior to implant placement.
• First using round as Pilot bur.• Twisted bur with triangular end to determine the length.• Master bur which is round bur with blind end to determine the width of the bone.• During bone preparation, the temperature most not exceeds 43c because it causes osteocyte necrosis.• Insertion of implant body and suture this will end the first stage fixture have to stay about 3 month in mandible and 5-6 month in maxilla.• After that 2nd stage start which is exposed implant body again remove the cover screw and insert healing cap for up to 20 days after that the crown sealed and