Dental implant in esthetic zone


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Dental implant in esthetic zone

  2. 2. NOWADAYS osseointegrated implants are used, which have been proven to be totally biocompatible.
  3. 3. 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.
  4. 4. • PARTS OF IMPLANT1. Implant body2. Healing screw3. Healing caps4. Abutments5. Impression post
  5. 5. • CLASSIFICATIONA. Depending on placement within the tissue Endosteal implant subperiosteal implant transosteal implant
  6. 6. B.Depending on materials used Metallic ex: Non metallic ex: titanium ceramicC. Depending on design : screw shaped
  7. 7. Dental implantswill fuse withbone; howeverthey lack theperiodontalligament , sothey will feelslightly differentthan naturalteeth duringchewing.
  8. 8. 1. Uncontrolled diabetes2. Cardiovascular disorders3. Psychological disorders4. Systemic hematological disorders5. Smoking Drug and alcohol abuse6. Local pathology (root fragment, cyst, foreign body, granuloma)7. Problematic occlusal and functional relationships8. Irradiation of jaws9. Osteoporosis/ low bone mineral content
  9. 9. position of the incisive canal bone resorption in both a labial andThe verticalinfluence directionof the lipposition midline
  10. 10.  Analysis of appropriate and adequate radiographs. Analysis of mounted study models. Measurement of bone and mucosal thickness.
  11. 11. 1. Analysis of appropriate and adequate radiographs.Panoramic radiograph with template Lateral cephalometric radiograph
  12. 12. Computed tomography
  13. 13. 2. Analysis of mounted study models.
  14. 14. 3. Measurement of bone and mucosal thickness.using sterile needle with verniarubber stop X-ray ruler
  15. 15. 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.
  16. 16. 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
  17. 17. • 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.
  18. 18.  Preoperative measures Flap less and Flap Designs Crestal flap 3 sided flap
  19. 19. Crestal flap
  20. 20. 3 sided flap
  21. 21. 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.
  22. 22. 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.
  23. 23. 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.
  24. 24. • 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