Dental implants are artificial fixtures placed surgically into the jawbone to replace missing teeth. There are different types of implants including subperiosteal, transosseous, and endosteal implants, with endosteal implants being the most common today. The process of osseointegration, where bone bonds to the implant surface without soft tissue interference, was discovered in 1952 and refined for successful dental implant treatment. The surgical procedure for placing implants involves two stages - the initial surgery to place the implant fixture followed by a second surgery once osseointegration is complete to place the abutment and crown. Factors like patient health, bone quality and quantity, surgical technique, and loading conditions can
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
This seminar deals with implant-related complications that lead to implant failure.this also discus diagnostic criteria and preventive methods for an implant failure.
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
This seminar deals with implant-related complications that lead to implant failure.this also discus diagnostic criteria and preventive methods for an implant failure.
Attachments in implant retained overdentures/ cosmetic dentistry trainingIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Classification and impression techniques of implants/ dentistry dental implantsIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
lecture 1
Dental implant introduction
1- implant history
2-micro and macro inplant desigen features
3- patient medical evaluation
4- introduction to treatment planning
the dental implant design from the point of view of dental biomaterials and the effect of force factors on choice of implant design in correlation with bone defects and anatomical anomalies
Screw vs cement retained implant prosthesisApurva Thampi
This is a journal club presentation featuring a recent article regarding a screw and cement retained implant prosthesis.
the presentation and all its related material is available on request. Mail me at apurvathampi@gmail.com
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
Attachments in implant retained overdentures/ cosmetic dentistry trainingIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Classification and impression techniques of implants/ dentistry dental implantsIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
lecture 1
Dental implant introduction
1- implant history
2-micro and macro inplant desigen features
3- patient medical evaluation
4- introduction to treatment planning
the dental implant design from the point of view of dental biomaterials and the effect of force factors on choice of implant design in correlation with bone defects and anatomical anomalies
Screw vs cement retained implant prosthesisApurva Thampi
This is a journal club presentation featuring a recent article regarding a screw and cement retained implant prosthesis.
the presentation and all its related material is available on request. Mail me at apurvathampi@gmail.com
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
Split ridge and expansion techniques are effective for the correction of moderately resorbed edentulous ridges in selected cases.
Transverse expansion is based on osseous plasticity obtained by corticotomy. It progressively allows for an adequate transversal intercortical diameter large enough to insert one or several dental implants.
The gap created by sagittal osteotomy expansion undergoes spontaneous ossification, following a mechanism similar to that occurring in fractures.
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
3. Dental Implant
I. Definition
II. Indications
III. Materials used for dental implant.
IV. Types of dental implant
V. Osseointegration
VI. Surgical procedures
4. Dental implant is an artificial
mtallic or non metallic fixture
which is placed surgically into the
jaw bone to substitute for a missing
tooth or teeth .
DENTAL IMPLANT
6. History of Dental Implants
In 1952, Professor Branemark, a Swedish
surgeon, while conducting research into the healing
patterns of bone tissue, accidentally discovered that when
pure titanium comes into direct contact with the living
bone tissue, to form a permanent biological adhesion. He
named this phenomenon "osseointegration".
After years of careful research and study, dental implants
placed into the jawbone to support replacement teeth
were refined with high success rates.
7. Indications of dental implant
1. Patients who do not accept removable prosthesis
2. Where complete denture has deleterious effect on tissues
3. High gag reflex
4. Long edentulous span
5. Unfavorable number and location of abutments
6. When it offers to solve psychological problems associated
with edentulism
7. esthetics
8. Types of dental implant
1. Sub-periosteal implant
2. Transosseous
(transmadibular)implant
3. Endosteal or Endosseous implant
22. (Patients selection)
1. Medical history.
2. Psychological status.
3. Dental history.
4. Study cast
5. Clinical and radiographic examination
6. Decision making and surgical phases
23. I. Medical History
Diseases that complicate or contraindicate
of implant selection:
1. Bleeding disorders
2. local or systemic bone diseases
3. Maxillofacial radiotherapy
4. Uncontrolled diabetes
5. Epilepsy
6. Hormonal dysfunctions
7. tobacco and alcohol
24. Pt selection
Psychological Status.
The dentist assesses the patient's
attitude, ability to cooperate during
complex procedures, and overall
viewpoint on dental treatment.
25. Pt selection
III. Dental History
It is also vital to evaluate the patient’s
chief complaint, or pt demand.
For example, the treatment plan
recommended to the patient desiring a more
secure lower denture will be quite different from
the one proposed to the patient seeking a fixed
and rigid appliance.
26. Evaluation of Implant Site
Clinical examination.
Visual inspection and Palpation
27. Pathologic conditions in the
jaws
Status of remaining teeth
Quality of the bone (bone
density)
Quantity of the bone height and
diameter of implant
Vital structure and anatomical
27
34. Osseo-integration
Osseointegration refers to the
structural, and functional union between
functional implants and healthy bone
without soft, noncalcified connective
tissue intervening
41. 4- Bone Quality
Quality I (D1)
Was composed of homogenous
compact bone.
42. 4- Bone Quality
Quality II (D2)
Had a thick layer of
cortical bone surrounding
dense trabecular bone,
usually found in the
posterior lower jaw.
43. 4- Bone Quality
Quality III (D3)
Had a thin layer of
cortical bone surrounding
dense trabecular bone
44. 4- Bone Quality
Quality IV (D4)
Had a very thin layer of
cortical bone surrounding a core of
low-density trabecular bone
45. 4- Bone quantity
Implants placed in the posterior mandible are
usually shorter, do not engage cortical bone
inferiorly, and must support increased
biomechanical occlusal force once loaded.
As a result, slightly increased time for
integration may be beneficial.
Additionally, if short implants (8 to 10 mm) are
used, it is advisable to "overengineer" and to
place more implants than usual to withstand the
occlusal load.
46. 4- Bone quantity
the quality of the bone in the
maxilla, particularly the posterior
maxilla, is poorer than mandibular
bone.
which affect treatment planning
because increased time must be
allowed for integration of implants.
47. 5- Surgical technique
a) Prevent Heat generation
b) Precisely implant site preparation
c) post insertion care
48. 5- Surgical technique
Heat generation
If the temperature rises, alkaline phosphatase within
the bone is denatured, which prevents alkaline
calcium synthesis.
Temperatures at 47° -56° C, lead to irreversible bone
damage occurs.
49. 5. Surgical technique
Heat generation
So careful cooling while surgical drilling is performed at low
rotatory rates
Use of sharp drills
Use of graded series of drills
High torque (35-55N)
50. 5- Surgical technique
Heat generation
Copious irrigation by either internal or external
methods to keeps mean maximum temperature
not exceed 47°C.
51. Surgical technique
B-Precisely implant site preparation
4
Use of sharp drills
Use of graded series of drills
High-torque drills are
essential to precise a
traumatic bed preparation
52. C- post insertion care
Once the implant is placed, a healing cover is inserted
and the mucosa is sutured over the implant.
In some cases the implant is not covered and a short
healing screw protrudes through the gingival.
In all cases the implant is protected from occlusal
forces.
56. 6. Loading condition
1. Immediate loading:
(placed within 48 hours postsurgery)
3-Delayed loading:
implant remain functionless for 3-6 months
57. 7- Soft Tissue-to-Implant Interface
The successful dental implant should have an
unbroken, perimucosal seal between the soft
tissue and the implant abutment surface.
To maintain the integrity of this seal, the patient
must maintain a high level of oral hygiene
specific to dental implants.
58. Timing of implantation
Treatment options
• immediate - place implant at time of tooth
extraction
• delayed - 9-10 months or longer
immediate will not allow bone resorption, but
delayed allows bone fill for stabilization
59. Immediate placement in extraction
socket
implant placement at the time of extraction
will require the following:
• No purulent drainage or exudate from the
site
• Excellent gingival tissue quality without
excessive granulation tissue
• Lack of periapical, uncontrolled
radiolucency
• Adequate bone levels circumferentially
without the need for additional soft or
hard tissue grafting
60. Implants placed in fresh extraction sockets must have 4 mm of precise fit
along apical aspect of implant. They should be countersunk 2 mm, and
gap between sides of extraction socket and implant should be less than
1 mm. If gap is greater than 1 mm, grafting with demineralized allogeneic
bone should be considered.
61. Surgical procedure
The placement of osseointegrated
implants includes two stages:
Stage one surgery
Stage two surgery
62. Basic Treatment Order
1. Examination—clinical and radiographic/medical history/pathological test, etc.
2. . Fabrication of provisional or transitional restorations
3. . Fabrication of surgical guide or stent
4. . Surgical placement of implants
5. . Allow adequate time for osseointegration
6. . Prosthodontics phase
7. . Maintenance phase
Decision regarding the treatment order may vary, based on the degree
of difficulty. But, for cases involving a traditional plan, the following may
be used.
70. Reflection of flap and exposure of bone where implants are to
be placed.
71. Implant Recipient Site Preparation
- Guiding drill
the round guide bur first used to flatting
the bone at the implant site with speed,
approximately 2000 rpm
Constant irrigation of saline solution, while
the bur must move in an up-down
direction
73. Preparation of initial recipient site with a 2-mm-
diameter bur and placement of paralleling pin.
74. The entire length of the recipient sites
is widened with serial diameter of
drills according to the diameter of
the selected implant and the
quality of the bone.
83. Implant Placement
After the desired depth and diameter of the
recipient site is accomplished, the implant is
placed using implant carrier .
Avoid implants touching with instruments made of
a dissimilar metal or by contact with cloth, soft
tissue, or even surgical gloves that may affect the
degree of osseointegration.
84. Implant Placement
In this step, the implant is adapted to the
receiver of the implant mount, which has
been placed in the low-speed contra-angle
handpiece and is transferred to the
implant recipient site. The implant is
screwed into the bone without pressure.
85. Implant Placement
Afterwards, a cylinder wrench is used to screw
the implant manually as far as the deepest
part of the recipient site. The implant mount
is removed either by hand using a
screwdriver, or mechanically with a
screwdriver attached to the lowspeed contra-
angle handpiece.
86. Cover screw placed
In the final step, a cover screw is placed,
screwed over implant, thus preventing
intervention or proliferation of the mucosal
tissues inside the implant. Final tightening
must be done by hand, being careful that it is
not so tight that removal is rendered difficult
in the second stage of surgery.
87. Wound closure
the wound is closed. A tension-free closure is
important to prevent wound dehiscence.
Horizontal mattress closure with
monofilament suture will produce a
watertight closure.
88. Post operative care
A radiograph should be taken postoperatively to evaluate the
position of the implant in relation to adjacent structures
-antibiotics
-analgesics for management of postoperative pain.
-Regular oral hygiene
- The sutures are removed 7 days after the operation.
90. Delayed postoperative care
The patient is evaluated on a weekly basis
until soft tissue wound healing is complete
(approximately 2 to 3 weeks). If the patient
wears a denture over the area of implant
placement, the denture can be relined with
a soft liner after 1 week and may be worn.
93. second stage of the surgical
procedure
Uncovering
The length of time necessary to achieve integration
varies from site to site and may require modification
based on the particular situation. Successful loading
with shorter integration times has been reported
when various protocols are follow.
94.
95. the second phase of the surgical
procedure
Abutment Connection.
After the first-stage surgical procedure, the second phase of the surgical
procedure follows, which involves the exposure of the implants and
the placement of abutments on the implants. After administration of
local anesthesia, the position of the implants is identified with
palpation and the cover screw is localized using an explorer.
Exposure is achieved with a continuous incision on the alveolar
mucosa, corresponding to the pre-calculated positions of the implants.
104. A radiograph to ascertain the precise connection between
the abutments and implants is only necessary for external
implant abutment connections (Branemarktype).
Then 15–20 days after placement of the abutments, the
patient is ready to begin the procedure for a fixed or mobile
prosthetic restoration .
A bar may be fabricated joined to the implants with screws,
and an over denture may be adapted to the bar with the aid
of clips.
105. Implants joined by over-denture bar over which
prosthetic restoration is to be placed
106. Complications
The main complications that may arise during placement
of the implants as well as postoperatively are:
Damage to adjacent anatomic structures, in the case of
perforation of the maxillary sinus, nasal cavity, and
mandibular canal by the implant
107. Complications
Failure of osseointegration, which may be due to
premature loading of implants during the
healing period, to bone damage because of the
surgical procedure, to improper design of the
prosthetic restoration or ill-fitting prosthetic
work, and to poor judgment of the quality of
bone at the implant recipient site
108. Complications
Gingivitis, gingival hyperplasia, or the
appearance of a fistula
Exposure of implant threads
Fracture of implant, which usually involves
the abutment screw or the implant itself
109. Criteria for successful implants
• Implant clinically immobile
• No radiographic evidence of any peri-implant
radiolucency
• Vertical bone loss of <0.2 mm after the first year of
function
• Absence of any symptoms, such as pain, infection,
numbness, or maxillary sinus or nasal symptoms
• Success rate of 85% after 5 years and 80% after 10 years
110. ADVANTAGES Of DENTAL IMPLANTS
1. Aids in bone maintenance—prevents the
progress of residual ridge resorption.
2. Restoration and maintenance of occlusal
vertical dimension.
3. Maintenance of facial esthetics (muscle tone)
Implants also provide a natural emergence
profile.
4. Improved phonetics
5. Improved occlusion
6. Improved occlusal awareness
7. Improved masticatory performance,
maintenance of masticatory muscles and
muscles of facial expression
8. Reduced size of prosthesis
(elimination of palate or flanges)
9. Provision for fixed or removable
prosthesis
10. Improved stability and retention
of fixed prosthesis implants provide
stable retention due to
osseointegration
11. Eliminates need to alter adjacent
teeth
12. More permanent replacement
13. Improved psychological health
14. Improved comfort level.
111. Basic principles of implant surgery
1. Implants must be sterile and made of a biocompatible material (e.g.,
titanium).
2. Implant site preparation should be performed under sterile conditions.
3. Implant site preparation should be completed with an atraumatic
surgical technique that avoids overheating of the bone during
preparation of the recipient site.
4. Implants should be placed with good initial stability.
5. Implants should be allowed to heal without micro-movement
111