Implants in orthodontics 2 /certified fixed orthodontic courses by Indian dental academy

Implants
in orthodontics

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INDIAN DENTAL ACADEMY
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contents
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Introduction
Historical background
Classification of implants
Basic terminologies
principles


Historical background


 Earliest dental implants used were of stone
& ivory, cited in archeological records of
china & Egypt , before the common era.
 Gold & ivory dental implants were used in
16th & 17th century.


Metal implants device of gold , lead, iridium,
stainless steel, cobalt alloy were developed
in 20th century.
Cobalt – chromium – molybdenum subperiosteal & titanium blade implants were
introduced in 1940s & 60s respectively &
became the most popular & successful
implants device from 1950-80 .

Exaggerated claims in the wake of long term
morbidity & unpredictability engendered
disbelief & disinterest & even denial on the
part of organized dentistry.
These implants never really caught.


Ancient implants –
Attempts to replace lost teeth with endosteal
implants have been traced to ancient egyptian &
south American civilization.
A skull from Pre Columbian era in museum shows
an artificial tooth carved from dark stone replaced
a lower left lateral incisor.
Implanted animal & carved ivory tooth cited in
ancient Egyptian writings are oldest examples of
primitive implantology.

Early implants –
1809 Maggido placed a single staged gold implant
without a crown to heal passively in a fresh
extraction site ,just above the gingiva the crown
was added after healing.
The insertions of such tooth roots of gold was added
after healing .
The insertion of such teeth roots of gold was
inevitably followed by intense pain & gingival
inflammation

Terminologies


Implant-:
A dental implant is a device of
biocompatible material/s placed within or
against the mandibular or maxillary bone to
provide additional or enhanced support for a
prosthesis or tooth.


Endosteal implantEndo – within
Osteal – bone.
alloplastic material surgically
inserted into a residual bony ridge, primarily
to serve as a prosthodontic foundation.
Endosteal implants – root forms
plant form.

Cylinder fit ( press fit )-: root form implants
depends upon microscopic retention & / or
bonding to the bone & usually are pushed or
tapped into a prepared bone .
Screw root form are threaded into a bone site
& have obvious macroscopic retentive
elements
for initial bone fixation
.combination root forms are common &
have feature of both cylinder & screw root
form.

Subperiosteal implants –
Because there is often not enough bone in
which to place an endosteal implant
dentists turned to placing a on & around the
bone


Transosteal implants –
175 Small introduced the transosteal
mandibular
staple
bone
plate,
a
reconstructive device placed through a
submental incisions & attached to the
mandible with multiple fixation & 2
transosteal screws to support a full arch
prosthesis.

CLASSIFICATION


Implants

Endosteal

Root form

subperiosteal

plate/blade form

transosteal

endodontic stabilizer


Endoosteal implants –
Endosteal implants comprise one broad
category of implants . The most commonly
applicable abutment providing modalities
are endosteal.
The endosteal implants are placed within a
fully or partially edentulous alveolar ridges
with sufficient residual bone available.

Some endosteal implants are attached to
components for the retention of a fixed or
removable prosthesis. Other implants are
equipped with an abutment integral with the
implant body, which protrudes into the oral
cavity during healing.


Root form –
root form implants are designed to resemble
the shape of a natural tooth root. They
usually are circular in cross section .
As a general rule root form must achieve
osseointegration to succeed. Therefore they
are placed in a functional state during
healing until they are osseointegrated

Most of the root forms are 2 stage implants .
Stage 1 – is submersion or semi submersion.
To permit a functional healing
Stage 2 – is attachment of an abutment or
retention mechanism.
A root form can be placed anywhere in the
mandible or maxilla where there is sufficient
bone available.

Plate / Blade form –
As the name suggests the basic shape of plate or
blade implant is similar to that of a metal plate or
blade in cross section . Some plate blade forms
have combination of parallel & tapered sides.
Plate / Blade forms are unique among implants in
that they can function successfully in either
osseointegration or osteopreservation mode of
tissue integration.

Plate/blade form implants


Endodontic stabilizer implants


The endodontic stabilizers function in the
osteopreservation mode of tissue integeration


Ramus frame implants –
often intended for treatment of total
mandibular edentulism with severe alveolar
ridge resorption.


Transosteal implants –
Surgically invasive & technique sensitive.
These implants feature a plate that is placed
against the exposed inferior border of the
mandible with extension that pass from this
plate through symphyseal area out of the
creast of the alce


Consultation
 Chief complaint
 Patients Goals of Treatment


Clinical Examination
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Medical examination
Radiography
Diagnostic Models


Diagnosis & Treatment Planning
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Periodontics
Operative
Prosthodontics
– Abutment support evaluations
 New implant abutment support
– Evaluation of available bone
 Quality
 Quantity
– Choice of implant modality
 Endosteal
- root form
- plate / blade form
 Subperiosteal

 Natural implant abutment support

 Goal-oriented case presentation
– Other treatment options
– Thoroughly informed consent

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Acceptance of treatment plan
Treatment
Maintenance
– Professional maintenance
 Recall examination and prophylaxis
 Early detection & treatment related complication
 Patient education

– Home care

Rigid Implant Anchorage to Close a Mandibular
First Molar Extraction Site
Age = 34 year
Sex = Male
Class I mutilated malocclusion
Missing: maxillary right first and mandibular left
first permanent molars
 Treatment : Implant-supported anchorage
 Tx planning : non-extraction  to close the
asymmetric first molar extraction  unidirectional
(mesial) space closure.
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W. EUGENE ROBERTS,
CHARLES L. NELSON,
CHARLES J. GOODACRE,

$


The use of implants for orthodontic correction of
an open bite
Beth Prosterman, DDS, Leonard Prosterman, BA, DDS, MS, Cert.Ortho.,
Ronald Fisher, BSc, DMD, MSD, Mervyn Gornitsky, BSc, DDS

The patient, a 25-year-old healthy man, sustained a
traumatic injury to the anterior mandible. A
panoramic radiograph revealed nondisplaced
horizontal and vertical fractures of the mandibular
anterior alveolar processes with displacement of
lower right incisors, canine, and premolar. The
lower left incisors were avulsed at the time of
trauma. He was treated initially with a temporary
acrylic splint involving the lower right incisors, and
the lower canines and premolar.

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Prediction of mandibular growth
rotation
A. Björk, Odont. Dr.
 The technique whereby metal implants are
inserted in bone has been used in animals for
more than a century.
 The application of the method in craniometric
studies of growth in man is of more recent date.
begun in 1951.
 It comprised study of 100 children of each sex
covering the age period from 4 to 24 years. The
sample consists of normal children with and
without malocclusion and also children with
pathologic conditions.

A growth analysis consists essentially of three items,
each of which is clinically significant:
1. An assessment of the development in shape of
the face which, in the first place, implies changes
in the intermaxillary relationship.
2. An assessment of whether the intensity of the
facial growth in general is high or low.
3. An evaluation of the individual rate of maturation.
This is important in establishing whether puberty
has been reached and when the growth may be
expected to be completed.

Osseointegrated titanium, implants for
maxillofacial protraction in monkeys


Forced eruption and implant site
development: Soft tissue response
Theo Mantzikos, DMD, and Ilan Shamus, DDS


Roentgen stereometry with the aid of metallic
implants in hemifacial microsomia

 Bodil Rune, Odont. Dr., Karl-Victor Sarnäs, M.S., Odont. Dr., Göran
Selvik,
M.D.,
and
Sten
Jacobsson,
M.D.
Malmö and Lund,


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Leader in continuing dental education


Implants in orthodontics 2 /certified fixed orthodontic courses by Indian dental academy

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Implants in orthodontics 2 /certified fixed orthodontic courses by Indian dental academy