simple and easy

2.  OS – ‘bone’
 Integration – ‘state of being combined into a
whole’
 The term osseointegration was coined by Dr.
Per-Ingvar Branemark in 1972

3.  The apparent direct attachment or
connection of osseous tissue to an inert
alloplastic material without intervening
connective tissue. -G.P.T.8
 Contact established without interposition of
non bone tissue between normal remodeled
bone and an implant entailing a sustained
transfer and distribution of load from the
implant to and within the bone tissue. -
American Academy of Implant dentistry
(1986)

5.  Implant material
fixtures – titanium
 When the fixtures comes into contact with
the atmosphere , an oxide layer, 50-100 A
thick, immediately forms.
 When fixture has properly healed in bone, a
glycoprotein layer, then a calcified layer
approximately 100A thick surrounds the oxide
layer. Prior to insertion into the bone the
surface of titanium fixture must be sterile.

6.  Implant design
root form implants are advocated.
 Surface area
The surface area can be increased by
using wider diameters, threading the surface
and/or roughening the surface.

7.  Implant site
Precision fit in vital bone is essential.
Precise fit of implant in bone without any
observed movement is termed as primary stability.
 Implant surgery
Bone should not be heated beyond 43
degree celsius to maintain vitality and
ideally it should not exceed 39 degree celsius.
Low drilling speeds below 2000 rpm with
minimal trauma
Use of coolant while drilling
Use sharp drills and widening the site
gradually
inserting the implant into bone at very low
speeds (15-20 rpm)

8.  Asepsis
 Strict infection control measures should be adopted
during surgery.
 Loading
 Maintaining fixtures in the bone without any
occlusal forces or load
 Mandible- 3-4 months
 Maxilla - 6 months
 Restoration is commenced only after this period.
 Bone healing begins within the first week after
insertion of fixtures and reaches peak at third and
fourth weeks.
 It gradually becomes bony tissue after 6-8 weeks

9.  Soft tissue interface
 Similar to gingiva around the teeth
 Junctional epithelium surrounds the abutment
surface at crevice and connective tisssue
adapts to abutment surface beneath
 Sulcular epithelium consists of keratinised
epithelial cells
 Criteria for successful osseointegration
 Albrektsson, zarb, worthington and
eriksson(1986)
 That an individual, unattached implant is
immobile when tested clinically

10.  That a radiograph does not demonstrate an
evidence of peri implant radiolucency
 That vertical bone loss should be less than
0.2mm annually following the first year of
service of implant
 That individual implant performance should be
characterised by an absence of persistent and
/or irreversible signs and symptoms such as
pain,infection,neuropathies,parasthesia or
violation of mandibular canal
 a success rate of 85% at the end of a 5 year
observation period and 80% at the end of a 10
year period

11.  The successful replacement of lost natural
tooth by means of tissue integrated implants
represents a major advance in clinical
treatment.
 The knowledge of understanding of implant
prosthesis has evolved from experimental
laboratory phases into evidence based
clinical practice over past four decades.