Introduction to Dental Implant for undergraduate student

Introduction to Dental Implant
Dr Shamsuddin Mahmud
Assistant Professor, Department of Prosthodontics
Nortth East Medical College (Dental Unit)

Definition of Dental Implant
A prosthetic device
made of alloplastic material(s)
implanted into the oral tissues beneath the mucosal and/or periosteal layer and
on or within the bone
to provide retention and support for a fixed or removable dental prosthesis.
Classification of Dental Implant
According to placement within the tissue
Blade/Plate form implant
According to Material Used
A) METALLIC IMPLANTS
Commercially pure Titanium
Cobalt chromium molybdenum
Titanium aluminum vanadium
Stainless steel
B) NON-METALLIC IMPLANT
Zirconium
Ceramic
Carbon

According to the ability of implant to stimulate bone formation�
A) Bio active
Hydroxyapatite
Tri Calcium Phosphate
B) Bio inert
Metals
Parts of Dental Implant
Implant fixture
Implant mount
Cover screw
Gingival former/healing screw/healing abutment/permucosal extension
Impression post/impression transfer abutment
Implant analogue
Abutment
Fixation screw

Implant Fixture
Implant Mount
Connected to the fixture

Function: used to carry implant from its vital to the prepared osteotomy site either by hand or with a ratchet/ handpiece adaption
Cover Screw
component that is used to cover the implant connection during the submerged healing of the implant

Function: preserves the patency of the connection by preventing any soft tissue ingrowth in the connection

Gingival former/ Healing Abutment/ Healing screw
Screw/ abutment used to create the soft tissue emergence profile around the implant.

Time of placement:
During 1st surgery – One step surgery
After Osseointegration – Two step/stage surgery
Gingival former/ Healing Abutment/ Healing screw

Placed in the site 2-3 weeks for soft tissue healing

Function:
Create gingival emergence profile
Formation of biological width
Impression post/impression transfer abutment
component that is used to trans- fer the implant Hex position and orientation from the mouth to the working cast.
Types
Closed tray
Open tray
Implant analogue/
component which has a different body but its platform and connection are exactly similar to the implant. The analogue is used to replicate the implant platform and connection in the laboratory mode.
Abutment
Abutments
Advantages of Dental Implant Retained Prosthesis
Maintain bone height and width by preventing bone resorption
Maintain facial esthetics
Improve masticatory performance
Improve stability and retention of prosthesis
More esthetics
Increase survival times of prostheses
There is no need to alter adjacent teeth
Improve psychological health
Disadvantages of Dental Implant Retained Prosthesis
Very expensive.
Cannot be used in medically compromised patients who cannot undergo surgery.
Longer duration of treatment
Requires a lot of patient co-operation because of repeated recall visits are essential
INDICATION OF DENTAL IMPLANT
Dental implants can successfully restore all

1. Introduction to Dental Implant Dr Shamsuddin Mahmud Assistant Professor, Department of Prosthodontics Nortth East Medical College (Dental Unit)

2. Definition of Dental Implant A prosthetic device made of alloplastic material(s) implanted into the oral tissues beneath the mucosal and/or periosteal layer and on or within the bone to provide retention and support for a fixed or removable dental prosthesis.

3. Classification of Dental Implant

4. According to placement within the tissue

5. Plate Form

6. Blade/Plate form implant

7. According to Material Used A) METALLIC IMPLANTS Commercially pure Titanium Cobalt chromium molybdenum Titanium aluminum vanadium Stainless steel B) NON-METALLIC IMPLANT Zirconium Ceramic Carbon

8. According to the ability of implant to stimulate bone formation A) Bio active Hydroxyapatite Tri Calcium Phosphate B) Bio inert Metals

9. Parts of Dental Implant Implant fixture Implant mount Cover screw Gingival former/healing screw/healing abutment/ permucosal extension Impression post/impression transfer abutment Implant analogue Abutment Fixation screw

10. Implant Fixture The component that is surgically placed into the bone Also known as “Implant Body” Parts- Crest module Body Apex

11. Implant Mount Connected to the fixture Function: used to carry implant from its vital to the prepared osteotomy site either by hand or with a ratchet/ handpiece adaption

12. Cover Screw component that is used to cover the implant connection during the submerged healing of the implant Function: preserves the patency of the connection by preventing any soft tissue ingrowth in the connection

13. Gingival former/ Healing Abutment/ Healing screw Screw/ abutment used to create the soft tissue emergence profile around the implant. Time of placement: D uring 1st surgery – One step surgery After Osseointegration – Two step/stage surgery

14. Gingival former/ Healing Abutment/ Healing screw Placed in the site 2-3 weeks for soft tissue healing Function: Create gingival emergence profile Formation of biological width

15. Impression post/impression transfer abutment component that is used to trans- fer the implant Hex position and orientation from the mouth to the working cast. T ypes C losed tray Open tray

16. Implant analogue/ component which has a different body but its platform and connection are exactly similar to the implant. The analogue is used to replicate the implant platform and connection in the laboratory mode.

17. 29 Open tray copings Pick up copings Square copings Closed tray copings Transfer copings Tapered copings. Impression copings

18. 30

19. Abutment

20. Abutments

21. Implant surface Implant microstructure refers to the surface structure, or degree of surface roughness, of the dental implant. Function The surface structure of dental implants is critical for adhesion and differentiation of cells during the bone remodeling process. Types of surface modification subtractive and additive processes

22. Subtractive processes Etching with acid Blasting with an abrasive material, such as silicon or HA; Treatment with lasers

23. Additive processes HA coating TPS Anodization to thicken the titanium oxide surface

24. Advantages of Dental Implant Retained Prosthesis Maintain bone height and width by preventing bone resorption Maintain facial esthetics Improve masticatory performance Improve stability and retention of prosthesis More esthetics Increase survival times of prostheses There is no need to alter adjacent teeth Improve psychological health

25. Disadvantages of Dental Implant Retained Prosthesis Very expensive. Cannot be used in medically compromised patients who cannot undergo surgery. Longer duration of treatment Requires a lot of patient co-operation because of repeated recall visits are essential

26. INDICATION OF DENTAL IMPLANT Dental implants can successfully restore all forms of partial edentulism and complete edentulism, if there are no general or local contraindications. For the following situations dental implants are strongly indicated : 1) Single tooth is missing with healthy adjacent teeth

27. 2) Partial edentulism on one or both sides of the dental arch with missing distal abutment (Kennedy class I and class II partially edentulous arches)

28. 3) Complete edentulism 4) Patients who cannot tolerate a removable denture. 5) Patients with high aesthetic and/or functional demands

29. CONTRAINDICATION OF DENTAL IMPLANT A) General contraindications a) Absolute contraindications 1) Heart diseases affecting the valves, recent infarcts, severe cardiac insufficiency, cardiomyopathy 2) Active cancer, certain bone diseases ( osteomalacia , Paget's disease, brittle bones syndrome, etc.)

30. 3) Certain immunological diseases, immunosuppressant treatments, clinical AIDS, awaiting an organ transplant 4) Certain mental diseases 5) Strongly irradiated jaw bones (radiotherapy treatment)

31. b) Relative contraindications Dental implants can only be placed (with the greatest caution) after some preliminary treatments. 1) Diabetes 2) Angina pectoris 3) Significant consumption of tobacco 6) Drug and alcohol dependency 7) Pregnancy

32. B) Local contraindications The alveolar bone where the implants would be positioned, shows chronic infections, has an inadequate structure or an insufficient height or width. Important anatomical structures such as the maxillary sinus, the inferior alveolar nerve, have an abnormal position that can interfere with the dental implants. Poor oral hygiene. Bruxism or involuntary grinding of the teeth