Introduction to Oral Implantology
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The document provides an introduction to dental implants, discussing why they are used to maintain bone volume, preserve adjacent teeth, and provide a natural emergence profile. It describes the different types of implants including root form, blade, and ramus frame implants and explains the process of osseointegration. The document also covers implant abutment connections, surface treatments, and relative and absolute contraindications for dental implants.
Introduction to Oral Implantology
- 1. INTRODUCTION TO CONTEMPORARY DENTAL IMPLANTOLOGY Dr. Mohamed A. Fouda BDS, MSc Cairo University Periodontist
- 2. Prosthetic Options in Dentistry
- 10. • It Maintains Bone Volume.
- 11. • Bone needs stimulation to maintain its form and density. • Loss of teeth leads to loss of width then height of the bone. • After one year 25% of width and up to 4 mm of height will be lost. TODAY THE PROFESSION MUST CONSIDER NOT ONLY THE LOSS OF TEETH BUT ALSO THE LOSS OF BONE.
- 12. • It Maintains Bone Volume. • Preservation Of Adjacent teeth. • Natural Emergence Profile. • Increases stability and Retention. • Reduce Removable prosthesis size.
- 13. What is a dental implant ? • A dental implant is an artificial tooth root replacement and is used in prosthetic dentistry to support restorations that resemble a tooth or group of teeth.
- 21. Mucosal inserts
- 23. Blade implants
- 29. Osseointegration Osseointegration is defined as “a direct structural and functional connection between the ordered living bone and the surface of the load carrying implant” (Branemark, 1983). Bone has been shown to be approximately 20 nm away from the implant surface when examined with the electron microscope (Albrektsson, 1985).
- 30. Branemark
- 31. The Edentulous Alveolar Ridge • The formation and the continued preservation of alveolar ridge is dependant on the continued presence of teeth. • Also the shape of teeth is an important factor in determining the shape of the alveolar process.
- 32. Thick tissue biotype subjects have short and wide teeth Thin tissue biotype subjects have long and narrow teeth
- 33. Effect of tooth loss on the alveolar ridge
- 34. Bone loss is more pronounced on the buccal aspect than the lingual/palatal aspect of the ridge
- 35. CLASSIFICATION OF REMAINING BONE A& B Substantial amount of alveolar bone remains C, D & E Minute amount of alveolar process remains Lekhom and Zarb (1985)
- 36. CLASSIFICATION OF BONE DENSITY CARL MISCH
- 37. Topography of the alveolar process
- 40. MACRO DESIGN IMPLANT MATERIALS Commercially Pure Ti Ti Alloy Zirconia Titanium 6AL-4V
- 41. • Titanium implants are biocompatible due to the formation of an oxide layer on their surface which is resistant to corrosion and have hydrophilic properties (Hansson et al 1983), When exposed to air, Titanium forms an oxide layer immediately that reaches a thickness of 2 to 10 nm by 1 sec and provides corrosion resistance (Ducheyne 1988; Donley and Gillette 1991). • Because of the high passivity, controlled thickness, rapid formation, ability to repair itself instantaneously if damaged, resistance to chemical attack, catalytic activity for a number of chemical reactions and modulus of elasticity compatible with that of bone of titanium oxide, Titanium is the material of choice for intraosseous applications (Parr et al 1985; Kasemo and Lausmaa 1985).
- 43. MINI IMPLANTS
- 46. • The original endosseous implants were cylindrical (parallel) in design, although this design was proven to be successful, it was not suitable for all applications. One of the most obvious limitations of its use is narrow ridges and ridges with concavities as there is an increased risk of perforation in the labial bone (Garber et al 2001).
- 47. • The introduction of tapered implants resulted in improved esthetics and easier placement between the adjacent natural teeth as it resembles more closely the shape and taper of the original teeth roots (Shapoff 2002) , also it has the ability to accommodate the shape of thin ridges and ridges with labial concavities more than cylindrical implants (Garber et al 2001).
- 48. • The theory behind the use of tapered implants is to provide for a degree of compression of the cortical bone in a poor implant site, tapered implants distribute forces into the surrounding bone, thereby creating a more uniform compaction of bone in adjacent osteotomy walls compared with parallel walled implants. Thus when inserted, it creates lateral compression of bone (O’sullivan et al 2004).
- 49. TYPES OF IMPLANT-ABUTMENT CONNECTIONS
- 50. External Hex
- 51. Internal Hex
- 53. Internal Taper
- 54. Morse Taper Morse taper refers to a taper of 5/8ths of an inch per foot
- 55. Spline
- 56. Cover Screw
- 57. Implants Threads • Threads are added to the implant body and are used to: 1. maximize initial contact between the implant and bone 2. To improve initial stability 3. To enlarge implant surface area 4. To favor dissipation of interfacial stress.
- 61. MICRO ANATOMY
- 62. • The original studies on osseointegration were performed using turned (machined) surface implants. Efforts to enhance implant surface technology have focused on improving the predictability, rate, and degree of osseointegration. • Until now, there is no consensus concerning the most appropriate implant surface topography (Raghavendra et al 2005).
- 63. • Some important advantages have been attributed to increased surface roughness. These include increased surface area of the implant adjacent to bone, improved cell attachment to the implant surface, increased bone present at the implant surface, and increased biomechanical interaction of the implant with bone (Cooper 2000).
- 64. SURFACE TREATMENT Addition: 1- HA Coated 2- TPS
- 65. SURFACE TREATMENT Subtraction: 1- Acid etching 2- Acid etching and Grit blasting
- 66. •Edentulous ridge (Branemark 1952) 60 years of research •Single tooth replacement 41 years of research •Immediate tooth replacement 34 years of research
- 67. RELATIVE CONTRAINDICATIONS •Age •Patient’s general health •Smoking •Patient psychology and motivation •Availability
- 68. ABSOLUTE CONTRAINDICATIONS •Drug or Alcohol abuse •Psychological •Debilitating or uncontrolled disease
- 69. PERIODONTAL THERAPY VS. IMPLANT THERAPY The 0, 5, 10 years rule •Included in treatment •Extraction and site plan development •Can be joined to implants •Independent implant restoration. • If adjacent to an edentulous site consider reducing the prognosis
- 70. EXAMPLES •Smokers moderate and sever Periodontitis extraction and dental implant placement (implant is in direct contact with bone less effect from smoking) •Unsuccessful treatment with progressive bone loss When remaining bone is 10 mm extraction (minimum predictable implant length 10 mm). •Grade III Furcation involvement Implants is more predictable than root amputation and hemi sectioning. •Mobility mobile teeth are poor in terms of load carrying and should be removed.
- 71. MUCOSA AT TEETH AND IMPLANTS
- 79. Microphotograph of a cross section of the buccal and coronal part of the periodontium of a mandibular premolar. Note the position of the soft tissue margin (top arrow), the apical cells of the junctional epithelium (center arrow) and the crest of the alveolar bone (bottom arrow). The junctional epithelium is about 2 mm long and the supracrestal connective tissue portion about 1 mm high.
- 81. Microphotograph of a buccal– lingual section of the peri- implant mucosa. Note the position of the soft tissue margin (top arrow), the apical cells of the junctional epithelium (center arrow), and the crest of the marginal bone (bottom arrow). The junctional epithelium is about 2 mm long and the implant–connective tissue interface about 1.5 mm high.