BDS 11113 Implants History and Intro PDF

1. 2. 3. 4. 5. 6. History of dental implants The Branemark concept (osseointegration) Implant components Procedures for implant placement (armamentarium) Loading protocols Factors affecting success of dental implants Definition: a surgical component that interfaces with the bones of the jaw to su...

1. 2. 3. 4. 5. 6. History of dental implants The Branemark concept (osseointegration) Implant components Procedures for implant placement (armamentarium) Loading protocols Factors affecting success of dental implants Definition: a surgical component that interfaces with the bones of the jaw to support a dental prosthesis Root form  Inserted a titanium chamber in rabbit femurs to investigate blood flow and discovered that the titanium chamber integrated with the bone  The direct structural and functional connection between the living bone and the surface of a load bearing implant  Root form endosseous implant A minimum of 3-4 months healing period before placement of a restoration A. B. C. D. Fixture (implant) Abutment Abutment Screw Implant restorations  Different lengths and diameters: increasing surface area for osseointegration. Depends on the amount of available bone.  Different thread designs  Different surface treatments  Abutment angulations  Abutment materials (stainless steel, castable gold, zirconia, PEEK)  Prefabricated vs. custom made  One piece implant/abutment  Attachments (ball and socket/locators) The ball/locator is screwed onto the implant fixture (male part) The female part is placed into The fitting surface of the denture  Cement retained vs. screw retained Cement retained Screw retained Advantages Cement retained: Screw retained Passive fit Esthetics Ideal occlusal form With limited inter-occlusal distance Absence of cement in gingival tissues Retrievability  Single implant restoration Cement retained/screw retained  Partially edentulous implant restoration Screw retained/cement retained Completely edentulous implant restoration Implant supported Screw retained/cement retained Implant -tissue supported (overdenture) Attachments/screw retained High torque with sufficient cooling to prevent bone necrosis Implant kit specific to different implant systems drills  Implant drivers and torque wrench Cover screw and healing abutment  The original Branemark concept advocated a waiting period of 3-6 months before loading (placement of the prosthetic restoration on the implant) in order to allow stress – free healing and osseointegration  Placement of a restoration on the same day of the implant surgery Immediate non-functional/functional  Prosthetic loading of the implant at anytime between immediate and conventional loading Multiple studies have been performed to compare the different loading protocols. The survival rates are comparable, but several factors must be considered  Placement of an implant immediately after extraction A. Surgical factors Primary stability (most important factor) The biometric stability immediately after implant insertion  Surgical technique Proper cooling to prevent bone necrosis  Bone quality and quantity Bone quality Bone quantity  Implant design Surface coating Diameter and length Natural teeth have PDL fibers which act as shock absorbers Occlusal forces should be directed vertically Proper prosthesis design to minimize forces Students are advised to read details at: Fundamentals of implant dentistry, surgical principles, Peter K. Moy, Alessandro Pozzi, John Beumer III. (chapters 1 and 2) Fundamentals of implant dentistry, prosthetic principles, John Beumer III, Robert F. Faulkner, Kumar C. Shah, Peter K. Moy.