BDS 11115 Components of Implants PDF

NEWGIZA UNIVERSITY BDS11115 Components of Implant Dentistry Date : / / 20 NEWGIZA UNIVERSITY Team Approach NEWGIZA UNIVERSITY Implant Dentistry Surgical Radiology Prosthetic Periodontal NEWGIZA UNIVERSITY A multidisciplinary approach Radiology Imaging Diagnosis Computer guided implant place...

NEWGIZA UNIVERSITY BDS11115 Components of Implant Dentistry Date : / / 20 NEWGIZA UNIVERSITY Team Approach NEWGIZA UNIVERSITY Implant Dentistry Surgical Radiology Prosthetic Periodontal NEWGIZA UNIVERSITY A multidisciplinary approach Radiology Imaging Diagnosis Computer guided implant placement – 3D imaging Prosthetic Diagnosis Treatment planning Prosthodontic phase of implant treatment Surgical Preparation of implant site eg. Grafting, guided bone regeneration, sinus lifting Surgical placement of dental implants – prosthetic driven implant placement Periodontal Soft tissue augmentation Periodontal/ gingival surgeries Management of implant complications NEWGIZA UNIVERSITY Implant Components Components will be discussed according to the sequence of use during the restorative procedure Superstructure Abutment Implant NEWGIZA UNIVERSITY The Implant NEWGIZA UNIVERSITY Two-piece Implant Separate implant body and abutment joined together by a screw One-piece Implant abutment and implant are one component NEWGIZA UNIVERSITY The Implant Crest module Body Apex NEWGIZA UNIVERSITY Implant Body Screw cylinder Combination NEWGIZA UNIVERSITY Screw Design Implants Threaded into osteotomy Macroscopic retentive elements Straight, tapered, conical, cylinderical Surface treatment Thread geometry threads Thread geometry Square thread V-thread Reverse buttress Buttress NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY The functional surface area of the threaded design is greater than a cylinder implant by a minimum of 30% and may exceed 500% depending on thread geometry NEWGIZA UNIVERSITY Crest Module One Piece implant Designed to exit soft tissue Transition zone from implant body to transosteal region at crest of ridge 1. Platform 2. Antirotational feature Implant-abutment connection Joint Stability Implant-abutment Connection External Connection NEWGIZA UNIVERSITY Internal Connection NEWGIZA UNIVERSITY External abutment connection Original protocol by Branemark was a twostage surgical procedure involving the placement of multiple implants for a mandibular full-arch restoration (Branemark et al. 1985) Connection was an external hex, 0.7mm in height, only designed to serve as a transfer and torquing device, not an antirotational feature. Problematic when used for single tooth replacements Screw loosening/fracture, micromotion External abutment connection NEWGIZA UNIVERSITY Distinct geometric projection external to the body of the implant Antirotational feature Hex height (at least 1.2mm) NEWGIZA UNIVERSITY Internal abutment connection Connection is within the body of the implant Internal abutment connection Distributes forces deep within the body of the implant Deep and rigid connection which prevents joint opening Improved shielding of the abutment screw from stress NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY Conventional Loading Two-stage approach Submerged One-stage approach Non-submerged Immediate Loading NEWGIZA UNIVERSITY Two-stage / Submerged approach Cover Screw on top of the implant to prevent bone, soft tissue or debris from invading the implant Two-stage / Submerged approach 1. Cover Screw 2. Healing Abutment NEWGIZA UNIVERSITY 3. Abutment Healing Abutment / Permucosal Extension Allows soft tissue to heal and mature around future implant abutment May be straight/ flared to develop emergence profile Available in multiple heights to accommodate soft tissue variations NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY Healing abutments with different widths Healing abutments with different heights Healing abutments with different emergence profiles NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY One-stage/ non-submerged approach Involves placing a healing collar at time of implant placement Only one surgical procedure Reduced healing time and allows the possibility of early loading NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY The abutment is the component of the implant system that supports or retains implant superstructure NEWGIZA UNIVERSITY Prosthetic Options Types of Abutments According to retention to prosthesis According to fabrication According to axial inclination According to anatomy According to number of pieces NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY According to retention to prosthesis Abutment for cement retention Abutment for screw retention Attachment Abutment for Cement Retention Abutment is screwed to the implant and superstructure is cemented to the abutment The most commonly used type NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY Retention is by friction Depends on the height of the axial walls (at least 5mm) Abutment For Screw Retention NEWGIZA UNIVERSITY Transmucosal abutment 1 screw 2 screws N E W G I Z A U N I V E R S I T Y Crown screw Abutment Screw Abutment for Attachment NEWGIZA UNIVERSITY Overdenture NEWGIZA UNIVERSITY According to Method of Fabrication Prefabricated / Standard Abutment Custom / castable Abutment CAD/CAM abutment Prefabricated Standard Abutments NEWGIZA UNIVERSITY Premachined abutments that can be modified clinically or in the laboratory NEWGIZA UNIVERSITY Zirconia Abutment No grey hue  used in esthetic areas NEWGIZA UNIVERSITY Custom / Castable abutments Used in more complicated clinical situations where prosthetic corrections with prefabricated abutments are not possible Insufficient interocclusal space Severe angulation problems If the collar height needed is more than 1mm greater than the largest collar height available in prefabricated abutments Splinting three or more implants NEWGIZA UNIVERSITY Plastic unitubes Gold palladium cylinders Can be cast as abutment for cement retained restorations OR 1-piece restorations screwed directly to the implants (final crown can be made directly on the abutment) NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY CAD/CAM Abutments NEWGIZA UNIVERSITY Digital means of impression making and scanning and then milling out prefabricated metal alloys to produce a restoration that is more precise than the traditional casting methods According to Axial Inclination Straight NEWGIZA UNIVERSITY Angled Available in 10, 15 and 25 degree inclination Angled abutments Can be used to decrease unfavorable inclinations of implants NEWGIZA UNIVERSITY According to Anatomy Standard (Bulk) NEWGIZA UNIVERSITY Anatomical (Contoured) NEWGIZA UNIVERSITY To sum up: The implant team should adopt a multidisciplinary approach in implant dentistry to include surgical, prosthetic and periodontal aspects to ensure a successful treatment outcome. There are many components involved in implant dentistry including the dental implant itself, healing collars, cover screws, and prosthetic abutments. An understanding of the different components used familiarize the dentist with the different implant systems available in the market. NEWGIZA UNIVERSITY NEWGIZA UNIVERSITY