Complete Guide of Dental Implants

Contents (Index) of Dental Implants

  • Introduction
  • Osseointegration
  • Classification of dental implants
  • Implant parts
  • Treatment planning
  • Surgical procedure
  • Prosthetic stage
  • Complications
  • Conclusion

Introduction

The dental implants is unnatural titanium equipment which is placed surgically into the jaw bone to replace for a missing tooth and its root(s).

Dental implantation proposes a practical and aesthetic restoration of a patient affected by complete or partial edentulism.

Osseointegration

A Swedish orthopedic surgeon, Prof Branemark, in 1952 unexpectedly created osseointegration.

When pure Ti gets in touch with the living bone tissue the two really grow together to form a strong biological adhesion.

Functional like abnormal stiffening and immobility of a joint due to the fusion of the bones.

Factors for strong osseointegration

  • Biocompatible material- Ti, each commercially pure or in certain alloys.
  • Original implant stability- it should be exactly adjusted to the treated bony site.
  • Atraumatic operation to minimize tissue damage.
  • An immobile, undisturbed healing phase.

Titanium

  • Biocompatibility is adequate to its cover oxide
  • When presented to air it forms a dense 4-nm layer of Titanium dioxide TiO2 – chemically constant and very corrosion-resistant.
  • 4 grades of commercially pure titanium-differing with the percentage of trace pollutants in the metal.The greater the contaminants the harder the metal.
  • Grade 4 cpTi – commonly used for dental implants.
  • Grade 5 -Titanium alloy- Ti6Al4V. Offers similar biocompatibility but excellent tensile energy and fracture resistance than cpTi.
  • Zirconia- related in biocompatibility, enhanced cosmetics, fracture resistance lower, can be used as only one piece.

Steps of osseointegration

Folded bone is quickly set in the gap within the implant and the bone. It has a low biomechanical capacity,- the occlusal load should be controlled.

After 1 to 2 months, under the effect of load, the United bone will slowly transform into lamellar bone.

Fixed Teeth Bridge

Implant Tissue Interface

Implant and bone interface- The glycoprotein coating on the bone is adsorbed on the implant cover with the help of sticky macromolecules like Fibronectin, Laminin.

They are bonded to the iron oxide coating on the Ti by covalent bonds, ionic bonds or van-der-walls bonding.

Implant connective muscle interface- gingival tissues from the attachment, is tough enough to face the occlusal forces and microbial attacks.

Implant epithelial interface-Epithelium is attached to the implant surface through hemidesmosomes and glycoproteins and considered as Biologic seal.

It forms a sulcus depth of  3 to 4 mm.

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Kind of dental implants

Endosteal
Endosteal
Subperiosteal
Transosteal
transosteal
Intramucosal

Endosteal implants

A device which is placed into the alveolar bone Transect only one cortical plate. Blade/plate implant-thin plates in the form of blade embedded into the bone.

Ramus structure implant

Horse shoe formed stainless steel device. Embedded into the bone from one retromolar pad to the separate and passes through the anterior symphysis area

Root form implant

Designed to simulate the appearance of the tooth and for directional load sharing

Forms:
  • Cylinder
  • Screw root form
  • Combination
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Subperiosteal Implants

Put straight under the periosteum overlying the hard cortex, indicated in cases with the ineffectual bone length for endosteal implants.

Transosteal Implants

Penetrates both cortical plates
It has subperiosteal and endosteal components

transosteal

Intramucosal Implants

Embedded into the oral mucosa. The mucosa is used as an additional site for the metal enclosures of removable dentures

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