Dental Implants

Chapter 15DAE/DHE 203

Implants - defined

Surgically inserted into boneUsed as “anchors” to support a prosthetic Replace missing teeth in partially and/or fully edentulous areasMay be single tooth or several teeth prostheticPotential for ultimate stability for prostheticRelies on integration with natural bone/tissues for retention and sustainabilityVideo

Implants – Basic Diagrams

Prosthetics

Implants

Implants – Basic Diagrams

Relies on integration with bone (new bone growth) for support.

“Osseointegration”There must be a closed interface (implant to oral tissue) for success.

Types of Implants:

Endosseous – resides partially in bone Single tooth replacement thru

denture support Screw-shaped Most common type

Types of Implants:

Types of Implants:

Subperiosteal: rests on alveolar ridge, no bone invasion Less invasive, less stable Supports denture

Transosteal: placed through the mandible (only) Attachments reside above ridge Rarely used

Types of Implants:

Types of Implants:

Implant Materials:

Titanium: Used as almost pure metal Corrosion resistant Strong & lightweight Great biocompatibility

Implant Materials:

Ceramics: Most biocompatible Formation of hydroxyapatite at surface Potential for chemical bond between

bone & implant

Coated Metals: Combines strength of metal with good

interface potential of ceramic

Implant Materials:

Prosthetics & attachments: Crowns

PFM’s most common Could be gold, ceramic, composite Attached by screws or cemented

Dentures “Traditional” materials - acrylic Attached by various fasteners: clips,

balls, screws, etc.

Implant Materials:

Placement of Endosseous Implant

Soft tissue “flap” is laidPremeasured implant (body) placed into bone and covered entirely with soft tissueHealing: weeks - months

Placement of Endosseous Implant

The soft tissue is removed, exposing the implant, and a “healing cap” is placedHealing: several weeks

Placement of Endosseous Implant

Healing cap is removed and an abutment is placedAbutment is prepared (“post”/cylinder added) & impressed for prostheticSent to lab for fabrication

ImplantAbutment

Placement of Endosseous Implant

Crown (or other prosthetic) is seated with cement or screw (or other fastener)

Procedure: Diagrams

Patient Selection:

Highly motivated, healthy patient Time-consuming procedure (months

of healing post-sx) No systemic diseases or conditions

that impact healing & sustainability of implant

Substantial bone support

Must be able to practice good OH

Maintenance of Implants:

Great OH by patient: Toothbrushes, floss, interdental aids,

etc.

Caution during prophylaxis: Scaling with conventional instruments

may damage the titanium surface Sonic instruments are contraindicated! Use a very mild abrasive with rubber-

cup prophy