Introduction to Dental Implant

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Introduction to Dental

Implants

Joseph V. Califano D.D.S., Ph.D.


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Implants: Patient Selection

Relative contraindications:

Uncontrolled diabetes

Alcoholism

Heavy smoking

Post-irradiated jaws

Poor oral hygiene General surgical contraindications


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Implants: Presurgical Evaluation

Restorative requirements

Interarch space

Location of edentulous areaBone quality and quantity

Radiographs

Panoramic

Periapical Lateral cephs

Computerized tomograms


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Implants: Treatment Planning

Single most important aspect of dental

implantology.

High success rates are almost alwaysaccompanied by careful case selection.

The increased predictability of grafting

procedures allows for optimal estheticplacement.


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SimPlant®


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Bone Quality1. Type I (most dense) to Type IV

(least dense).

2. Impacts stability of fixture.3. Determines length of healing

period.

4. Influences osteotomy

preparation.

5.Established at time of surgery.


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Surgical Template1. Provides a visual

communication between the

restorative dentist and implantsurgeon.

2. Indicates optimal site for

placement of fixtures.

3. Conveys critical esthetic

information.

4. May be used to fix index

copings at the time of fixture

placement.


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Implants: Stage I - Placement


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Implant Placement Step 1

Round bur


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2 mm twist1. Apical portion of twist drills

are conical, which means thatthis portion of the drill is

deeper than the actual implantlength.

2. The graduations on the twistdrills represent the height ofthe fixture together with aslotted cover screw.

3. Direction and parallelismshould be checked frequentlyand by more than one person ifpossible.

4. Use direction indicators.


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Pilot drill1. Expands the entrance of the

osteotomy to 3 mm in

preparation for the 3 mm twist.2. Limited reorientation may be

accomplished at this step.

3. The cutting portion of this drill

are the sides.


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3 mm twist drill1. This is the terminal twist drill

for the standard platform

fixtures.

2. In very dense bone, a 3.15 mm

twist drill is recommended.

3. Reorientation may be

performed at this stage.


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Countersink 1. Used to widen osteotomy at

coronal position so that cover

screw may be placed at or

below the level of the bone.

2. Counersinking is NOT

typically performed.


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Fixture1. Come in a variety of lengths

and widths.

2. Typically, wider is better.3. A variety of surfaces and

thread configurations are

available.

4. One- and two-stage fixtures.

5. Type of fixture to be used is

often dictated by restorative

dentist’s preference.



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Cover screw


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3-6 month healing period.


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Implants: Stage II - Uncovering


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Implants: Restored


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Implants: Complications

Early failure: lack of integration

Late failure: rarely occurs after first year

after restoration, can due to occlusalconsiderations (heavy forces out of the

long axis), one loose screw in a multiunit

prosthesis, etc.Periimplantitis


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Implants: Maintenance

Regular recall schedule that is patient

specific

Titanium vs. steel vs. resin curettesImplants are subject to the same

problems that the natural dentition is

with respect to periodontal status.


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Documents

Introduction to Dental Implant