IMPLANTOLOGY. Dr. Barbara Kispélyi

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IMPLANTOLOGY Dr. Barbara Kispélyi

Definition A prosthetic device or alloplastic material implanted into the oral tissue beneath the mucosal or/and periosteal layer and/ or in the bone to provide retention and support for the fixed and removable prosthesis.

History - 15000 years ago Abradale: Dentistry - An illustrated history, Mosby

3000 years ago Egypt Abradale: Dentistry - An illustrated history, Mosby

600 years ago Honduras Abradale: Dentistry - An illustrated history, Mosby

1700-1800 Abradale: Dentistry - An illustrated history, Mosby

Dissertation on arteficial teeth 1797 Nicolas Dubois de Chémant Abradale: Dentistry - An illustrated history, Mosby

1800-1900 Abradale: Dentistry - An illustrated history, Mosby

1895-1952 1895 Gold or iridium tubes were implanted Bonewell 1905 Porcelain corrugated root implant 1913 Hollow basket implant meshwork (iridium, platinum, gold) - Greenfield 1948 Insertion of first viable subperiosteal implant Goldberg

1952 Threaded implant design of pure titanium Endosteal implants - Branemark

1982 In 1982, Brånemark presented his scientific data at the Toronto Conference on Osseointegration in Clinical Dentistry, which proved to be the turning point for the treatment s acceptance. In the same year, the US Food and Drug Administration (FDA) approved the use of titanium dental implants in the United States.

2002 An ADA survey showed that oral and oral and maxillofacial surgeons, periodontists, and general dentists near doubled the number of implants performed per dentist between 1995 and 2002.

TYPES OF IMPLANTS Autoplastic: an implant from within the same individual Homoplastic: an implant from the same species Heteroplastic: an implant from a different species Alloplastic: an implant from a non-living material

Types of classification 1.Based on implant design 2.Based on attachment mechanism 3.Based on macroscopic body design 4.Based on the surface of the implant 5.Based on the type of the material Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

CLASSIFICATION BASED ON IMPLANT DESIGN Endodontalis Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

1.ENDOSTEAL IMPLANT A device which is placed into the alveolar bone and/or basal bone of the mandible or maxilla Transect only one cortical plate Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

a) BLADE/PLATE IMPLANT It consist of thin plates in the form of blade embedded into the bone Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

b) RAMUS FRAME IMPLANT Horse shoe shaped stainless steel device Inserted into the mandible from one retromolar pad to the other It passes through the anterior symphysis area Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

c) ROOT FORM IMPLANT Designed to mimic the shape of the tooth For directional load distribution Forms: 1.Cylinder 2.Screw root form 3.Combination Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

2. SUBPERIOSTEAL IMPLANT Placed directly beneath the periosteum overlying the bony cortex Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

3. TRANSOSTEAL IMPLANT Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

4.INTRAMUCOSAL IMPLANTS Inserted into the oral mucosa Mucosa is used as attachment site for the metal inserts Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

5.ENDODONTAL IMPLANT

CLASSIFICATION BASED ON ATTACHMENT MECHANISM OF THE IMPLANT

Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

FIBROINTEGRATION Proposed by Dr.Charles Wiess Complete encapsulation of the implant with soft tissues. Fibro ossseous ligament formed between implant and the bone collagen fibers at bone implant interface Soft tissue interface could resemble the highly vascular periodontal fibers of natural dentition Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

OSSEO-INTEGRATION Direct contact between the bone and the surface of the loaded implant Described by Branemark Bio active material that stimulate the formation of bone can also be used Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

OSSEO-INTEGRATION -Dynamic process -Healing phase: 0-12 months -Remodeling phase: 3-18 months -Steady state: 18 months -

Factors affecting oseointegration Implant biocompatibility Implant design Implant surface Implant bed Surgical technique Loading condition

CLASSIFICATION BASED ON MACROSCOPIC BODY DESIGN OF THE IMPLANT

CYLINDRICAL DENTAL IMPLANTS In the form of cylinder Depends on coating or surface condition to provide microscopic retention and bonding to the bone Pushed or tapped into a prepared bone site Straight, tapered or conical Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

THREADED DENTAL IMPLANTS The surface of the implant is threaded, to increase the surface area of the implant This results in distribution of forces over a greater peri-implant bone volume Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

PLATEAU- DENTAL IMPLANTS Plateau shaped implant with sloping shoulder Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

PERFORATED DENTAL IMPLANTS Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

SOLID DENTAL IMPLANTS They are of circular cross section without vent or hollow in the body Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

VENTED DENTAL IMPLANTS Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

HOLLOW DENTAL IMPLANTS Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

CLASSIFICATION BASED ON THE SURFACE OF THE IMPLANT

SMOOTH SURFACE IMPLANT Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

MACHINED SURFACE IMPLANTS Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

TEXTURED SURFACE IMPLANT Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

COATED SURFACE IMPLANT Babysowdeswari R, M. Benazir Begam, S. Birundha, M. Brundha R. Desahanavi: Dental implants types and classification

CLASSIFICATION BASED ON THE IMPLANT MATERIAL

IMPLANT MATERIALS - mechanical strength - biocompatibility - structural biostability

Biologic classification IMPLANT MATERIALS Based on tissue response and systemic toxicity effects of the implant Biotolerant Bioinert Bioactive

LongBioinert term materials effects term Titanium Aluminum oxide Non-reactive

Titanium Lightweight biocompatible corrosion resistant (dynamic inert oxide layer) It is 6 times stronger than compact bone Its modulus of elasticity is 5 times greater than that of compact bone (thus equal mechanical stress transfer) Most commonly used Commercially pure (CP) titanium Titanium-aluminum-vanadium alloy (Ti-6Al-4V) - stronger & used with smaller diameter implants Kalpa Pandya Rachayta Parikh Priyank Pareek 3