Implant Dentistry

المساعد االستاذابراهيم الدكتور

الفهداوي- االنبار االسنان طب كلية

االسنان صناعة قس!م

What are dental implants?

A dental implant is a synthetic “root” which is literally implanted permanently, within the space where the natural tooth once lived

Implant Prosthodontics: It is the phase of

prosthodontic concerning the replacement of

missing teeth and/or associated structures by

restorations that are attached to dental

implant .

The responsibility of success or failure of implant is mainly on the prosthodontist.

Osseointegration: A process by which clinically asymptomatic rigid fixation of alloplastic materials is achieved and maintained in bone during functional

loading .

Another definition: A direct structural and functional connection between ordered living bone and the surface of a load carrying implant at the microscopic

level .

Factors which affect osseointegration 1 -Materials

CPT or Ti-6Al-4V 2 -Surface Design

The rougher surface the better osseointegration (6-7 times)

3 -Heat Generation Not more than(41ᵒC)

4 -Unloading Period Between 1st and 2nd stages (4-6 months)

Classification of dental implants

According to the relation of dental

implant to the bone:

1 -Endo-osseous in the bone

2 -Trans-osseous or through the bone

3 -Subperiosteal or on the bone

Classification of dental implant materials1 -Strunz's Classification: according to their biocompatibility-:

A- Biotolerate materials: 1st materials used in DI there will be space between B&I full of FCT as :

Gold, Stainless steel, PMMA or Co-Cr

B- :Bioinert materials contact between B&I surface as:Ti, Ti-6Al-4V or ceramic

C- Bioactive materials: there will be a chemical reaction (bond) with ionic exchange with bone---true bond osteogenesis as:

Tricalicium phosphate or hydroxy apatite

D- Bioinert and structure osteotropic materials: bond osteogenisis (physical & chemical bond) as:Ti with rough surface

2- Comb's Classification: according to type of materials

A- Metallic

B- None Metallic

ADVANTAGES OF THE IMPLANT-SUPPORTED OVERDENTURE

.As few as 2-4 implants may be used for support

.Good stability

.Good retention

.Improved function

.Improved esthetics

.Reduced residual ridge resorption

.Simplest implant-supported prosthesis

.Possible incorporation of existing denture into the new

prosthesis

RISK FACTORS FOR FAILURE OF DENTAL IMPLANTS. .Smoking

.Factors that affect healing of bone (such as diabetes, use of steroids)

.Untreated periodontal disease .Anatomy (if bone in recipient site is inadequate, grafting

may be necessary) .Poor bone quality

.Inadequate practitioner training, experience or both .Patient compliance concerns

Over DentureOverdenture, an complete or partial removable denture supported by retained roots, teeth or implant that is intended to provide improved support, stability, and tactile and proprioceptive sensation and to reduce ridge resorption

An Overdenture is a denture that uses precision dental attachments to hold the denture down. The overdenture attachment can be placed in tooth roots that have been saved, or placed into dental implants

which have been placed to receive them .  

Aims of over denture1 -the patients feel as he having natural teeth.

2 -Decrease the rate of bone resorption (8 time).

3 -Preservation of the properioreseptors (in PDL).

Advantages of a Conventional Over-Denture Feels more like having teeth More retentive in many cases Helps reduce shrinkage of surrounding bone Reduces pressure to portions of the alveolar

ridge Positive psychological advantage of still

having teeth

Disadvantages of a Conventional Over-Denture Scrupulous oral hygiene is essential in order to

prevent decay and gum disease The over-denture may feel bulkier than a

conventional denture Frequent maintenance examinations are

necessary Generally, this is a more expensive approach

than a conventional denture  

Some Characteristics of a Conventional Over-Denture Most of a tooth crown (that part of the tooth above the gums) is

removed. This often necessitates root canal therapy if not already done.

The remaining tooth, projecting above the gum, is rounded (DOOM SHAPE) and usually covered with a similarly shaped artificial crown-like covering.

Various configurations and extensions may be built onto some retained roots. In those cases, that portion of the denture overlying these configurations is modified to contain attachments that clip onto a framework or receive the individual extensions. In addition to preserving alveolar bone and sensory input, the denture is held securely in place, but may be comfortably and easily removed for cleaning.

Get tight fit dentures by preserving two to three teeth Called Over Dentures

Crowns are given on the preserved teeth

Counter crowns are fitted in the denture

The denture snaps on the crowns in the mouth and holds it tight

One can perform all the movements without shaking the denture

Bring tongue out, denture does not move

Move the tongue to left; denture is stable

Touch the tongue to palate; denture is stable

Have to use both hands and force to remove the denture

She is very happy, can laugh, sing, eat and whistle