Dental Implants

Chapter 15
DAE/DHE 203
Implants - defined
Surgically inserted into bone
Used as “anchors” to support a prosthetic
Replace missing teeth in partially and/or fully
edentulous areas
May be single tooth or several teeth
prosthetic
Potential for ultimate stability for prosthetic
Relies on integration with natural
bone/tissues for retention and sustainability
Video
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
laid
Premeasured
implant (body)
placed into bone
and covered entirely
with soft tissue
Healing: weeks -
months
Placement of Endosseous Implant
The soft tissue is
removed, exposing
the implant, and a
“healing cap” is
placed
Healing: several
weeks
Placement of Endosseous Implant
Healing cap is
removed and an
abutment is placed
Abutment is prepared
(“post”/cylinder
added) & impressed
for prosthetic Abutment
Implant
Sent to lab for
fabrication
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