This document provides an overview of oral implantology. It discusses the history and terminology of implants, the biological aspects including biomaterials and peri-implant tissues, classifications of implants, clinical aspects such as patient selection and diagnosis, surgical procedures, prosthetic options, complications, and maintenance. The key points are that implants replace tooth roots by securely attaching to bone, there is a healing period, and restorations can be screwed or cemented onto implants.
This document provides an overview of oral implantology. It discusses the history and terminology of implants, the biological aspects including biomaterials and peri-implant tissues, classifications of implants, clinical aspects such as patient selection and diagnosis, surgical procedures, prosthetic options, complications, and maintenance. The key points are that implants replace tooth roots by securely attaching to bone, there is a healing period, and restorations can be screwed or cemented onto implants.
This document provides an overview of oral implantology. It discusses the history and terminology of implants, the biological aspects including biomaterials and peri-implant tissues, classifications of implants, clinical aspects such as patient selection and diagnosis, surgical procedures, prosthetic options, complications, and maintenance. The key points are that implants replace tooth roots by securely attaching to bone, there is a healing period, and restorations can be screwed or cemented onto implants.
This document provides an overview of oral implantology. It discusses the history and terminology of implants, the biological aspects including biomaterials and peri-implant tissues, classifications of implants, clinical aspects such as patient selection and diagnosis, surgical procedures, prosthetic options, complications, and maintenance. The key points are that implants replace tooth roots by securely attaching to bone, there is a healing period, and restorations can be screwed or cemented onto implants.
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ORAL
IMPLANTOLOGY INTRODUCTION INTRODUCTION Implants are replacement tooth roots. They securely attach themselves to the bone. There is a waiting period for bone healing. Restoration are screwed or cemented on to the implants. HISTORIC BACKGROUND FIVE ERAS: ANCIENT ERA ( BEFORE 1000 AD) MEDIEVAL ERA (1000 TO 1799 AD) FOUNDATION ERA ( 1800 TO 1910 AD) MODERN ERA ( 1910 TO 1978 AD) CONTEMPORARY ERA ( 1978 TILL DATE) TERMINOLOGY Oral implantology is "the science and discipline concerned with the diagnosis, design, insertion, restoration, and/or management of alloplastic or autogenous oral structures to restore the loss of contour, comfort, function, aesthetics, speech and/or health of the partially or completely edentulous patient“ A dental implant "is a permucosal device that is biocompatible and biofunctional and is placed on or within the bone associated with the oral cavity to provide support for fixed or removable prosthesis". TERMINOLOGY An oral or dental implant "is a biologic or alloplastic biomaterial surgically inserted into soft or hard tissues of the mouth for functional or cosmetic purposes". Osseointegration implies that "is a contact established without interposition of non bony tissue between normal remodeled bone and an implant at the light microscopic level, entailing a sustained transfer and distribution of load from the implant to and within the bone tissue". BIOLOGIC ASPECTS BIOMATERIALS: The European society of Biomaterials defined the term "biomaterial" as "non living materials used for medical application (e.g., as a dental implant) with the goal of achieving a reaction (interaction) with the biologic system". The most commonest material used today in implantology is titanium, which is a light weight, soft non corroding metal which forms an oxide layer in millisecond after contact with oxygen. The surface is roughened through acid etching or sand blasting and can be covered by a layer of hydroxyapatite. Roughing is not done near the implant neck. BIOLOGIC ASPECTS PERI IMPLANT TISSUES: PERI – IMPLANT MUCOSA IMPLANT BONE INTERFACE ○ FIBRO OSSEO INTEGRATION ○ OSSEOINTEGRATION 40 to 50% contact with bone. The main etiological factors leading to lack of osseointegration are: - Premature loading of the implant system, Apical migration of the junctional epithelium, Soft tissue proliferation into the interface, Over heating of bone during preparation, Placement of implant with too much pressure, Improper fit of the implants and Underlying systemic diseases. CLASSIFICATION BASED ON SHAPE AND FORM Endosteal implants, Subperiosteal implants, Transosteal implants, Intramucosal inserts / Submucosal implants / Subdermal implants & Endodontic stabiliser/ implants.
BASED ON SHAPE Post or root form implants & ○ Internal helix ○ External helix Blade implants CLASSIFICATION ROOT FORM IMPLANTS ARE FURTHER CLASSIFIED INTO: Solid tapering types Solid cylinder type Pin type Screw shaped implant type Basket design Hollow cylinder design
BLADE IMPLANTS ARE CLASSIFIED AS:
Conventional blade design & Vented blade design. CLINICAL ASPECTS PATIENT SELECTION: INDICATIONS CONTRAINDICATIONS ○ ABSOLUTE MEDICAL CONTRAINDICATION Smoking Uncontrolled diabetes Osteoporosis Age Radiotherapy Immunocompromised conditions ○ INTRA ORAL CONTRAINDICATION ○ TEMPORARY CONTRAINDICATION CLINICAL ASPECTS ANATOMIC PREREQUISITES ○ AVAILABLE BONE ○ SOFT TISSUE ○ ANATOMIC INTERFERENCES ○ HEIGHT AND WIDTH OF BONE ○ IMPLANT CROWN INTERRELATIONSHIP ○ BONE QUALITY CLINICAL ASPECTS DIAGNOSIS: THREE ASPECTS ARE CHECKED: ○ Analysis of appropriate and adequate radiographs. ○ Analysis of mounted study models. ○ Measurement of mucosal thickness. Ridge mapping
RADIOGRAPHS ○ IOPA ○ LATERAL CEPHALOGRAPHS ○ OPG ○ OCCLUSAL ○ TOMOGRAPHY ○ CT ○ ENHANCED CT CLINICAL ASPECTS CLASSIFICATION OF BONE Based on quality ○ Class I TO IV OR D1,D2,D3,D4. Based on quantity ○ A TO D
CORRELATION TO BONE Implant length Implant diameter Implant surface Implant position SURGICAL ASPECTS IMPLANT SURGERY ONE STAGE TWO STAGE ADDITIONAL SURGERIES IMMEDIATE IMPLANTS HEALING AFTER SURGERY SURGICAL COMPLICATIONS INTRA OPERATIVE COMPLICATIONS POST OPERATIVE COMPLICATIONS ○ IMMEDIATE COMPLICATIONS ○ LATE COMPLICATIONS ADVANCED SURGERY BONE GRAFTS GROWTH FACTORS GUIDED BONE REGENERATION RIDGE AUGMENTATION HORIZONTAL AUGMENTATION ○ PARTICULATE BONE GRAFT ○ MONOCORTICAL BONE GRAFT VERTICAL AUGMENTATION DISTRACTION OSTEOGENESIS SINUS/NASAL LIFT NERVE REPOSITIONING PROSTHETIC ASPECTS BIOMECHANICS: The sum total of the procedures for analysis and determination of loading and deformation of bone is usually called biomechanics.
SUPERSTRUCTURES ○ OVER DENTURES ○ FIXED BRIDGES ○ FIXED DETACHABLE BRIDGES ○ SINGLE CROWNS
PROSTHETIC COMPLICATIONS PERI - IMPLANT COMPLICATIONS Pathologic alterations in the tissues that contact a dental implant fall under the definition of peri-implant pathology. The development of an inflammatory process that is limited to the peri-implant soft tissues can be defined as peri-implant mucositis. Progressive peri-implant bone loss accompanied by inflammatory pathology in the soft tissues is referred to as peri- implantitis. PERI - IMPLANT COMPLICATIONS CLASSIFICATION: SUCCESSFUL IMPLANTS & NOT SUCESSFUL IMPLANTS: ○ COMPROMISED SUCESSFUL IMPLANTS, ○ FAILING IMPLANTS & ○ FAILED IMPLANTS.
