Dental Implants History and Definition.docx

8/11/2019 Dental Implants History and Definition.docx

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Dental Implants History and Definition

materialalloplasticis a device made ofDental Implant (inert material that does not react with the body tissues)usually its titanium; implanted in the oral tissues undermucosa and periosteum or within bone to provideretention and support for a fixed or removable prosthesis.

stones in implants are:foundationThe

;or toothnot a rootaresmplant I-1implant is not analogues to the root ortooth , it's just a device for a finalprosthesis. If a patient has three missing

teeth we put two implants and a bridge ,not three implants so not every missingtooth should be replaced by implant andnot every missing root should be replacedby implants, for example we place oneimplant for upper missing six with threeroots.

- At the beginning of implants for all missing teeth they were put animplant for every tooth then they became 12 then 10 then 8 butnowadays there is a concept called ( All In Four ); four implants perarch.

; not all patients with implant havenot always fixedaresmplant I-2fixed restoration, some implants are supported with denture called

madesimplant , and there aredenture partial implant supported over


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over hybrid which is something can be inserted and removed by thepatient.

removable ororSo the restoration on implants can be fixed-

.ion between fixed and removablecombinat

;ast predictable treatment plansometimes implants are the le-3in some cases it's not esthetically to go for implants especially withtwo adjacent implants with soft tissue loss and bone loss.

8missingpatient with;We dont replace every missing tooth-4doesn't need implant , and a patient with missing 7 since 10 yearsesthetically and functionally no need to go for implant unless he

come with fresh extraction and he s afraid of drifting or supra-eruption or he doesn't like the space and keep complaining about it .

- This is a picture for an (implantsupported crown or restoration) or(implant retained crown or restoration)shows the difference between theimplant and natural tooth, in which thenatural tooth is a calcified tissue withcrown, root and PDL while the implantis a fixture ankylosed device , (means nofibrous tissue between implant andbone, if there is a fibrous tissue therewill be lack of osseointegration which is failure).

-this is called endooseous implant which hasdifferent shapes; threads, micro threads, parallelsided, screws, tapered, hollow, solid,

-There is another part of implant which is the abutment , it's alwaysscrew retained, the screw to tighten the abutment to the implant .And the final restoration which is the crown.


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History Of Dental Implants

Maya civilization which is in south America worked withendosseous implant 1350 years before per-ingvar branemark )

implant inventor) work with titanium . Archeologists excavated Maya burial sites Honduras in 1931 and

found fragments of mandible of Maya origin and they thought thatshe is a female, dating from about 600 AD. They found three shellsin a tooth shape in anterior mandible were osseointegrated withthe compact bone that means this female has these shells in hermandible before her death, because no way of osseointegrationafter death.

1950s research at Cambridge University in England: titaniumchamber was embedded in the soft tissue of the ears of rabbits.

1952 Swedish orthopedic surgeon per-ingvar branemark:titanium chambers in rabbit femurs, after several months he wasunable to remove them that mean there is osseointegrationbetween them.

1965: branemark placed the first dental implant into a human

volunteer, and he made a surprise that his patients usedprosthesis supported by implant in anterior mandible 15 yearsago without telling anybody.

Implant is documented in the worldwide in 1977 and started to be one of the options.

:Types Of Dental Implants

Endosteal: it could be screws either cylindrical or threaded

tapered most commonly used , or in some cases plates orblades least commonly.

Subperiosteal; elevating a flap then putting titanium piece likeplate subperiosteal then bone will be formed over this piece .useful in reduced bone volume . They are not common such asendosteal because of their high failure rate .


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-Implants have different sizes and diameter but ingeneral they are classified into narrow (3.5mm),regular (4mm) and wide (5mm).

options:Treatment1- No treatment (missing 8, for example).2- RPD3- FPD (bridge)4- Complete denture5- Implant supported prosthesis

Restoration of implants: Direct to fixture or Direct to implant:

simply the restoration is connected tothe implant by screw, used when theimplant is in the proper position withoutdeviation .

Angulated or tilted implant in which we can'tput the restoration directly over it So we usean abutment to change the angulationby screwing the abutment in the implant to

achieve proper restorative contours then attachthe final restoration to the abutment either byscrew (vertical screws like occlusal screws or horizontal screws like transverse or cross-pinscrews) or you cement it.

Ideally placed implant

Poorly placed implant


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Why titanium is the best material of choice?

Titanium is a natural cheap base metal in which very minimal oxidelayer composed above it. To get strong osseointegration there are

two Features : presence of oxide layer, have minimal thick layer inwhich titanium has minimal thick oxide layer so it has bestosseointegration

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Now lets talk about some cases ,

A case for an implant in a proper position to restore right centralincisor, the final restoration will be just one piece withoutabutment so called direct to fixture.

of implant we use aimproper positionIn cases of.restoration with an abutment

A case for 24 years old male had bike accident, he lost central,lateral and canine with dentoalveolar fracture , So bone graft wasdone first then three implants were placed, two of them were inproper position so the final restoration placed directly to theimplant without abutment, and the other implant was in improperposition in this case we need abutment by screwing it in theimplant then attach the final restoration to the abutment.

A case for African patient who his lower centrals and canines wereextracted as a tradition ,two implants were used to replace themissing teeth .

anterior mandible is one of the best locations for dentalimplants because it has such good compact bone.


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In a case of a patient has unstable denture due to boneresorption we put two implants in the lower arch and 2-4 inthe upper and an attachment so it's called denture supportedimplant.

The denture will be clicked on locatorsin the mouth instead of depending on saliva and cohesion.

- Nowadays implants aredone without elevating flap,they use the computer to

convert a CT scan to 3D viewwhich allows us to visualizeanatomy then selecting thelocation of implantsaccording to surgical guides,the implant frame becomesready according to operatorguidance, and the final

restoration is made using the computer .

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Done by :

Rawan Shatnawi & Rasha Al-Shboul

Documents

Dental Implants History and Definition.docx