dental implants

1. ‫دو ر‬
‫ة‬
Implantology course
Basic course
01-2014
Dr kamal Masarwa
1

2. Dr. Kamal Masarwa
2

3. ?Why Implants
Indications
Single tooth anterior
3
Dr. Kamal Masarwa

4. Single tooth-Molar
4

5. 5

6. 6

7. Multiple Implants to Replace
Multiple Missing Teeth
7

8. teeth missing 2
8

9. teeth missing 3
9

10. Free end
10

11. 11

12. 12

13. 13

14. Fully edentulous-Fixed Bridge
14

15. Fully edentulous- over denture
Ball Attachment- 1
15

16. 16

17. Fully edentulous- over denture
Dolder Bar
17

18. 18

19. ?How can a dentist start to make Implants
19

20. 20

21. Implantation
■Transfer of non-living tissue or material into a
biological system
Transplantatio
n ■Transfer of living tissue
21

22. History of dental Implants
22

23. 23

24. TEETH WERE BOUND TOGETHER
WITH GOLD WIRE
At an ancient burial site, dental bridges
are excavated. Most probably inserted
post-mortem
24

25. THE EGYPTIANS
sea shells
25

26. Jaw of ancient Egyptian showing drill holes
used in dental repair.
Courtesy of the Gordon Museum
26

27. THE MAYAS
, strictly for ritual
religious or purely self
.adornment purposes
Jade and turquoise stones are implanted
.in the teeth
27

28. In 400 BC, the use of gold or
wood tooth-shaped implants was
reported
Watzek G (ed), Blahout R. Historical Review. In: Endosseous
Implants: Scientific and Clinical Aspects. Chicago: Quintessence
Publishing Inc;1995:17-28.
28

29. B.C was the first Reference to the 720-609
therapeutic Extrction of teeth
Assyrian physician associated diseased
teeth with a systemic disturbance and
recommended extraction in cases of
oral sepsis
29

30. THE GREEKS
HIPPOCRATES
writes about tooth decay
30

31. Fingers or a thin linen towel were used
. to cleanse the teeth
31

32. THE ROMANS
gold crowns
. fixed bridgework
32

33. The earliest known dental prosthesis from
Rome resulted from multi-karat gold wire
33

34. ,The Siwak, a primitive form of toothbrush
is used for cleaning teeth
34

35. The Favorite Dental
( Chair (circa 1901
35

36. 36

37. 37

38. 38

39. 39

40. 40

41. 1975
41

42. ‫الترجمه :‬
‫”ورد أن الجراح العربي المشهور ابو القاسم‬
‫الذي عاش في أسبانيا )كوردوفا( وتوفي حوالي سنة 3101‬
‫كان قد اجرى عمليات زراعة اسنان في العظم ” .‬
‫24‬

43. ‫:نبذة‬
‫،هو أبو القاسم خلف بن عباس الزهراوي‬
‫.اشتهر بالطب، توفي سنة 404 هجرية‬
‫،لم يكن الزهراوي جراحا ماهرا فحسب‬
‫ ً‬
‫اّ‬
‫.بل كان حكيما ذا خبرة واسعة‬
‫ ً‬
‫وقد أفرد قسما مهما من‬
‫ ً ً‬
‫،كتابه لمراض العين، والذن، والحنجرة‬
‫،وقسما مهما لمراض السنان، واللثة، واللسان‬
‫ ً ً‬
‫،وأمراض النساء، وفن والولدة، والقبالة‬
‫.وبابا كامل للجبر، وعل ج الفك والكسر‬
‫ ً‬
‫ ً‬
‫34‬

44. 44

45. ”The first “Implants
45

46. Transdental Fixation
46

47. 47

48. Implant Types
48

49. .… Lets remember some facts
49

50. Subperiosteal Implants
50

51. Subperiosteal Implants
51

52. 52

53. Subperiosteal Implants
53

54. 54

55. In 1943, Dahl reported using a
subperiosteal implant
55

56. Implant Types
1- Subperiosteal Implants
56

57. Transdental Fixation
57
Transdental Fixation

58. Needle Implants
58

59. Needle Implants
Lambotte 1934
59

60. 60

61. 61

62. 62

63. 63

64. Implant Types
1- Subperiosteal Implants
2- Enossal Implants(needle)
64

65. Types of enossal Implants
Needle Implants - 1
65

66. 66

67. 67

68. Blade Implants
68

69. Blade Implants
69

70. 1966
Blade Implants
70

71. 71

72. 72

73. Types of enossal Implants
Needle Implants - 1
Blade Implants - 2
73

74. 74

75. Disc Implants-
75

76. 76

77. 77

78. 78

79. 79

80. Types of enossal Implants
Needle Implants - 1
Blade Implants - 2
Disc Implants - 3
80

81. 81

82. Types of enossal Implants
Needle Implants - 1
Blade Implants - 2
Disc Implants - 3
Root form Implants – 4
Cylider ImplantsScrew Implants-
82

83. Root form Implants – 4
A - Cylider Implants
83

84. Root form Implants – 4
Cylider Implantsperformed-
Inserted with Hammercannot be removed84

85. 85

86. Stability development over time
86

87. Placement Stability
Initial Stability
Primary Stability
87

88. …To increase the mechanical Stability
functional surface area
88

89. 89

90. 90

91. Ather way
…To increase the mechanical Stability
91

92. Root form Implants – 4
B - Threaded,screw Implants
The functional surface area of a
threaded implant is greater
than a cylinder implant by minimum
of 30% and may eceed 500%
dependending on the thread geometry
92

93. Types of Screw Implants
93

94. 94

95. screw Implants
More functional Surface(Inserted with Hand (no hammerSelf thread(Less Boring (Bone DamageCan be removed-
95

96. Screw Implants
96

97. The “Sargon” expandable implant
97

98. 98

99. 99

100. NEW
Orthodontic Implants
100

101. 101

102. 102

103. Implant Materials
Ivory
seashells
bones of animals
teeth from human donors
Gold, platinum and other metal alloys
103

104. 1952
Professor
Per-Ingvar
Brånemark
104

105. 105

106. Dr. Brånemark demonstrated that
under carefully controlled conditions
titanium could be structurally integrated
into living bone with a very high degree
of predictability and, without long-term
soft tissue inflammation or fixture
rejection. Brånemark named the
phenomenon
Osseointegration
106

107. Osseointegrati
on
“A direct structural and functional
connection between ordered , living
bone and a surface of a loadcarrying implant “
Brånemark
Brå
1985
107

108. Carl Misch 2001
Implant and restorative Denistry
Dorland’s illustrated Medical Dictionary
(1994) defines osseointegration as ‘the
direct anchorage of an implant ,without
the growth of fibrous tissue at the boneimplant interface’(between Implant and
(.Bone
108

109. 109

110. 110

111. 111

112. 112

113. 113

114. 114

115. 115

116. Brånemark Implant
Machined Surface
about 1 µm
116

117. =Bone growth around inserted implant
0.6µm - 1µm / day
healing period = 3-6 months
117

118. ?How to decrease the time
118

119. …To increase the biological Stability
119

120. What happened with the bone after
?inserting an implant
Resorption
120

121. 121

122. 122

123. osteocytes
123

124. Formation
124

125. Osteozyt
125
©

126. 126

127. 127

128. a bone cell attaching to titanium
128

129. 129

130. There are Materials who increase the
. differentiation of osteoblasts
Osteoconductiv characteristics
130

131. µm 1
Bone growth= 0.6 – 1µm / day
131

132. ,If the Valleys are bigger
so the Bone growth is
Faster
Faster Osseointegration►
Less wait time for Laoding►
132

133. 133

134. ‫‪Caoting‬‬
‫ציפוי‬
‫طلء‬
‫431‬

135. 1-TPS (Titanium Plasma Spraying)
about 15 µm
bigger 6-10
135

136. 2 - SLA (Sand Blasting and Acid-Etched)
136

137. 3 – HA (Hydroxyapatite) Coating
of the bone 70%
Hydroxylapatite can be
found in teeth and
bones
137

138. 138

139. 4 - TCP (Tricalciumphosphat)
Osteoconductiv
Bioactive
139

140. BONIT®coating
BONIT is a fully resorbable
bioactive coating
that is replaced by new bone
in 6-10 weeks.
This coating allows early loading of dental
and orthopaedic implants.
The application is preferred on rough
implant surfaces.
140

141. 141

142. 142

143. 143

144. 144

145. ►Affinity ,Attachment and Growth of
bone forming cells (osteoprogrnitors)
145

146. 146

147. - Bioaktive Calcium-Phosphat
CaP)-Coating
(
BONIT®coating
147

148. 148

149. ?Are all Implants titanium maded
149

150. 150

151. Metalfree Implantation
151

152. 152

153. 153

154. 154

155. 155