Dental Implant Classification and Components Guide

EVOLUTION
CLASSIFICATION AND
COMPONENTS OF
IMPLANTS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

TABLE OF CONTENT:
Introduction
Historical background
Classifications
Endosteal implants
Subperiosteal implants
Intramucosal inserts
Transosseous implants
Components of root form implants
Conclusion
Bibliography

INTRODUCTIONS-
The goal of modern dentistry is to restore the
patient to normal contour, function, comfort,
esthetics, speech and health.

Dental implants-
A dental implants is a device of
biocompatible materials placed within the mandibular
or maxillary bone to provide additional or enhanced
support for the prosthesis or tooth .

EARLY HISTORICAL DEVELOPMENT
The first history of implants dates back to 600 A.D.
Archaeological findings show that ancient Egyptian
experimented with reimplanting lost teeth with
animal teeth or teeth carved from ivory .

In 18th century lost teeth were replaced with
extracted teeth of other human donor.

In 1809, Maggiolo described a process of
fabricating and inserting gold implants into fresh
extraction socket .
In 1887, Harris attempted the same procedure with
platinum post instead of gold.

In 1886 – Edmisids was the first person in USA to
implant platinum disc into the jaw bone .
In 1906- Greenfield described endosseous implant
made of an iridium – platinum alloy.
In 1939 – Strock succeeded in anchoring a vitallium
screw and mounting a porcelain crown on it .

In 1943 – Gustavo Dahl conceived the concept of
subperiosteal implant .
In 1948 – Goldberg and Gershkoff refined the
subperiosteal implant with an extension of the
framework .

In early 1960 Orlay utilized vitallium posts for
endodontically treated teeth with extension beyond
apex.
Linkow in the mid 1960s introduced the blade vent
implant .

in 1952 Branemark began extensive study on the
microscopic circulation of bone marrow
In 1965 human studies began, after 10year follow
up, were reported in 1977
He defined the term osteointegration for the first
time

In 1980, Dr George a Jarb at the university of
Toronto , Canada , began the clinical use of this
system .
In 1982 the Toronto conference on osteointegration
in clinical dentistry laid down the first parameters on
what is to be considered successful implant
treatment within the stringent confines of the
scientific community.

In late 1960s Robert and Robert developed the
ramus blade implant
In early 1970s they designed the mandibular staple
implant for the edentulous atrophic mandible.

In 1970s ramus frame implant was designed .

In early 1970s the use of Intramucosal inserts
was popularized by Weiss and Judy.

In early 1970 s Schroeder and his team designed a
single stage implant system known as ITI implant
system.
In 1974 IMZ implant system was introduced .
Elastic component is inserted between implant and
superstructure .

In early 1980s Niznick introduced core vent implant
which is hollow implant with threaded component to
engage bone.
In late 1980s cylindrical plasma spray titanium and
hydroxyapatite coated implant were introduced.

In 1986 – The root form implants superceded the blade
form implants as ‘the most frequently placed implant’.
In 1984- Ct scan
In 1987 – Sinus lift
In 1988 – Nerve transposition
In 1989 – Pterygoid implants
In 1995 – Distraction osteotomies spilt ridge technique

CLASSIFICATION OF DENTAL
IMPLANTS

IMPLANTS CAN BE CLASSIFIED AS -
Implants
Totally buried Semi - buried
Sub periosteal
implant
Endosteal
implant

IN 1881 WILLIAM CLASSIFIED THE USE OF DENTAL
IMPLANTS AS-
For prosthetic treatment
For endodontic stabilization
For periodontal surgery
For simulation of congenitally
absent tissue
For treatment of facial fracture

CLASSIFICATION BASED ON IMPLANT POSITION -
Endosseous
Transoss
eous
Sub-
periosteal

ACCORDING TO WEISS AND WEISS -
Endosteal
Subperiosteal
Denture enhancing intra
mucosal inserts

IN 1998 AFNOR CLASSIFIED ENDOSSEOUS
DENTAL IMPLANT BASED ON THEIR MODE OF
INSERTION-
Crestally inserted
dental
implants(crestal
approach )
Laterally inserted
dental
implant(basal
approach)

Osteotomy is initiated on the crest .
This category includes root- form and blade form
implant .
Referred as Crestally inserted implants
Axially inserted dental implants

Osteotomy initiated on the buccal or lingual
/palatal aspect of jaw .
The entire osteotomy is performed laterally at
the same initial depth.
Laterally inserted dental implants

ENDOSTEAL IMPLANTS
An Alloplastic material surgically inserted into a
residual ridge primarily as prosthodontics
foundation.
They are most commonly applicable abutment
providing modalities.

ENDOSTEAL IMPLANT CAN BE FURTHER CLASSIFIED
AS –
Root form
Plate form
Endodontic
stabilizer

ROOT FORM IMPLANTS-
Designed to resemble the shape of a natural tooth
root.
Most commonly used dental implants.
One stage /two stage implant.
Placed in mandible and maxilla where sufficient bone
are present.

Available in four form –
Threaded
stepped
tapered
Parallel sided

The primary types based on design –
Cylinder or press fit
Screw form
combination

PLATE / BLADE FORM IMPLANTS-
The basic shape is similar to that of a metal plate or
blade in cross–section.
Combination of parallel and tapered sided.
Supplied in one stage or two stage varieties.

Maxillary and mandibular arch for partially or
complete edentulous where adequate bone is
present .
Bone required- >8mm vertical bone height
- >3mm bone bucco-lingually .
- >10mm bone mesio-distally.

RAMUS BLADE AND RAMUS FRAME IMPLANT-
The ramus implant is a one piece blade .
Use when insufficient bone exist in the body of jaw
prosthetic option: overdentures
Suitable arch : mandibular , completely edentulous.

They features an external attachment bar that
courses a few millimeters superior to the crest of the
ridge from one side of the ramus to another side .
Required bone- >6mm vertical bone height
(symphysis and rami)
>3mm bone width (buccal to lingual)

ENDODONTIC STABILIZER IMPLANT-
Endodontic stabilizers are used to extend the
functional length of an existing tooth root.
Improves prognosis and crown
root ratio

parallel sided or tapered
Smooth or threaded
Indication – mandible first molar and anterior to it .
- - in maxilla first premolar and anterior to it

SUBPERIOSTEAL IMPLANTS-
Implant is placed under the periosteum rather
than within the bone.
Always custom made .
Indicated - advanced alveolar ridge resorption .
Required bone is >5mm

Total subperiosteal
implants
Subperiosteal
implants
Circumferential
implants
Interdental
implants
Unilateral
implants

INTRAMUCOSAL INSERTS-
They differ in form ,concept and function from the
other modalities.
 Mushroom shaped titanium projections .
Attached to the tissue surface of a partial or complete
removable denture in the maxilla.
 Provide additional support and stability.

Intramucosal inserts doesn’t contact bone .
The mode of tissue integration is not osteointegration.
Rather , the receptor sites in the tissue into which the
inserts seat become lined with tough , keratinized
epithelium.
Indicated to patients who are poor medical risks.

Prosthetic options-removable dentures, full or partial
Suitable arch- maxillary , completely or partially
edentulous: mandibular partially only
Required bone – none ; required mucosa 2.2mm thick

Types -single component ,
-multiple component
-staple design
Prosthetic options- overdentures , fixed bridge
are rarely made
Transosteal implants

Required bone >6mm vertical bone height
>5mm bone width
Suitable arch-mandible anterior region,
completely or partially edentulous

COMPONENTS OF IMPLANTS-

COMPONENTS OF ROOT FORM IMPLANTS-
Body or fixture
Cover screw
Abutment and abutment
screw
Gold cylinder and screw

Transfer coping
Analog
coping
Coping or
prosthesis
screw

BODY OR FIXTURE
Divided into 3 parts
Crest module
Body
apex

FIRST STAGE COVER SCREW
Placed into the top of the implant to prevent bone,
soft tissue or debris from invading the abutment
connection area during healing .

PERMUCOSAL EXTENSION/HEALING ABUTMENT
/GINGIVAL FORMER
It extends the implant above the soft tissue and
result in the development of a Permucosal seal
around the implant.

It can be straight, flared or anatomical to assist in
the initial contour of the soft tissue healing .

ABUTMENTS
The portions of implants that support and retain a
prosthesis or implant superstructure.

TYPES OF ABUTMENT-
Depending
upon retention
Abutment for
screw retention
Abutment for cement retention
Abutment for
attachment

Abutment for cement retention
single unit or one
piece abutment
Two piece abutment

Advantages-
Easier to obtain esthetic .
Can join teeth and implant more readily.
Minor discrepancies in fit.
Disadvantages-
Difficult to retrieve.
Harder laboratory technique .
Conventional impression can lead to errors in fit.

Advantages-
Easily retrieved
Machined accurate component
Disadvantages-
Implant position and angulation is critical
Potential of screw fracture and loosening
Screw may spoil the appearance
Abutment for screw retention
BDJ VOL 187 NO 11 DEC 1999

Uses as attachment device to retain
removable prosthesis
Abutment for attachment

Depending upon design
Flat topped
abutment
Tapered
shouldered
abutment
Direct gold
coping abutment

Placed over the abutment
 Prevent debris and calculus from invading the
internal threaded portion of the abutment
Hygiene screw

Analog

Analog
Abutment
analog
Implant
analog

Purpose-Fabrication of master cast to replicate the
retentive portion of the implant body and abutment

Use to position an analog in an impression .
Transfer copings
Implant
body
transfer
coping
Abutment
transfer
coping
Direct
transfer
coping
Indirect
transfer
coping

Two basic type of impression for
implant are
Indirect or
closed tray
technique
Direct or open
tray technique

Indirect or closed tray technique

Transfer coping –
abutment analog

Transfer coping in abutment

Transfer coping
replaced in
impression
Transfer coping and
analogues mounted in
the impression

Coping removed

Direct or open tray technique
Connect transfer coping
with guide pins
Block out the transfer
coping with two thickness
of base plate wax

Resin tray is fabricated
Head of guide pins is
exposed

Guide pin hole is enlarged

Finished tray

connect square transfer
coping with guide pin

Abutment analog connected
to transfer coping

Guide pins are unscrewed
after setting of stone

Cast with abutment analog

Thin covering usually designed to fit the implant
abutment for screw retention .
It serves as the connection between the abutment
and the prosthesis or superstructures .
Prosthetic coping

Prefabricated copings
• Metal component machined precisely to fit the
abutment
Castable copings
• Plastic pattern cast in the same metal as
superstructures or prosthesis

CONCLUSION
The desire has always been to replaced missing
teeth with something similar to root of a tooth and
implant dentistry helps us to achieve that .
Regardless of the implant system use the generic
term is descriptive of function of components rather
than its proprietary name .

BIBLIOGRAPHY-
Contemporary implant dentistry –Carl E Mish (third
edition )
Atlas of oral implants – Cranin
Principles and practice of implant dentistry – Weiss
and Weiss
Oral implantology – Kakar
Implant and restorative dentistry –martin Dunitz
BDJ 1999
BDJ 2006,2007

Thank you
For more details please visit

Dental Implant Classification and Components Guide

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Dental Implant Classification and Components Guide

Similar to Dental Implant Classification and Components Guide (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

Dental Implant Classification and Components Guide