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IMPLANTS
Presented by
Dr.ABBASI BEGUM
PG - DEPT.OF PROSTHODONTICS
Narayana Dental College and Hospital
COMPONENTS &
CLASSIFICATION OF
IMPLANTS
content
Introduction
Definitions
Implant components
Classification of implants
Introduction
Implant dentistryImplant dentistry is a boon for
restoration of missing teeth
It overcomes many disadvantages...
DEFINITION OF IMPLANT
A substance or other tissue, which
partially or completely inserted or
grafted into the body for the...
Implantology
Study of art & science concerned
with the surgical insertion&
restoration of material & devices
restoring the...
Dental implants
A prosthetic device made of
alloplastic material(s) implanted into
the oral tissues beneath the mucosal
on...
INDICATIONS FOR IMPLANTS
1. For completely edentulous patients
with advanced residual ride
resorption, where it is difficu...
Advantages
To overcome the drawbacks of
removable prosthesis
Bone maintenance of height & width
Ideally esthetic tooth pos...
Parts
Parts
1. Implant body
2. Healing screw
3. Healing caps
4. Healing abutment or per mucosal
extension
5. Abutment
6. Hygieni...
1. Implant body
• The component that
is placed within the
bone during first
stage of surgery
• It could be threaded
or non...
First stage cover screw or healing
screw
First stage :
Cover is placed
into the top of
the implant to
prevent bone
,soft t...
Functions of healing screw
Facilitates suturing of soft tissues
Prevents growth of the tissues over
the edge of the implan...
Length ranges from 2-10mm
They project through the soft tissues
into the oral cavity
They function to prevent overgrowth
o...
Permucosal extension :healing
abutment
After a prescribed healing period sufficient to
allow a supporting interface to dev...
Also called as healing abutment
because ;
Stage 2 uncovery surgery often uses this
device for initial soft tissue
healing…...
Implant abutment
Implant abutment is the
intermediate
connector between the
implant and the
restoration, it may
extend abo...
Implant abutment
supports or retains a prosthesis or
implant super structure
Defined as: a metal framework that fits
the i...
Categories of implants
Depending on method by which the
prosthesis is retained to abutments
1. Abutment for screw retentio...
Hygienic cover screw
An abutment for screw retention uses
a hygienic cover screw placed over
the abutment;
To prevent debr...
Transfer coping:
A metallic, acrylic resin, or other
covering or cap used to position a dye
in an impression
to position a...
Transfer technique
Two technique
• Indirect
• Direct
Indirect– impression material requires
elastic properties.
Indirect t...
Parallel sided or slightly tapered
To allow ease in removal of impression
Flat sided or smooth undercuts
To facilitate reo...
Impression post
It is a small stem that facilitates the
transfer of te intraoral location (of the
implant or the abutment ...
Impression posts
27
Analog
Used in fabrication of master cast
To replicate the retentive portion of
implant body or abutment
1. Implant body a...
These are machined structures ,which
represent the body of implant
Placed on laboratory cast in order to
fabricate an impl...
Laboratory analogs
30
A prosthetic coping
A thin covering to fit implant abutment
for screw retention & serve as
connection between abutment & t...
32
Classification of implants
1. Based on placement within the
tissue
A)endosteal a)ramus frame
b)root form
c)blade form
B...
33
Subperiosteal implants
Subperiosteal implant
Derive primary support by resting on
the bone
Indicated when there are several
missing teeth or when...
Endosteal implant
36
Endosteal implants
It is the most common & successful dental
implant today.
Placed directly into the bone & works like a
n...
Root form Implant
Used over a vertical
column of bone
Available in different forms
i.e cylinder or press fit
form, screw r...
Blade form implant
Also known as plate form implant
Less common type of implant
indicated: when the jaw bone is too
narrow...
Ramus frame
Indication: when pt
has no enough
bone or thin bone
It is a metal bar to
provide root to
replace missing
teeth
41
Transosteal implant
Penetrates both cortical plates &
passes through the entire thickness
of the alveolar bone
Mucosal inserts
42
Intramucosal implants
Used with removable dentures
Have mushroom shaped design
It will attach to the gum side of the
dentu...
2)Based on attachment mechanism
of implants
1. OSSEOINTEG
RATION
2. FIBRO
INTEGRATION
FIBROINTEGRATION
Proposed by Dr. Charles Weiss
Complete encapsulation of the
implant with soft tissues
Soft tissue interfa...
Osseo-Integration
Direct contact between the bone &
the surface of the loaded implant
Described by BraneMark
Bioactive mat...
3)Based upon materials used
1.Metallic implants- Commercially pure
titanium
Titanium alloy
Cobalt chromium
molybdenum
2.No...
Cylindrical dental implant
In the form of cylinder
Depends on coating or surface
condition to provide microscopic
retentio...
Threaded Implant
The surface of the implant is threaded
to increase the surface area of
implant
This results in distributi...
Perforated dental implant
The implant of inert micro porous
membrane (MIXTURE OF
CELLULOSE ACETATE)in intimate
contact wit...
Solid dental implant
Circular cross section without vents or
hollow in the body
Vented dental implants
In the hydroxyapatite coated cylinder
implant patented vertical grooves
connecting to the apical ve...
Hollow dental implant
Hollow design in the apical portion
Systemically arranged perforations on
the sides of the implants
...
Cylindrical Screw shaped implants.
Threaded Non threaded.
55
5)Classification based on surface of
implants
Smooth surface
Machined
Textured
coated
Smooth surface implants
Has very smooth surface
Prevents microbial plaque
retention
Machined surface implants
For the purp...
Textured implant
The implant of increasing surface area
to which the bone is bond
Coated
The implant surface is covered wi...
Hydroxyapatite coatings
6)Based upon their surface coating
1. Titanium plasma sprayed
2. Hydroxyapatite coating
3. Grid blasting with TiO
4. SLA (...
Titanium plasma sprayed coating
(TPS)
6-10 times increase surface area.
Sand blasting large grid Acid
etching
Decrease in contact angle by 100 –
better cell attachment.
Acid etching with 1% HF a...
Based on implant material
Metallic
Ceramic
Polymer
Metallic :most popular material used is
titanium
Other materials are-st...
Ceramic & ceramic coated implant
These materials are also used to coat
the metallic implants
These ceramics can either be ...
Polymeric material
In the form of polymethylmethacrylate
& poly tetrafluroethylene
Have only been used as adjuncts
stress ...
Based upon the surgical stage
Two stage implants One stage implant
66
Two stage implant
Multi component implant system is used
During the first stage ,the implant body is seated
in the bone & ...
Advantage:
• Direct observation of crestal bone
volume before osteotomy
• Direct observation during osteotomy
preparation
...
Local hygiene issues or anaerobic bacterial
infiltration are not critical factors during
initial healing
The ability to de...
One stage implant
The implant fixture is placed such that
the prosthetic post of the implant
extends into the oral cavity
...
Implant body is usually placed slightly
above the crest of the bone
Soft tissue is then placed around the
PME
Based upon tissue response
o Biotolerant materials-
polymethylmethacrylate
o Bioinert materials-titanium and aluminium
oxi...
References
1. Atlas of oral Implantology-
2. Contemporary implant dentistry –
Carl.E.Misch
3. Prosthodontic treatment for
...
Thank
you
Implant classification
Implant classification
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Implant classification

  1. 1. IMPLANTS Presented by Dr.ABBASI BEGUM PG - DEPT.OF PROSTHODONTICS Narayana Dental College and Hospital
  2. 2. COMPONENTS & CLASSIFICATION OF IMPLANTS
  3. 3. content Introduction Definitions Implant components Classification of implants
  4. 4. Introduction Implant dentistryImplant dentistry is a boon for restoration of missing teeth It overcomes many disadvantages of other conventional methods of restorations i.e with removable prosthesis & with fixed prosthesis.
  5. 5. DEFINITION OF IMPLANT A substance or other tissue, which partially or completely inserted or grafted into the body for therapeutic, diagnostic, prosthetic or experimental purposes.
  6. 6. Implantology Study of art & science concerned with the surgical insertion& restoration of material & devices restoring the partially or totally edentulous patients to function or The study or science of placing & restoring dental implants- GPT
  7. 7. Dental implants A prosthetic device made of alloplastic material(s) implanted into the oral tissues beneath the mucosal on/or within the bone to provide retention & support for removable or fixed dental prosthesis ;a substance that is placed into or/and upon the jaw bone to support a removable or fixed dental prosthesis.
  8. 8. INDICATIONS FOR IMPLANTS 1. For completely edentulous patients with advanced residual ride resorption, where it is difficult to obtain adequate retention. 2. For partially edentulous arches where RPD may weaken the abutment teeth & also provides reduced masticatory efficiency. 3. For single tooth replacement 4. Patient’s desire.
  9. 9. Advantages To overcome the drawbacks of removable prosthesis Bone maintenance of height & width Ideally esthetic tooth positioning Improved psychological health Increased stability in chewing Increased retention Eliminates need to involve adjacent teeth
  10. 10. Parts
  11. 11. Parts 1. Implant body 2. Healing screw 3. Healing caps 4. Healing abutment or per mucosal extension 5. Abutment 6. Hygienic screw 7. Prosthesis retaining screw
  12. 12. 1. Implant body • The component that is placed within the bone during first stage of surgery • It could be threaded or non threaded • Threaded implants are available in commercially pure titanium or as titanium alloys • The Ti or Ti alloys may be with or without a hydroxyapatite coating.
  13. 13. First stage cover screw or healing screw First stage : Cover is placed into the top of the implant to prevent bone ,soft tissue or debris from invading the abutment connection area during healing
  14. 14. Functions of healing screw Facilitates suturing of soft tissues Prevents growth of the tissues over the edge of the implant 3)Healing caps Dome shaped screws placed over the healing screw after 2nd stage of surgery & before insertion of prosthesis.
  15. 15. Length ranges from 2-10mm They project through the soft tissues into the oral cavity They function to prevent overgrowth of tissues around the implant….
  16. 16. Permucosal extension :healing abutment After a prescribed healing period sufficient to allow a supporting interface to develop a second stage procedure is performed. To expose the implant or to attach a transepithelial portion It is called Permucosal extension because it extents the implant above the soft tissue & results in development of Permucosal seal around the implant.
  17. 17. Also called as healing abutment because ; Stage 2 uncovery surgery often uses this device for initial soft tissue healing…….
  18. 18. Implant abutment Implant abutment is the intermediate connector between the implant and the restoration, it may extend above the tissue. In some instances is subgingival, to provide a more esthetic restoration.
  19. 19. Implant abutment supports or retains a prosthesis or implant super structure Defined as: a metal framework that fits the implant & provides retention for a removable prosthesis OR Provides the framework for a fixed prosthesis.
  20. 20. Categories of implants Depending on method by which the prosthesis is retained to abutments 1. Abutment for screw retention 2. Abutment for cement retention 3. Abutment for attachment Uses an attachment device to retain a removable prosthesis such as o- ring attachment Used for CD & or partial dentures.
  21. 21. Hygienic cover screw An abutment for screw retention uses a hygienic cover screw placed over the abutment; To prevent debris & calculus from invading the internally threaded portion of abutment during prosthesis fabrication.
  22. 22. Transfer coping: A metallic, acrylic resin, or other covering or cap used to position a dye in an impression to position an analog in an impression It is defined by portion of implant it transfers to master cast. 1. Implant body transfer coping or 2. the abutment transfer coping
  23. 23. Transfer technique Two technique • Indirect • Direct Indirect– impression material requires elastic properties. Indirect transfer coping is screwed into abutment or implant body remains in place when set impression is removed from mouth..
  24. 24. Parallel sided or slightly tapered To allow ease in removal of impression Flat sided or smooth undercuts To facilitate reorientation in the impression after removal Direct technique Direct transfer coping consists of hollow transfer component, often square & a long screw to secure it to abutment or implant body. Used as pick up impression coping They remain within the impression until master model is poured & seperated.
  25. 25. Impression post It is a small stem that facilitates the transfer of te intraoral location (of the implant or the abutment )to a similar position on the cast They are placed over the implant body during impression making.
  26. 26. Impression posts 27
  27. 27. Analog Used in fabrication of master cast To replicate the retentive portion of implant body or abutment 1. Implant body analog 2. Implant abutment analog After master impression the analog is attached to transfer coping & the assembly is poured in stone to fabricate master cast.
  28. 28. These are machined structures ,which represent the body of implant Placed on laboratory cast in order to fabricate an implant supported prosthesis During surgery, after the implant body is inserted into the prepared bone cavity,the impression post is placed over it. An impression is made & the analogue impression post complex gets attached to impression & comes away with it. When the impression is poured ,the impression post analogue complex will get embedded to the cast.
  29. 29. Laboratory analogs 30
  30. 30. A prosthetic coping A thin covering to fit implant abutment for screw retention & serve as connection between abutment & the prosthesis superstructure. Prefabricated coping A castable coping A prosthetic screw; a screw retained prosthesis is secured to implant body or abutment with a prosthetic screw…
  31. 31. 32 Classification of implants 1. Based on placement within the tissue A)endosteal a)ramus frame b)root form c)blade form B)Subperiosteal C)Transosteal D)Intramucosal
  32. 32. 33
  33. 33. Subperiosteal implants
  34. 34. Subperiosteal implant Derive primary support by resting on the bone Indicated when there are several missing teeth or when there is no enough jaw bone width & height can easily fit over the jaw bone & provide root for multiple teeth
  35. 35. Endosteal implant 36
  36. 36. Endosteal implants It is the most common & successful dental implant today. Placed directly into the bone & works like a natural tooth. Made up of metal, ceramic, or polymeric material 3 types root form blade form ramus frame form
  37. 37. Root form Implant Used over a vertical column of bone Available in different forms i.e cylinder or press fit form, screw root form & combination root form Cylinder root form depends on microscopic retention It is tapped or pushed into the prepared bone site Screw root forms have threads & have macroscopic retention which provides superior bone fixation
  38. 38. Blade form implant Also known as plate form implant Less common type of implant indicated: when the jaw bone is too narrow & not suitable for bone grafting
  39. 39. Ramus frame Indication: when pt has no enough bone or thin bone It is a metal bar to provide root to replace missing teeth
  40. 40. 41 Transosteal implant Penetrates both cortical plates & passes through the entire thickness of the alveolar bone
  41. 41. Mucosal inserts 42
  42. 42. Intramucosal implants Used with removable dentures Have mushroom shaped design It will attach to the gum side of the denture Help to increase the chewing efficiency
  43. 43. 2)Based on attachment mechanism of implants 1. OSSEOINTEG RATION 2. FIBRO INTEGRATION
  44. 44. FIBROINTEGRATION Proposed by Dr. Charles Weiss Complete encapsulation of the implant with soft tissues Soft tissue interface could resemble the highly periodontal fibers of mature dentition.
  45. 45. Osseo-Integration Direct contact between the bone & the surface of the loaded implant Described by BraneMark Bioactive material that stimulate the formation of bone can be used
  46. 46. 3)Based upon materials used 1.Metallic implants- Commercially pure titanium Titanium alloy Cobalt chromium molybdenum 2.Nonmetallic implants- Ceramics Carbon 47
  47. 47. Cylindrical dental implant In the form of cylinder Depends on coating or surface condition to provide microscopic retention & bonding to the bone Pushed or tapped into the prepared bone site Straight, tapered or conical
  48. 48. Threaded Implant The surface of the implant is threaded to increase the surface area of implant This results in distribution of forces over a greater peri- implant bone volume
  49. 49. Perforated dental implant The implant of inert micro porous membrane (MIXTURE OF CELLULOSE ACETATE)in intimate contact with & supported by the layer of perforated metallic sheet material (pure titanium)
  50. 50. Solid dental implant Circular cross section without vents or hollow in the body
  51. 51. Vented dental implants In the hydroxyapatite coated cylinder implant patented vertical grooves connecting to the apical vents were designed to facilitate seating & allow bone ingrowth to prevent rotation
  52. 52. Hollow dental implant Hollow design in the apical portion Systemically arranged perforations on the sides of the implants Increased anchoring surface…..
  53. 53. Cylindrical Screw shaped implants. Threaded Non threaded. 55
  54. 54. 5)Classification based on surface of implants Smooth surface Machined Textured coated
  55. 55. Smooth surface implants Has very smooth surface Prevents microbial plaque retention Machined surface implants For the purpose of better anchorage of implant to the bone, the surface of the implant is machined….
  56. 56. Textured implant The implant of increasing surface area to which the bone is bond Coated The implant surface is covered with a porous coating The material used for coating are 1. Hydroxyapatite 2. titanium
  57. 57. Hydroxyapatite coatings
  58. 58. 6)Based upon their surface coating 1. Titanium plasma sprayed 2. Hydroxyapatite coating 3. Grid blasting with TiO 4. SLA (sandblasted-large grid-acid etched) 5. Acid etched 6. Machined surface
  59. 59. Titanium plasma sprayed coating (TPS) 6-10 times increase surface area.
  60. 60. Sand blasting large grid Acid etching Decrease in contact angle by 100 – better cell attachment. Acid etching with 1% HF and 30% NO3 after sand blasting – increase in osseointegration by removal of aluminum particles (cleaning).
  61. 61. Based on implant material Metallic Ceramic Polymer Metallic :most popular material used is titanium Other materials are-stainless steel -cobalt chromium molybdenum alloy -vitallium
  62. 62. Ceramic & ceramic coated implant These materials are also used to coat the metallic implants These ceramics can either be plasma sprayed or coated to produce bio- active surface Non reactive ceramic material are also present
  63. 63. Polymeric material In the form of polymethylmethacrylate & poly tetrafluroethylene Have only been used as adjuncts stress distribution along with implants rather than used as implants by themselves.
  64. 64. Based upon the surgical stage Two stage implants One stage implant 66
  65. 65. Two stage implant Multi component implant system is used During the first stage ,the implant body is seated in the bone & completely covered with mucoperiosteal flap The fixture is allowed to heal with bone (osseointegration) The second stage is done 6 weeks after the first surgery During the second surgery the implant fixture is uncovered so that the prosthetic component can be placed over the implant
  66. 66. Advantage: • Direct observation of crestal bone volume before osteotomy • Direct observation during osteotomy preparation • Ability to bone graft the site at the time of implant placement • Implant body healing at or below the crest of bone, which reduces the risk of early loading during initial bone healing
  67. 67. Local hygiene issues or anaerobic bacterial infiltration are not critical factors during initial healing The ability to deliver a soft tissue –borne transitional appliance in the esthetic zone During second stage The crestal & the facial region may be directly evaluated & Minor defects corrected before beginning the prosthetic reconstruction The facial plate of bone may resorb during initial healing & may be grafted during the second surgery
  68. 68. One stage implant The implant fixture is placed such that the prosthetic post of the implant extends into the oral cavity They are usually stabilized by inter implant splints to avoid the action of excessive loading forces on the implant during healing phase At the conclusion of the surgery ,a Permucosal Healing Element (PME) is placed into the implant body
  69. 69. Implant body is usually placed slightly above the crest of the bone Soft tissue is then placed around the PME
  70. 70. Based upon tissue response o Biotolerant materials- polymethylmethacrylate o Bioinert materials-titanium and aluminium oxide o Bioactive materials-glass and calcium phosphate ceramic 72
  71. 71. References 1. Atlas of oral Implantology- 2. Contemporary implant dentistry – Carl.E.Misch 3. Prosthodontic treatment for edentulous patients-complete dentures & implant supported prosthesis-Zarb -Bolender
  72. 72. Thank you
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