Transcript Dental implants

Dental implants
• Dental implants are titanium screws that are
surgically inserted to be permanently
anchored to the jaw.
Dental implant is an artificial
alloplastic material placed
surgically into the jaw to
support a dental prosthesis.
• The titanium has been selected due to the
following proven characteristic:
1- strength.
2- light weight.
3- biocompatibility.
4- history of success in the field of medical joints
replacement.
Anatomy or parts of the dental implant
• 1- the crown: a replacement tooth, custom
made to match the color of adjacent teeth.
• 2- abutment : a devise that support and
connect the crown to the implant fixture.
• 3- fixture : is a titanium device imbedded in
the jaw bone to replace the original root of
the tooth.
Dental implants
Dr,salah hegazy
Indications for dental implants.
1. Intolerance to removable dental prosthesis.
2. Need for long span fixed prosthesis with
questionable prognosis.
3. Single tooth loss that will make it necessary to
prepare sound adjacent teeth for a fixed
prosthesis.
4. Unfavourable condition, location and number of
abutment teeth.
Contraindications for dental
implants.
1- the mandible is atrophic as there is a high risk of
fracture.
2- there is an alveolar bone deficiency and the
patient declines bone grafting.
3- The patient is emotionally and psychologically
unstable (eg, bruxism, poor home care).
4- underlying disease or disorders of the bone are
present ( eg, osteoporosis)
5- the patient is a smoker.
6- In the case of patients subject to radiant
therapy, wait for at least one year from the
interruption of the radiant therapy before
proceeding with the implant treatment.
7chronic
alcoholism
are
absolute
contraindications
Advantages & disadvantages of implant over
conventional treatment
• Advantages: 1- Implants do not involve
preparation of the adjacent teeth,2- they
preserve the residual bone, and 3- excellent
aesthetics can be achieved.
• Disadvantage: 1- it is expensive,2- the
patient requires surgery, 3- time consuming,
and 4- technically complex.
Dr,salah hegazy
Advantages of dental implants
1. Preservation of tooth structure.
Fixed bridge
Implant
• Eliminates the need to grind healthy teeth
necessary to produce conventional bridge
work.
Cont …
Fixed partial dentures
Single tooth implants
• Significant reduction
• no need for
in the amount of tooth preparation of adjacent
structure is necessary teeth.
• long term survival:
• Long term survival:
87% at 10 yrs, 69% at 15 yrs
•
Less expensive
96.5% at 11 yrs
•
More expensive
Advantages of dental implants
2. Preservation of bone: reduce bone loss and
gum recession associated with missing teeth
loss of teeth →
Lack of stimulation to the residual bone →
Decrease in bone density, height and width.
Bone resorption after extraction
Bone resorption in edentulous
patients
• Most of the bone loss occurs in the first year after
extraction )2mm per a year).
• Continued bone loss for more than twenty years 0.2
mm per a year.
• Four fold greater in mandible than in maxilla.
Upwards and medially in maxilla, downwards •
and laterally in mandible.
•
•
•
1.
2.
3.
Teeth stimulate bone → maintain bone.
Implants stimulate bone → maintain bone.
Complete and partial dentures don’t
stimulate bone →
Bone resorption, acceleration of bone
resorption if ill fitting →
Decreases the surface area available for prosthesis support.
Eliminates favourable anatomy for retention.
Results in unfavourable denture bearing areas.
• Always inform your patient of the anatomical
consequences of tooth loss.
• Always inform your patient of the preventive nature
of dental implants.
Advantages of dental implants
3. Provision of additional support .it assist in
proper chewing allowing for a healthy and
improved deit.
 Dentate patient can exert up to 1000 psi of bite
force.
 Edentulous patient ( complete denture wearers)
can only exert up to 50 psi of bite force.
 Transitioning a patient from complete denture
to an implant supported prosthesis will result in
a dramatic increase in bite force.
Advantages of dental implants
4. Retrievability , replacement and salvaging of
the restoration.
Advantages of dental implants
5. Resistance to disease.
 Implants are resistant to caries, natural teeth
are not.
• Consider extraction of teeth and place
implants if :
The patient has poor manual dexterity, and
hence can’t maintain good oral hygiene.
The patient has Xerostomia due to
medications (root surface caries).
Advantages of dental implants
6. Increased confidence.
7- Improved aesthetics, function and speech.
Confidence
 Dental implants have
become the standard
of care for the
replacement of teeth.
 They allow your mouth
to be restored to
optimum function and
appearance without
invading or damaging
other teeth or tissue.
Advantage of Dental Implants
• 8- Increase chewing ability
and improve bite force
• 9- Decrease denture mobility
: ensure a secure and
comfortable fitting denture.
• Use of removable prosthesis will not allow patient to
recover normal function, aesthetics, speech and
comfort.
• Implant supported prosthesis allow patient to
function with confidence and enjoy better quality of
life.
osseointegration
•A direct structural and functional
connection between living alveolar bone
and the load carrying surface of the
dental implant .
• An osseointegrated implant takes anywhere
from three to six months to anchor and heal,
at which point the dentist can complete the
procedure with the placement of a crown.
Once the implant has anchored with the
jawbone, artificial prosthesis may be attached
. If osseointegration does not occur, the
implant will fail ( fibrous integration).
1.Osteophyllic phase: fibrocartligenous callus
formation ( 1 month ).
2.Osteoconductive phase: Spongy callus ( 3 month
)
3.Osteoadaptive phase: Cortical bone
( steady state )
migration of osteoblasts & osteoid
production to the implant surface
.Last of approximately 1 month
‫‪the bone cells spread along‬‬
‫‪the implant surface laying‬‬
‫‪down osteoid and takes‬‬
‫‪about 3 months‬‬
‫جمعــية الحفــــاظ على صـــحة الفــــم واألسنـــــان العـــراقيــــة – مــــركـــــز زراعــــة االسنــــان‬
a steady state ( no gain or loss of bone
against metal) resorption remodeling
sequence that continues even after
the implants are exposed and loaded
‫جمعــية الحفــــاظ على صـــحة الفــــم واألسنـــــان العـــراقيــــة – مــــركـــــز زراعــــة االسنــــان‬
Factors affecting osseointegration
1.
2.
3.
4.
5.
6.
Implant biocompatibility
Implant design
Implant surface area
Implant bed ( type of bone),
Surgical technique.
Loading condition
Dr,salah hegazy
‫‪Failed‬‬
‫‪OI‬‬
‫‪Why‬‬
‫جمعــية الحفــــاظ على صـــحة الفــــم واألسنـــــان العـــراقيــــة – مــــركـــــز زراعــــة االسنــــان‬
Primary stability
• Primary stability is the initial mechanical lock between
the screw implant and the bone , it depend on :
1- the length of the implant .
2- the diameter of the implant .
3- the thread design: number and thickness of the
grooves.
4- the quality of the bone site : cortical versus spongy
bone .
5- the preparation of the surgical site, heat generation,
torque, and speed of the handpiece.
Secondary stability
• When the inflammation subsided and the
Osseo integration takes place . usually after 36 months.
Loading condition
•
Delayed loading:loading withen 4-6 months after
surgery.
•
Immediate loading:
1. Immediate occlusal loading (placed within 48 hours
postsurgery)
2- Early loading (prosthetic function within two months)
Dr,salah hegazy
Thank You!
THANK •
YOU
Dr,salah hegazy