FIXED DENTAL PROSTEHSIS IMPLANT’S

8/3/2019 FIXED DENTAL PROSTEHSIS IMPLANTS

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IMPLANT SUPPORTEDIMPLANT SUPPORTED

FIXED PROSTHESESFIXED PROSTHESES

BY;BY;

DR. SUNDUS WAHIDDR. SUNDUS WAHIDDR. XAINAB RASHEEDDR. XAINAB RASHEED


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Introduction to implantsIntroduction to implants


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Definition:Definition:

Implants are surgically fixedImplants are surgically fixedsubstitutes for roots ofsubstitutes for roots ofmissing teeth and dentalmissing teeth and dental

implantology is the study ofimplantology is the study ofarts and science concernedarts and science concerned

with surgical insertion andwith surgical insertion andrestoration of materials andrestoration of materials anddevices restoring partially ordevices restoring partially or

totally edentulous patient tototally edentulous patient tofunction.function.


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History & evolution of dentalHistory & evolution of dental

implantsimplantsThe history of dental implantsThe history of dental implants

goes back to thousand ofgoes back to thousand ofyears. Traces of root formsyears. Traces of root forms

includes civilizations such asincludes civilizations such asthe ancient chinese(4000yearsthe ancient chinese(4000years

ago), Eygptians(2000yearsago), Eygptians(2000yearsago) & Incas(1500years ago).ago) & Incas(1500years ago).However, the first screwHowever, the first screw

implants are credited toimplants are credited toStock 1939 with a priorStock 1939 with a prior

introduction to implantintroduction to implantmaterial Comaterial Co--CrCr--My in 1938.My in 1938.


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Indications of implantsIndications of implants

Particularly any edentulousParticularly any edentulousspace.space.

Patient with history ofPatient with history oftraumatrauma

Congenitally missing teethCongenitally missing teeth

Periodontal diseasePeriodontal disease

Failure of fixed or removableFailure of fixed or removableprosthesisprosthesis

Oro and maxillofacial cleftsOro and maxillofacial cleftsand other defectsand other defects

EstheticsEsthetics


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Contraindications of implantsContraindications of implants

Debilitating or uncontrolledDebilitating or uncontrolleddisease like uncontrolleddisease like uncontrolleddiabetes ,cardiac valves,diabetes ,cardiac valves,

dialysis, liver failuredialysis, liver failure Pregnancy.Pregnancy.

Lack of adequate training ofLack of adequate training ofpractitioner.practitioner.

ImmunocompressionImmunocompressione.g.,HIV,radiation therapy.e.g.,HIV,radiation therapy.

Poor patient motivation.Poor patient motivation.

Psychiatric disorders.Psychiatric disorders.


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Contraindications of implantsContraindications of implants

(contd.)(contd.) Inability of patient to manageInability of patient to manage

oral hygiene.oral hygiene.

Patient hypersensitivity toPatient hypersensitivity to

specific components of thespecific components of theimplant.implant.

Acute bone resorptionAcute bone resorption

Chronic inflammationChronic inflammation

History of smoking andHistory of smoking andalcoholismalcoholism

Unattainable prosthodonticUnattainable prosthodonticreconstruction.reconstruction.


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Structural components ofStructural components of

an implantan implant


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Structural components of an implantStructural components of an implant

(contd.)(contd.) Crest moduleCrest module forfor

retention of prostheticretention of prostheticcomponent in two piececomponent in two piece

system.system. BodyBody either screw typeeither screw type

or cylindrical oror cylindrical orcombinedcombined


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Other componentsOther components

Cover screwCover screwprevents debrisprevents debris

contaminationcontamination

TransepithelialTransepithelial portionportion

known as the healing portionknown as the healing portion AbutmentsAbutments retains theretains the

prosthesisprosthesis

SuperstructureSuperstructure providesprovides

attachment for fixedattachment for fixedprosthesis in the frameworkprosthesis in the framework

Transfer copingTransfer coping is used tois used toposition die in an impressionposition die in an impression


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Other components (contd.)Other components (contd.)

Prosthetic copingProsthetic coping fitsfitsthe abutment for screwthe abutment for screwconnectionconnection ..


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Abutment

Cast

Healing gingiva

Positioning of abutment


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Classification of implantsClassification of implants

On the basis of implantOn the basis of implant

tissue interfacetissue interface

Direct bone implantDirect bone implant

interfaceinterface(osseointegration)(osseointegration)

Indirect bone implantIndirect bone implant

interface (blade andinterface (blade andsubperiosteal)subperiosteal)


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On the basis of locationOn the basis of location

and stress responseand stress response

SubmucousSubmucous

SupraperiostealSupraperiosteal

SubperiostealSubperiosteal

EndosseousEndosseous

TransosseousTransosseous endodonticendodontic


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On the basis of functionOn the basis of function

RetentiveRetentive

SupportiveSupportiveOn the basis of implant materialOn the basis of implant material

MetallicMetallic

PolymerPolymer

CeramicCeramic

Vitreous carbonVitreous carbon


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On the basis of implantOn the basis of implantdesigndesign

BranemarkBranemark implantimplant--

threaded screwthreaded screw Core ventCore vent implantimplant--openopen

basket vents with threadsbasket vents with threads

IMZIMZ--rough plasmarough plasma

sprayed implant surfacesprayed implant surface StrykerStryker implantimplant--flutedfluted

designdesign


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Success criteria for dental implantsSuccess criteria for dental implants

NoNo periperi--implantitisimplantitis

No periNo peri--implant radiolucencyimplant radiolucency

Marginal bone loss of about 1.0Marginal bone loss of about 1.0--1.5mm1.5mmfirst year after placement; then


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PeriPeri--implantitisimplantitis

Is an inflammatoryIs an inflammatoryreaction with loss ofreaction with loss ofsupporting bone in thesupporting bone in the

tissues surrounding atissues surrounding afunctioning implant.functioning implant.

Causes can be bacterial,Causes can be bacterial,systemic or overloadingsystemic or overloading

of an implant.of an implant.


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Treatment planning & generalTreatment planning & general

considerations for dental implantsconsiderations for dental implants

Initial evaluationInitial evaluation

chief complaintchief complaint

medical/dental historymedical/dental historyreviewreview

intra/extraoral examintra/extraoral exam

evaluation of existingevaluation of existing

prosthesisprosthesis

diagnosticdiagnosticimpressions/articulatedimpressions/articulatedcastscasts

radiographsradiographs

photographsphotographs


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treatment options/informedtreatment options/informed

consentconsent

explanation of longexplanation of long--termtermcommitmentcommitment

restorativerestorative -- surgical jointsurgical joint

consultconsult

TwoTwo--stage surgerystage surgery Restorative phaseRestorative phase

Regular recallRegular recall

Payment policyPayment policy

Form, function andForm, function andestheticsesthetics


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Problem list & considerationsProblem list & considerations

Number of remnant teethNumber of remnant teeth

Relationship to adjacent teethRelationship to adjacent teeth

Root angulationsRoot angulations

quality, quantity, width,quality, quantity, width,support of the bonesupport of the bone

MD width of edentulousMD width of edentulousspace (min of 6space (min of 6--7mm space7mm space

b/w teeth,>than 1.5mm b/wb/w teeth,>than 1.5mm b/wtooth & implant) fortooth & implant) foredentulous 7mm from theedentulous 7mm from thecenter of implantcenter of implant


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Problem list & considerationsProblem list & considerations

(contd.)(contd.)

Crown/root ratioCrown/root ratio

MobilityMobility

Oral hygieneOral hygiene FurcationsFurcations

Probing depthsProbing depths

Systemic manifestationsSystemic manifestations

Destructive habitsDestructive habits

Mucogingival problemsMucogingival problems


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Radiographic analysisRadiographic analysis --

(periapical,panaromic,CT,R/G(periapical,panaromic,CT,R/G

stents)stents) Periapical pathologyPeriapical pathology Radiopaque/radiolucentRadiopaque/radiolucent

regionsregions

Adequate vertical boneAdequate vertical boneheight in edentulous areaheight in edentulous area 10mm10mm alveolar bonealveolar bone

Implants should be placedImplants should be placedat a minimum of 2mmat a minimum of 2mm

from the inferior alveolarfrom the inferior alveolarcanal or below thecanal or below themaxillary sinusmaxillary sinus

Adequate interradicularAdequate interradicularareaarea -- 8mm interradicular8mm interradicular

bone widthbone width


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Implant replacement optionsImplant replacement options

ImmediateImmediate implantimplantplaced at time of toothplaced at time of tooth

extractionextraction Delayed immediateDelayed immediate --

(8(8--10 week delay from10 week delay fromextraction)extraction)

DelayedDelayed (9(9--10 months10 monthsor longer)or longer)


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Surgical analysisSurgical analysis

Surgical handling of thetissues with minimal heatgeneration is necessary.

(< 47 . for one minuteor less) provides themost predictable healingresponse.


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Esthetic analysisEsthetic analysis

Smile lineSmile line

Lip shapeLip shape full Vs. thinfull Vs. thin

Existing ridge defectExisting ridge defect

Implant emergenceImplant emergenceprofileprofile (360 degree)(360 degree)

Occulosal analysisOcculosal analysis

MaxMax--mand relationsmand relations


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Procedure of implant insertionProcedure of implant insertion


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1. Raising of surgical flap 2. Bone contouring 3. Osteotomy

4. Implantation by

fixture mounts

5. Removal of fixture

mounts

6. Placing cover screws

7. Closure 8. Healing period

(3-4 months)

9. Transfer coping fixed


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10. Impression made &

implant analogue fixed11. Cast poured 12. Abutment fixed

13. Abutmentmanipulated for the

construction of

superstructure

14. Abutmenttransferred into the oralcavity & final

contouring done

15. Fixation ofmanufactured

superstructure using luting

agent


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Teeth in an Hour.flv


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Our job, your smile!Our job, your smile!


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Thank You.Thank You.

FIXED DENTAL PROSTEHSIS IMPLANT’S

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