WHAT IS A DENTAL IMPLANT? Dental implant is an artificial titanium fixture (similar to those used in orthopedics) which is placed surgically into the jaw bone to substitute for a missing tooth and
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WHAT IS A DENTAL IMPLANT? WHAT IS A DENTAL IMPLANT?
Dental implant is an artificial titanium fixture (similar to those used in orthopedics)
which is placed surgically into the jaw bone to substitute for a missing tooth and its root(s).
Dental implant is an artificial titanium fixture (similar to those used in orthopedics)
which is placed surgically into the jaw bone to substitute for a missing tooth and its root(s).
Alternative Solutions
Partial and Full Dentures
Crowns
Bridges
History of Dental Implants
In 1952, Professor Per-Ingvar Branemark, a Swedish surgeon, while conducting research
into the healing patterns of bone tissue, accidentally discovered that when pure titanium comes into direct contact with the living bone
tissue, the two literally grow together to form a permanent biological adhesion. He named this
phenomenon "osseointegration".
Biocompatibility of Material
Desired MechanicalDesired MechanicalPropertiesProperties
High yield strengthHigh yield strength Modulus close to that Modulus close to that
of bone’sof bone’s Built-in margin of Built-in margin of
safety: Changes in safety: Changes in environment around environment around implantimplant
SurfacesSurfaces CompositionComposition Ion releaseIon release Surface Surface
modificationsmodifications
Metallic Implant SurfaceMetallic Implant Surface
Problem:Problem:
Implant surface change with time due to oxidation, Implant surface change with time due to oxidation, precipitation…precipitation…
Possible solutions:Possible solutions: Oxide layers ( minimize ion release)Oxide layers ( minimize ion release) Prosthetic component from noble alloys Prosthetic component from noble alloys Phase stabilizers other than Al & V (eg. Ti-13Nb-Phase stabilizers other than Al & V (eg. Ti-13Nb-
13Zr, Ti-15Mo-2.8Nb )13Zr, Ti-15Mo-2.8Nb ) Surface ModificationsSurface Modifications
Problem:Problem:
Implant surface change with time due to oxidation, Implant surface change with time due to oxidation, precipitation…precipitation…
Possible solutions:Possible solutions: Oxide layers ( minimize ion release)Oxide layers ( minimize ion release) Prosthetic component from noble alloys Prosthetic component from noble alloys Phase stabilizers other than Al & V (eg. Ti-13Nb-Phase stabilizers other than Al & V (eg. Ti-13Nb-
13Zr, Ti-15Mo-2.8Nb )13Zr, Ti-15Mo-2.8Nb ) Surface ModificationsSurface Modifications
Screw Implants (Left to Right: TPS screw, Ledermann screw, Branemark screw, ITI Bonefit screw) Cylinder Implants (Left to Right: IMZ, Integral, Frialit-1 step-cylinder, Frialit-2 step-cylinder)
Types of Implants
First Surgical Phase (Implant Placement)Under Local anesthetic the dentist places dental implants into the jaw bone with a very precise surgical procedure. The implant remains covered by gum tissue while fusing to the jaw bone.
Second Surgical Phase (Implant Uncovery)After approximately six months of healing. Under local anesthetic, the implant root is exposed and a healing post is placed over top of it so that the gum tissue heals around the post.
Prosthetic Phase (Teeth)Once the gums have healed, an implant crown is fabricated and screwed down to the implant.
Procedure
Cost
Wide variability in costsWide variability in costs Single implant costs anywhere from Single implant costs anywhere from
$500 - $6000$500 - $6000 Average ~ $1250 - $5000Average ~ $1250 - $5000 $80,000 for full mouth reconstruction$80,000 for full mouth reconstruction
MarketMarket
Nobel Biocare Nobel Biocare currently the currently the leader leader
US market US market grows ~ 20% grows ~ 20% annually, annually, though it has though it has historically historically been weakbeen weak
Nobel Biocare Nobel Biocare currently the currently the leader leader
US market US market grows ~ 20% grows ~ 20% annually, annually, though it has though it has historically historically been weakbeen weak
Growing Dental MarketGrowing Dental Market
Potential Market Size:Potential Market Size: 10% over 18 missing 10% over 18 missing
a tootha tooth11
69% of those aged 35-69% of those aged 35-44 missing at least 1 44 missing at least 1 toothtooth
2% of market 2% of market penetrationpenetration22
10% of worldwide dental 10% of worldwide dental marketmarket33
US market for implants is US market for implants is growing ~20% annuallygrowing ~20% annually
1. US Department of Health
2. www.3implant.com
3. http://investor.nobelbiocare.com/phoenix.zhtml?c=139018&p=irol-dental
Surface modification for metallic implants
PassivationPassivation Ion implantationIon implantation Texturing Texturing
This work was supported by grants from University of Ferrara, Italy (F.C.), Fondazione CARIFE (F.C.), Guya-bioscience, Ferrara, Italy (F.P.), Fondazione CARISBO (F.P.), Finalized Project ‘‘Materials Tailored for Advanced Technologies’’, National Research Council (C.N.R.), Rome, Italy (A.P.), and Ministry of Education, University and Research (M.I.U.R.), Rome, Italy (A.P.).
This work was supported by grants from University of Ferrara, Italy (F.C.), Fondazione CARIFE (F.C.), Guya-bioscience, Ferrara, Italy (F.P.), Fondazione CARISBO (F.P.), Finalized Project ‘‘Materials Tailored for Advanced Technologies’’, National Research Council (C.N.R.), Rome, Italy (A.P.), and Ministry of Education, University and Research (M.I.U.R.), Rome, Italy (A.P.).
Contract grant sponsors:
Unife 60%; CARIFE; CARISBO;
Guya-Bioscience (Ferrara, ITALY)
Contract grant sponsors:
Unife 60%; CARIFE; CARISBO;
Guya-Bioscience (Ferrara, ITALY)
Acknowledgements:
This work was supported by grants from Unife 60%(F.C.) and
Guya-bioscience (F.P.).
Acknowledgements:
This work was supported by grants from Unife 60%(F.C.) and
Guya-bioscience (F.P.).
OsseointegrationOsseointegration
(A) Hematoma occurs near screw threads
(B) After 3 weeks – Osteoblasts begin forming spongy bone
(C) After 4 months – spongy bone replaced by compact bone Lamellar bone – strongest type of bone, most desired next to implant
(D) Osseointegration failure
(A) Hematoma occurs near screw threads
(B) After 3 weeks – Osteoblasts begin forming spongy bone
(C) After 4 months – spongy bone replaced by compact bone Lamellar bone – strongest type of bone, most desired next to implant
(D) Osseointegration failure
Endorsing an intuition of a potential future successful application on mankinds, it was started a trial on rabbits using Biolok titanium dental implants, previously treated to obtain a surface coating with nanocrystalline film of metallic dioxide.
Three groups of dental implants has been manufactured and surgically inserted in rabbits tibia:
1. uncoated dental implants (control);
2. TiO2 surface coated dental implants;
3. ZrO2 surface coated dental implants.
Endorsing an intuition of a potential future successful application on mankinds, it was started a trial on rabbits using Biolok titanium dental implants, previously treated to obtain a surface coating with nanocrystalline film of metallic dioxide.
Three groups of dental implants has been manufactured and surgically inserted in rabbits tibia:
1. uncoated dental implants (control);
2. TiO2 surface coated dental implants;
3. ZrO2 surface coated dental implants.
After thirty days bone sections have been analyzed in correspondance of the contact bone-implant zone and different osseointegration rates have been evaluated among the three groups above. The difference has been based on the presence of marks identifying small bone trabeculae.
The results concerning osseointegration were extremely interesting: while in the cortical portion there are no differences among the three types of implants, around the implants embedded in the medullary portion, clearly appeared outstanding new bone apposition around TiO2 coated implants (55%) and ZrO2 coated implants (43%) if compared to the results obtained by uncoated implants (31%).
After thirty days bone sections have been analyzed in correspondance of the contact bone-implant zone and different osseointegration rates have been evaluated among the three groups above. The difference has been based on the presence of marks identifying small bone trabeculae.
The results concerning osseointegration were extremely interesting: while in the cortical portion there are no differences among the three types of implants, around the implants embedded in the medullary portion, clearly appeared outstanding new bone apposition around TiO2 coated implants (55%) and ZrO2 coated implants (43%) if compared to the results obtained by uncoated implants (31%).
Medullary portion in endosseous uncoated dental implant section.
new bone apposition = 31%
Medullary portion in endosseous uncoated dental implant section.
new bone apposition = 31%
Medullary portion in endosseous TiO2 coated dental implant section
new bone apposition = 55%
Medullary portion in endosseous TiO2 coated dental implant section
new bone apposition = 55%
Medullary portion in endosseous ZrO2 coated dental implant section
new bone apposition = 43%
Medullary portion in endosseous ZrO2 coated dental implant section
new bone apposition = 43%
Anatase surface nanoscopic topography (300 x 300 nm), produced according to the patented method .
Anatase surface nanoscopic topography (300 x 300 nm), produced according to the patented method .
Electronic Microscope zoom on zirconium dioxide coated surface
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