Download - FIXED DENTAL PROSTEHSIS IMPLANT’S
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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.