history,types of implants 2013
DESCRIPTION
dental implantsTRANSCRIPT
ردوة
Implantology courseImplantology course Basic courseBasic course
01-2014
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Dr kamal Masarwa
Dr. Kamal Masarwa
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Why ImplantsWhy Implants? ?
Indications Single tooth anterior
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Dr. Kamal Masarwa
Single tooth-Molar
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Multiple Implants to Replace Multiple Missing Teeth
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2 teeth missing
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3 teeth missing
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Free end
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Fully edentulous-Fixed Bridge
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1 -Ball Attachment
Fully edentulous- over denture
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Dolder Bar
Fully edentulous- over denture
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How can a dentist start to make Implants?
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Implantation
Transplantation
■Transfer of non-living tissue or material into a biological system
■Transfer of living tissue
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History of dental Implants
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TEETH WERE BOUND TOGETHER WITH GOLD WIRE
At an ancient burial site, dental bridges are excavated. Most probably inserted post-mortem 2424
THE EGYPTIANS
sea shells
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Jaw of ancient Egyptian showing drill holes used in dental repair.Courtesy of the Gordon Museum
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THE MAYAS
Jade and turquoise stones are implanted in the teeth.
strictly for ritual ,religious or purely self adornment purposes.
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In 400 BC, the use of gold orwood tooth-shaped implants was reported
Watzek G (ed), Blahout R. Historical Review. In: EndosseousImplants: Scientific and Clinical Aspects. Chicago: QuintessencePublishing Inc;1995:17-28.28
720-609 B.C was the first Reference to the therapeutic Extrction of teeth
Assyrian physician associated diseased teeth with a systemic disturbance and
recommended extraction in cases of oral sepsis
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THE GREEKS
HIPPOCRATES
writes about tooth decay
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Fingers or a thin linen towel were usedto cleanse the teeth .
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THE ROMANS
gold crowns
fixed bridgework .
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The earliest known dental prosthesis from Rome resulted from multi-karat gold wire
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The Siwak, a primitive form of toothbrush, is used for cleaning teeth
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The Favorite Dental Chair (circa 1901)
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1975
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الترجمه :القاسم ” ابو المشهور العربي الجراح أن ورد
) سنة ) حوالي وتوفي كوردوفا أسبانيا في عاش 1013الذيالعظم ” في اسنان زراعة عمليات اجرى قد .كان
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:نبذةالقاسم هو عباس أبو بن خلف
الزهراوي ،سنة توفي بالطب، 404اشتهر
فحسب .هجرية ^ ماهرا ^ احا aجر الزهراوي يكن ،لمواسعة خبرة ذا ^ حكيما كان .بل
من ^ مهما ^ قسما أفرد وقدوالحنجرة واألذن، العين، ألمراض ،كتابه
واللسان واللثة، األسنان، ألمراض ^ مهما ^ ،وقسماوالقبالة والوالدة، وفن النساء، ،وأمراض
والكسر الفك وعالج للجبر، ^ كامال ^ 4343.وبابا
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The first “Implants”
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Transdental Fixation
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Implant Types
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Lets remember some facts ….
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Subperiosteal Implants5050
Subperiosteal Implants
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Subperiosteal Implants
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In 1943, Dahl reported using a subperiosteal implant
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1- Subperiosteal Implants
Implant Types
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Transdental Fixation Transdental Fixation5757
Needle Implants5858
Needle Implants
Lambotte 1934 5959
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1- Subperiosteal Implants
Implant Types
2- Enossal Implants)needle(
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Types of enossal Implants
11 - - Needle ImplantsNeedle Implants
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Blade ImplantsBlade Implants6868
Blade ImplantsBlade Implants 6969
Blade ImplantsBlade Implants
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Types of enossal Implants
22 - - Blade ImplantsBlade Implants
11 - - Needle ImplantsNeedle Implants
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- -Disc ImplantsDisc Implants
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Types of enossal Implants
22 - - Blade ImplantsBlade Implants
33 - - Disc ImplantsDisc Implants
11 - - Needle ImplantsNeedle Implants
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Types of enossal Implants
44 – – Root form ImplantsRoot form Implants
22 - - Blade ImplantsBlade Implants
33 - - Disc ImplantsDisc Implants
11 - - Needle ImplantsNeedle Implants
- -Cylider ImplantsCylider Implants
- -Screw ImplantsScrew Implants8282
A - Cylider ImplantsA - Cylider Implants
44 –– Root form ImplantsRoot form Implants
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- -Cylider ImplantsCylider Implants
44 –– Root form ImplantsRoot form Implants
-performed
-cannot be removed
-Inserted with Hammer
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Stability development over timeStability development over time
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Placement Stability
Initial Stability
Primary Stability
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To increase the mechanical Stability…
functional surface area
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To increase the mechanical Stability…Ather way
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B - Threaded,screw ImplantsB - Threaded,screw Implants
44 –– Root form ImplantsRoot form Implants
The functional surface area of a threaded implant is greater
than a cylinder implant by minimum of 30% and may eceed 500% dependending on the thread geometry
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Types of Screw ImplantsTypes of Screw Implants
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screw Implantsscrew Implants
-More functional Surface
-Can be removed
-Inserted with Hand (no hammer)
-Self thread
-Less Boring (Bone Damage)
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Screw ImplantsScrew Implants
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The “Sargon” expandable implant
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Orthodontic ImplantsNEW
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Ivory seashells
bones of animals
teeth from human donors
Gold, platinum and other metal alloys
Implant Materials
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Professor Professor Per-Ingvar Per-Ingvar BrånemarkBrånemark
19521952
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Dr. Brånemark demonstrated that Dr. Brånemark demonstrated that under carefully controlled conditions under carefully controlled conditions
titanium could be structurally integrated titanium could be structurally integrated into living bone with a very high degree into living bone with a very high degree of predictability and, without long-term of predictability and, without long-term
soft tissue inflammation or fixture soft tissue inflammation or fixture rejection. Brånemark named the rejection. Brånemark named the
phenomenonphenomenon
Osseointegration106106
Osseointegration
“A direct structural and functional connection between ordered , living bone and a surface of a load-carrying implant “
BrBråånemarknemark 1985107107
Dorland’s illustrated Medical Dictionary (1994) defines osseointegration as ‘the direct anchorage of an implant ,without the growth of fibrous tissue at the bone-implant interface’(between Implant andBone.)
Carl Misch 2001Implant and restorative Denistry
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Machined SurfaceMachined Surface
BrBråånemark Implantnemark Implant
about 1 µm116116
healing period = 3-6 months
Bone growth around inserted implant= 0.6µm - 1µm / day
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How to decrease the time? 118118
To increase the biological Stability…119119
What happened with the bone after inserting an implant?
Resorption
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osteocytes
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Formation
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©
Osteozyt125125
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a bone cell attaching to titanium 128128
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There are Materials who increase the differentiation of osteoblasts .
Osteoconductiv characteristics
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1 µm
Bone growth= 0.6 – 1µm / day131131
so the Bone growth is
Faster
►Faster Osseointegration
►Less wait time for Laoding
If the Valleys are bigger,
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ציפוי ציפויطالءطالء
CaotingCaoting
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1-TPS (Titanium Plasma Spraying)1-TPS (Titanium Plasma Spraying)
6-10 biggerabout 15 µm 135135
2 - SLA (Sand Blasting and Acid-Etched)
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3 – HA )Hydroxyapatite) Coating
70% of the bone
Hydroxylapatite can befound in teeth and bones
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4 - TCP (Tricalciumphosphat(
Bioactive
Osteoconductiv
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BONIT is a BONIT is a fully resorbablefully resorbable bioactive coatingbioactive coating that is replaced by new bonethat is replaced by new bone in 6-10 weeks.in 6-10 weeks. This coating allows This coating allows early loadingearly loading of dental of dental and orthopaedic implants. and orthopaedic implants. The application is preferred on roughThe application is preferred on rough
implant surfaces.implant surfaces.
BONIT®coatingBONIT®coating
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►Affinity ,Attachment and Growth of
bone forming cells (osteoprogrnitors)
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Bioaktive Calcium-Phosphat -(CaP-)Coating
BONIT®coating 147147
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Are all Implants titanium maded?
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Metalfree Implantation151151
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