1. Dental Implants Chapter 15 DAE/DHE 203

2. Implants - defined Surgically inserted into bone Used as “anchors” to support a prosthetic Replace missing teeth in partially and/or fully edentulous areas May be single tooth or several teeth prosthetic Potential for ultimate stability for prosthetic Relies on integration with natural bone/tissues for retention and sustainability Video

3. Implants – Basic Diagrams Prosthetics Implants

4. Implants – Basic Diagrams Relies on integration with bone (new bone growth) for support. “Osseointegration” There must be a closed interface (implant to oral tissue) for success.

5. Types of Implants: Endosseous – resides partially in bone Single tooth replacement thru denture support Screw-shaped Most common type

6. Types of Implants:

7. Subperiosteal: rests on alveolar ridge, no bone invasion Less invasive, less stable Supports denture Transosteal: placed through the mandible (only) Attachments reside above ridge Rarely used

8. Types of Implants:

10. Implant Materials: Titanium: Used as almost pure metal Corrosion resistant Strong & lightweight Great biocompatibility

11. Implant Materials: Ceramics: Most biocompatible Formation of hydroxyapatite at surface Potential for chemical bond between bone & implant Coated Metals: Combines strength of metal with good interface potential of ceramic

12. Implant Materials: Prosthetics & attachments: Crowns  PFM’s most common  Could be gold, ceramic, composite  Attached by screws or cemented Dentures  “Traditional” materials - acrylic  Attached by various fasteners: clips, balls, screws, etc.

13. Implant Materials:

14. Placement of Endosseous Implant Soft tissue “flap” is laid Premeasured implant (body) placed into bone and covered entirely with soft tissue Healing: weeks - months

15. Placement of Endosseous Implant The soft tissue is removed, exposing the implant, and a “healing cap” is placed Healing: several weeks

16. Placement of Endosseous Implant Healing cap is removed and an abutment is placed Abutment is prepared (“post”/cylinder added) & impressed for prosthetic Sent to lab for fabrication Implant Abutment

17. Placement of Endosseous Implant Crown (or other prosthetic) is seated with cement or screw (or other fastener)

18. Procedure: Diagrams

19. Patient Selection: Highly motivated, healthy patient Time-consuming procedure (months of healing post-sx) No systemic diseases or conditions that impact healing & sustainability of implant Substantial bone support Must be able to practice good OH

20. Maintenance of Implants: Great OH by patient: Toothbrushes, floss, interdental aids, etc. Caution during prophylaxis: Scaling with conventional instruments may damage the titanium surface Sonic instruments are contraindicated! Use a very mild abrasive with rubber-cup prophy