Introduction Flashcards
Approximately –% of adults aged 20 to 64 have no teeth and almost –%
of seniors (above the age of 65) have no remaining teeth.
5
30
The leading causes for teeth loss are (2)
caries and periodontal disease.
Approximately —% of US adults aged 20-64 had dental caries in 2011-2012, —% of
which suffered from untreated dental caries.
91
26
Periodontal disease affects —% of the population between 35-44
years of age and —% of people over 65 years of age.
75
95
— million Americans are missing at least one tooth, and more than — million are currently edentulous, 2/3 of which in both arches (ACP).
120
36
The success rate of dental implants has been
reported in the scientific literature to be around
–%.
98
Denture - –% of lost function restored
30
Removable Partial - –% of lost function restored
60
Fixed Dental Prostheses (Crowns
and Bridges)
(2)
- 100% of lost function restored
- Can be tooth or implant supported
DentalImplant
“A prosthetic device or alloplastic material
implanted into the oral tissues beneath the
mucosal and/or periosteal layer, and/or within the
bone to provide retention and support for a fixed
or removable dental prosthesis.”
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H I S T O R Y O F I M P L A N T S
■As Early as 600AD Mayan Origin
■Modern Implant Dentistry Early 19thCentury
■Strock: 1931 Vitallium
■Formiggini:1947 Tantalum
■Chercheve: 1947 Chrome-cobalt
■Branemark: 1965 Titanium
- Eposteal:
on/around the bone
- Transosteal:
through the bone
- Endosteal:
in the bone
■EPOSTEAL -
Subperiosteal
■TRANSOSTEAL -
Transmandibular
■ENDOSTEAL -
Blade and Root Form
S u b p e r i o s t e a l I m p l a n t
■Early edition: 1941 by Dr. Gustav Dahl of Sweden
■Introduced in 1960 by Goldberg and Gershkoff
■Material
■Denture is
■Survival rate –% Ten years (Harvard Consensus)
■Indicated for
■Bone resorption leads to
Vitallium metal
implant supported / expensive
85
atrophic edentulous mandible.
mobility infection and loss
T r a n s o s tea l I m pl a n t
■Introduced I. Small 1968
■Matieral
■–% Success rate at fifteen years (excellent)
■Only indicated for the
■Denture is — supported
Titanium metal
91
edentulous mandible
tissue
Tr a n s o s t e a l I m p l a n t
Requires one surgery usually in the —.
hospital
Tr a n s o s t e a l I m p l a n t
approach
External incision / approach.
Tr a n s o s t e a l I m p l a n t
Excellent for the
atrophic mandible where root form implants would weaken the jaw.
Tr a n s o s t e a l I m p l a n t
Complex surgical procedure therefore
not widely used.
Tr a n s o s t e a l I m p l a n t
Restricted to the
anterior mandible.
T MI : T r a n s m a n d i bu l a r I m p l a n t
■–% success rate
■– supported denture
■Used for severe
■Material
■Reversible –
97
Implant
atrophic mandibles <10mm
Gold Alloy, not titanium
can be removed due to design of
screws and degree of integration, but not easy
process
T M I : T r a n s m a n d i b u l a r I m p l a n t
■Allows
facial muscles to be reattached to
improve facial profile
T M I : T r a n s m a n d i b u l a r I m p l a n t
stage/approach
One stage, extra-oral approach (submental)
T M I : T r a n s m a n d i b u l a r I m p l a n t
Eliminates
ridge augmentation or
vestibuloplasty
E n d o s tea l I m pl a n t T yp e s
BLADE :
■Leonard Linkow 1969
■Material
■— stage/best for
■–% five year survival
■Most widely used until 1980
■Titanium metal
One, partially edentulous mandibles
75
B l a d e I m p l a n t
■Early failures due to
heat at
preparation and immediate loading
B l a d e I m p l a n t
■Drawbacks:
Difficult to prepare a
precision slot and if it fails, a large
section of bone is involved
R o o t F o r m I m p la n ts
■Success rate greater than –%
■Indicated for
■Multiple uses:
90
partially and fully edentulous cases/any
area of the mouth (versatility)
overdenture, hybrid, crown and
bridge, ortho anchorage…
R o o t F o r m I m p l a n t s
Historically multiple attempts made with a multitude of metals.
Became the standard with the research of Per-Ingvar Brånemark in
1970 and the Concept of Osseointegration.
(5)
■Titanium or an alloy of titanium-aluminum-vanadium metal(s)
■1 or 2 stage approach
■In office procedure
■Screws/Cylinders
■Machined or rough (to increase surface area for integration)
Super I m p l a n t s : Z y g o m a t i c & P t e r y g o i d
Indicated when
there is no maxillary posterior bone
Osseointegration
Brånemark introduced the term osseointegration and defined it
as “a direct structural and functional connection between
ordered, living bone and the surface of a load-carrying implant.”
T I T A NI UM: 196 4 to P r e se n t
(3)
■Not recognized as a foreign object by the body
■Less host rejection than other metals/alloys
■Medicine also recognized utilization in joint replacements
and heart valves
I m p l a n t Vs To o t h
(2)
- Important distinction from
natural dentition - Implants are not teeth and
there is extensive evidence
that they behave differently
I m pl a n t V s T o o t h
Not susceptible to the same disease processes that
affect our dentate patients.
Teeth: (2)
Implants: (2)
*Caries
*Periodontal disease
*Peri-implantitis (bone)
*Peri-mucositis (soft-tissue)
P r o g n o sis
Predictability of single implant fixture survival is in
the —% range
94-98
I m p l a n t F i x t u r e L o s s
~—% of failures occur prior to the
placement of the restoration
~—% occur after the restoration
placement
55-60
40-45
