Professional Documents
Culture Documents
techniques in
implant
dentistry(part
Dr. Aziz Pahadwala1)
Contents
Introduction
Definition of implant related terminology
Classification
Historical background
Advanced diagnostic methods
Advanced surgical techniques.
Changing concepts in implant dentistry.
Conclusion.
Introduction
The replacement of soft tissue and hard tissue is
essential to rehabilitate and improve function and
esthetic of orofacial region. The entire scope of
replacement therapy has progressed originally
from tooth replacement to surgically oriented
implant reconstruction to the current and more
correct prosthetically driven approach.
The restorative efforts have expanded beyond the
single tooth replacement, to edentulous arch, the
partially edentulous patients, the radiated
patients and the patients with craniofacial
deformities.
Mish CE: Contemporary Implant dentistry 2nd Ed. Indiana University,
Mosby Elsevier, 2008.
All on four implant The All-on-4 concept using two axially implants
in the anterior region and two tilted posterior
implants has been well documented and
published by Malo P. et al.
Alveolar distraction osteogenesis Cope et al. (1999) defined distraction
osteogenesis as a process of new bone
formation between the surfaces of two
segments of a bone separate gradually for
incremental mechanics traction.
Historical background
Ancient Implants
The idea of permanently being able to replace
teeth has been a desire of civilizations since
the days of the Egyptians.
First implant- copper peg- 3000 yrs ago.
Central America- Replacing lost teeth with
animal ones.
16 th Dark stone
( Egyptian-South American)
17 th Carved ivory teeth
Classification
ADVANCE
D
TECHNIQ
UES
SUIRGICA
L
TECHNIQ
UES
ADVANCE
S IN
IMPLANT
S
ADVANCE
S IN
PROCEDU
RES
IMAGING
CBCT
ADVANCES IN
IMPLANTS
ADVANCES IN
PROCEDURES
ALL ON FOUR
ZYGOMATIC
IMPLANTS
PTERYGOID
IMPLANTS
GUIDED IMPLANT
SURGERY
ONLAY
AUGMENTATION
RIDGE EXPANSION
RIDGE SPLITTING
ALVEOLAR
DISTRACTION
SINUS LIFT
Classification
Advances in diagnostic imaging
Zonography
Cone beam Computed tomography(CBCT)
Microtomograph
Multi slice helical CT
Dentascan
Interactive CT
ADVANCES IN IMAGING/
DIAGNOSTIC MODALITIES
ADVANCES IN PANORAMIC IMAGING
ZONOGRAPHY
A modification of the panoramic x-ray machine
for making cross sectional images of the jaws.
The tomographic layer is approximately 5mm.
For appreciation of spatial relationship between
the critical structures and the implant site.
Zonography
Limitations:
Tomographic layers relatively thick .
Adjacent structures blurring and superimposition.
Not useful for determining the differences in
bone density or for identifying disease at implant
site.
Tomography
Tomography is the generic name
formed by the greek words
tomo(slice) and graphy(picture).
Enables visualization of a section
of patients anatomy by blurring
other regions above and below the
site of interest.
For dental implant patients, high
quality complex motion
tomography is required.
Recent advances in
Computed Tomography(CT)
Cone beam CT:
It uses a cone beam and reconstructs the image
in any direction using special software.
It gives all the information of a CT but, at 1/8th the
radiation dose and at a lower cost.
SAGGITAL CT
AXIAL CT
Recent advances in
Computed Tomography(CT)
Microtomograph:
Modification of CT, it is specially useful in acquiring
serial sections of bone implant interface.
Dentascan
DentaScan imaging
provides
programmed
reformation,
organization and
display of the
imaging study.
Limitations
1. Images may not be of true size and require
compensation for magnification.
2. Determination of bone quality requires use of
the imaging computer or workstation.
3. Hard copy dentascan images only include a
limited range of the diagnostic gray scale of the
study.
4. Tilt of the patients head during the
examination is critical
Interactive computed
tomography(ICT)
This technique enables
transfer of the imaging
study to the clinician as
a computer file.
The clinicians computer
becomes a diagnostic
radiologic workstation
with tools.
An important feature of
ICT is that the clinician
and radiologist can
perform electronic
surgery (ES)
With an appropriately
designed diagnostic
template, ES can be
performed to develop the
patients treatment plan
electronically in 3
dimensions.
Limitations of ICT:
Refinement and exact orientation of the implant
positions is difficult and cumbersome.
Executing the plan may be difficult for the
surgical team.
References
1. Griffitts, TM; Collins CP, Collins PC . "Mini dental implants: An adjunct for
retention, stability, and comfort for the endentulous patient". Oral Surg
Oral Med Oral Pathol Oral Radiol Endod 100 (5): E8184.
2. English, CE; Bohle GC . "Diagnostic,k procedural, and clinical issues with
the Sendax mini dental implants". Compendium. supplement 1 24: 123.
3. Block, MS; Delgado A, Fontenot MG . "The effect of diameter and length
of hydroxyapatite-coated dental implants on ultimate pullout force in dog
alveolar bone". Journal Oral Maxillofac Surgery 48 (2): 174178.
4. Binon, PP . "The effect of implant/abutment hexagonal misfit on screw
joint stability". Int Journal of Prosthodontics 9: 149160.
5. Shatkin, TE; Shatkin S, Oppenheimer BD, Oppenheimer AJ . "Mini dental
implants for long term fixed and removable prosthetics: A retrospective
analysis of 2514 implants placed over a five year period.". Compendium
28: 3641.
References
6. Christensen, GJ; Swift, Edward J. (2008). "Mini implants: Good or bad for
long term service?". J Esthetic Dentistry 20 (5): 343348.
7. Gibney, JW (2001). "Minimally invasive implant surgery". J Oral
Implantology 27 (2): 7376
8. Campelo, LD; Camara JR (2002). "Flapless implant surgery: A 10 year
clinical retrospective analysis". Int Journal Maxillofac Implants 17: 271276.
9. Ahn, M-R; An K-A, Choi J-H, Sohn D-S (2004). "Immediate loading with mini
dental implants in the fully edentulous mandible". Implant Dent 13 (4): 367
372.
10. Mazor, Z; Steigmann M, Leshern R, Peleg M (2004). "Mini-implants to
reconstruct missing teeth in severe ridge deficiency and small interdental
space: A five year case series". Implant Dentistry 12: 336341.
11. Shatkin, TE; Shatkin S, Oppenheimer AJ (2007). "Mini dental implants
for long term fixed and removeable prosthetics: A retrospective analysis of
2514 implants placed over a five year period.". Compendium 28: 3641.
12. Christensen, GJ; Swift, Edward J. (2008). "Mini implants: Good or bad for
long term service?". J Esthetic Dentistry 20 (5): 343348.
End of part
1
Thank you