implant systems in india

1. VARIOUS IMPLANT SYSTEMS
IN INDIA
ANISH AMIN

2. Contents
• Definition
• Classification
• Various implant systems
• Limitations
• Summary & Conclusion
• References

3. Introduction

4. Definition
• Implant system (GPT, 1993): Dental implant
components that are designed mate together and
implant system can represent a specific concept,
inventor or patent. It consists of the necessary
parts and instruments to complete the implant
body placement and abutment components.
• Dental implant: is defined as a substance i.e.,
placed into the jaw to support a crown or fixed or
removable denture.

5. Classification of Implants depending on
Implant placement within
the tissues
Materials used
1.Epiosteal
2.Endosteal
3.Transosteal
-Bioactive
-Bioinert
-Biotolerated

6. Epiosteal Implant
• It is a dental implant structure that covers almost the
entire crestal surface of the maxillary and mandibular
residual alveolar bone under the soft tissue
periosteum.
• It is a dental implant that receives its primary bone
support by resting on the bone.
• So new bone will grow around the implant.
• Example
– Subperiosteal implant

7. SUBPERIOSTEAL
IMPLANTS
• An implant structure that
covers the almost entire
crestal surface of maxillary &
mandibular RAR under the
soft tissue to include the
periosteum , with the four to
six posts protruding out
through gingiva and on it the
complete denture will be
attached.

8. • In 1930 Strock placed first
endosteal implant.
• It is a dental implant that
extends into the basal bone
for support
• It transects only one cortical
plate
• It can be further classified into
– Root form
– Plate form
Endosteal Implant

9. Root form Plate form
- Used over a vertical column of
bone
- Available in four forms
cylindrical, press fit, screw
root, combination.
They are used for horizontal
column of bone which is flat
and narrow facial lingual
direction.

10. Transosteal implants
• A dental implant that
penetrates both cortical
plates and passes
through entire thickness
of the alveolar bone.

11. Parts of in implant
• Body or fixture
• Healing screw
• Healing caps
• Abutments

12. Various Implant Systems
Branemark system
• Developed from the
pioneering work of
Prof. Per-Ingvar
Branemark who
introduced the term
osteointegration

13. Indications & Types

16. Types of fixtures in Branemark system
Fixture
standard
Fixture self
tapping
Fixture Mk
II
Fixture Mk
III
Fixture Mk
IV
Conical Mk
III
Universal
Self tapping
Used in type
I, II, III, IV
bone
Tapered
Double
thread
Uses soft
trabecular
bone
Bone type
III & IV
Self tapping
Used in
bone type I,
II, III, IV

17. BRANEMARK SYSTEM COMPONENTS
• FIXTURE –
• pure titanium with machined
threads .
• The top of the fixture has
hexagonal design & threads ..
• The apical portion tapered with
four vertical notches.
• COVER SCREW- seals the
coronal potion of fixture during
the interim period.

18. • ABUTMENT- -made of titanium in a
cylinder shape. the apical portion has
hexagonal shape to fit the coronal portion
of fixture.

19. • ABUTMENT SCREW – insert through the
abutment & threads into the fixture to connect the
two components .
• GOLD CYLINDER- made of lAu , Pl, Pd. It is
machined to fit the coronal portion of the abutment. It
becomes integral part of final prosthesis.
• GOLD SCREW –inserted through the gold cylinder
& threads into the abutment screw to connect the gold
cylinder & abutment.

21. Screw-retained restorations

22. Multiple Unit Restorations
• Abutment options
• Multiple unit abutment
(NP, RP, WP):
Indications: Short span
ridges, full jaw
reconstructions, available
in several heights
therefore possible to place
the prosthetic margin
above, at or below the
gingival margin - esthetics

23. • Gold cylinder to fixture – connects directly to
head of the implant eliminating the use of an
abutment.
• Advantages –
– For sulcus depth of 3mm or less
– Limited space
– Good esthetics
• Limitations
– Casting procedure

24. Types of fixtures in Branemark system
Fixture
standard
Fixture self
tapping
Fixture Mk
II
Fixture Mk
III
Fixture Mk
IV
Conical Mk
III
Universal
Self tapping
Used in type
I, II, III, IV
bone
Tapered
Double
thread
Uses soft
trabecular
bone
Bone type
III & IV
Self tapping
Used in
bone type I,
II, III, IV

26. Replace Select Tapered Implant
System
• It can be used where the anatomic condition
where limit the placement of standard root
implant.

27. Indications
• Maxillary sinus
• Labial concavities in the premaxilla
• Lingual undercuts in the mandible
• Converging roots of the adjacent teeth
• Immediate extraction site

29. • It has 2 surface treatments i.e.,
Ti Unite surface: combination of titanium oxide
texture + porosity = optimal osteointegration
HA coated surface:
• Accelerates the deposition of bone to the implant

30. FRIALIT Implant system
• 1n 1974 Dr. Willi Schulte
developed Frialit 1 also
known as Tubingen
Implants
• Worlds first root analog
system

31. • Implant concept: Root analog stepped cylinder,
stepped screws and synchro-stepped screw.
• Surgical indications: Immediate implant
placement, delayed implant placement, late implant
placement.
• Material: Medically pure titanium
• Implant surface: TPS coating, HA coating (stepped
cylinder), DPS (stepped screw, Synchro stepped
screw)
• Implant diameter: 3.4mm, 3.8mm, 4.5mm, 5.5mm,
6.5mm
• Implant length: 8 to 15mm
• Anti-rotation: Internal hex

32. • Instruments: Drills, Bone Condenser, Bone
Expander, Cortical Drill, Bone Profiler.
• Indications: Missing single teeth, free-end cases,
tooth bound gapes, edentulous jaws
• Forming of soft tissue: Gingival formersGingiva
formers: D 3.4 to 6.5, GH 1,2,3, and 5mm
• Abutments: Straight, customized crown abutments,
telescopic abutments, screw retained, or cemented,
CeraBase, AuraBase

33. Design
FRIALIT®-2 stepped cylinder :
• Stepped screw
• Synchro stepped screw
• The optimum implant for every
situation

34. Stepped cylinder
• Apex diameter in 3 to 5 steps by
0.4 to 0.6mm / step.
• Coronal section of the implant
body has 1.5mm collar.
• 3 longitudinal grooves
• Deep internal implant abutment
connection
Advantages of the FRIALIT®-2
stepped
• Improvement of the implant site in
the event of low bone density
• Atraumatic insertion in extremely
cortical bone
• High stability, strong bone
adhesion at the titanium surface

35. The FRIALIT®-2 stepped screw
• First step – no threads,
1.5mm machine polished
collar
• Self tapping thread from
second step.
• Deep profile surface
• Cover screw in the silicon
stopper

36. Advantages
• Implant can be inserted by finger pressure alone.
• Final position with ratchet implant driver.
• Increased osteointegration (DPS)
• Only 3 revolutions for complete seating

37. The FRIALIT®-2 Synchro stepped screw
• Crestal implant cervix –
machine polished 0.4mm.
• Threaded deep profile
surface has DPS.
• Cover screw in silicon
stopper
Advantages
• Applicable for all one
classes I to IV.
• Atraumatic insertion
• Increase self tapping in
cortical bone

38. Advantages

39. Implant abutment connection
• Tube-in-tube mechanism.
• The rotation stop is secure by
1.5mm tall and 2.5mm wide hex
 residual rotation less than 1°
• Highest mechanical stability by
internal 3.4mm long parallel
walled implant abutment
connection for a secure occlusal
load transfer
• Crown abutments have a groove
at their base for sealing ring
• 3mm in diameter, biodegradable
silicon – Bacteria proof sealing.

40. Color coding
FRIALIT®-2 colors provide
• Clear identification of the
implant diameter
• Easy assignment of implant
components
• Safe documentation
• Biocompatibility and
resistance to the oral
environment

41. Drills
Twist
drill D
2.0
Round
drill
Stepped
Drill
D 3.4
Stepped
Drill
D 3.8
Stepped
Drill
D 4.5
Stepped
Drill
D 5.5
Stepped
Drill
D 6.5
8, 10, 11, 13 and 15mm

42. Advantages
• Optimum stabilization of the implant abutment
interface
• Anti-rotational connection between the abutment
and the implant
• Clear and secure positioning of the abutment on the
implant
• No possibility of screw breaking or loosening
• Minimization of the risk of soft tissue perforation

43. ITI Implant System
• International team of
implantology
• Types –
– Hollow cylinder,
– Hollow screw
– Solid screw
• Single stage and 2 stage
versions
• Consists of pilot drills, hollow
traphine drills, depth gauges and
twist drills.

44. Advantages
• The microgap between the primary and secondary
components is supragingival – good peri-implant
hygiene.
• The construction of the implant body is such that
no second stage surgery for uncovering it is
required.

45. Types
• TPS screw
• TPS hollow
Indications
• Symphyseal region between the mental foramen
• Single tooth replacement
• Bridge abutments

46. Design
• Length 9,11,14,17 & 20mm
• Width 3.5 to 4.2mm
• 8 to 12 degree conical head with 4 slots – Prevents
rotation.
• Head: is internally threaded with 5mm deep socket which
will accept 4-8mm long, 2mm wide occlusal screws.
• Neck: highly polished, slightly concave  allows good
oral hygiene and gingival adaptation
• Body: Ti plasma sprayed increases the surface area
• Screw threaded with edges rounded - Causes the
compression of cortical and medullary bone.
• Apex: Fluted, angled to 120° - permits self tapping

47. • The Standard Implant:
one-stage or transgingival
healing, mainly indicated for the
posterior region.
• The Standard Plus Implant:
for subgingival implant
placement in the esthetic region.
• The Tapered Effect Implant:
for immediate and early
implantation in extraction alveoli.

48. Three prosthetic diameters are available:
• Narrow Neck:
Implants with the 3.5 mm Narrow Neck (NN) restorative
platform (Standard Plus Implant with a built-in octa
abutment with external connection, for single-tooth
restorations).
• Regular Neck:
Implants with the 4.8 mm Regular Neck (RN), restorative
platform.
• Wide Neck:
Implants with the 6.5 mm Wide Neck (WN), restorative
platform

50. Immediate loading of edentulous arches.
• The one-piece Monotype Implant with 8°
cone (endosteal diameter 4.1 mm) is
specially designed for immediate loading
with a bar denture.
• Because of the self-tapping thread,
tapping is not necessary with this implant
type.
Indications
• Immediate loading in the mandible with a
bar denture supported by four implants

51. The solution for narrow gaps
• The Narrow Neck prosthetic system is specially designed for
situations where space is limited in the lower incisor region and
the upper lateral incisors.
• The NN prosthetic system offers cast-on gold copings and
individually modifiable titanium copings (also available in an
angulated version) for the 3.5 mm shoulder diameter so that a safe
and esthetic restoration is ensured for both screw-retained and
cement-retained solutions.
• Only screwdriver and ratchet with torque control device are
needed to place the prosthesis.
Indications
• Single-tooth replacement of the upper lateral incisors and the
lower lateral and central incisors

52. Cementing on a solid basis.
• The Solid Abutment system for Regular Neck and Wide
Neck implants with its reliable Morse taper connection,
ensures a secure and exceptionally stable abutment-to-
implant connection to prevent loosening.
• The abutments are available in different heights. The
abutments and corresponding transfer components are
color-coded for accurate and simple prosthesis
fabrication.
Indications
• Cement-retained restorations with the crown and bridge
technique

53. Indications
• Standard Implant Ø 3.3 mm
RN:
used in limited alveolar ridge
width
• Standard Implant Ø 4.1 mm and
Ø 4.8 mm RN:
All indications
• Standard Implant Ø 4.8 mm
WN:
Crowns and bridges in the molar
region

54. synOcta for Regular and Wide Neck
Indications
• All indications for crown and bridge
techniques

55. Advantages
• All indications in the area of immediate and early
implantation

56. Core vent system
• Developed by Dr. Gerald Niznick in 1986
• Screw type designs with perforation or
hollow basket
• Types
– Core vent
– Screw vent
– Micro vent
– Bio vent

57. Core vent
• Made up of Ti alloy 90% Ti-6Al-4V
• Diameters – 3.5,4.5mm
• Threaded or beveled hex threaded
• Length –8, 10.5, 13 and 16mm
• Fixture having threaded screw design as a
horizontal and vertical vent at the apex made up of
CP Ti.

58. Screw vent
• Smooth neck – offers the option
of placing the implant level with
bone or 1mm above it.
• Screw vent is narrower than core
vent
• Diameter 3.75mm
• Length: 7,10,13,16mm
• Made up of CP titanium threaded
at the apex – self-tapping easier.
• Surface is acid etched.

59. Micro vent
• Root form shape
• Made up of Ti alloy, Ha
coating
• Diameters: 3.25, 4.25mm
• Length: 7, 10,13, 16mm

60. Bio-vent
• Bullet shaped implant
• Hydroxyapatite coated has
vertical slot and an apical
hole offered in length
7,10,13,16mm.
• Main indicated in maxilla

61. Advantages
• Screw type helps in easy insertion
• Hollow cylinder type – good bone to implant
contact.
• 8 different widths are provided for different types of
bone.

62. Integral Implant System
• It’s a 2 stage implantation process
Indications
• Totally edentulous mandible or maxilla
• Fixed and removable bridge work

63. Design
• Cylindrical shape
• Coated with dense HA
• Diameter: 3.25 to 4mm
• Length: 8,10,13, & 15mm
• The central core is a Ti alloy healing
screw and gingival cuff
• Consists of drills : Pilot drill, rosette
bur, intermediate spade drill and
spade drill.
• Length: 8,10,13,15mm

64. Advantages
• Different diameters so wide selection for the dentist
• Cylindrical shape
• More favourable stress distribution

65. Pitt-Easy
• The System The two-phase
• Cylindrical screw implant
• Made of pure titanium, with two
different surfaces
• VTPS coating
• The vacuum titanium plasma
spray coating
• Safe osseointegration.
• Fast bone regeneration surface .
Prof.Dr. h.c. Hans L.
Grafelmann

66. Design
• Different colours
• Green code 3.25mm from 8
to 24 mm length
• Yellow code 3.75mm from
8 to 20mm length
• Red code 4mm from 8 to
16 mm length

67. Indications
• Freshly extracted sockets
• Extremely atrophied ridge.
• Mainly in frontal and pre-antral area.
• Seldom below the sinus and rarely in the tuber area

68. Advantages
• Ensure precise and most atraumatic bone
preparation
• Due to the design, shape and dimension
• Minimum alveolar bone resorption  Good
osteointegration
• Tight cervical to apical adaptation of
surrounding bone
• Polished cervical portion
• Establishes and immediate close friction fit at
the marginal bone entrance.
• 5 months healing period

69. Bi-cortical Implants System
• Bi cortical screw is a screw type implant which finds
optimal support in bone i.e., bicortical support.
• One phase implant

70. • Self tapping
• Pure Ti implant
• Design
– Square
– Universal round head
• Diameter: 2.5, 3.5, 4.5, 5.5mm
• Length: 13, 14, 16, 19, 21, 23, 25mm
• Smaller length: 21 to 26mm used in children
(Standard length is 30mm)
• Threads: 3, 4, 5
• More effective self tapping helix with cutting
segments each displaced by 30°.
• Helix design has deeper arching with a progressive
diameter upwards from the apical tip.

71. Indication
• Single tooth replacement
• Bridge or bar abutments in anterior regions (Maxilla or
mandible)
Contraindication
• Bone as little as 8mm
• Insertion possibilities in maxilla are limited distally to the
sinus.
Advantages
• Easy to handle
• Simple insertion technique
• Immediate and lasting stability
• The bone particles cut during insertion are utilized for
closer bone contact.
• No post operative swelling
• Little or no bone resorption

72. Osteoplate 2000 (Blade implant)
• Linkow blade implants invented in 1967.
• Long thin blade that will be surgically inserted into
the groove in the bone .
• Abutment projecting out from the blade to this
crown or attachment for denture can be placed.
• Osteoplate 2000 is developed by prof.dr.h.c.hans
l.Grafelmann

73. INDICATIONS
In the maxilla & mandible
• Less than 4mm crest width (subnasal, labial atrophies or
concavities - vertical blade plate shapes
• Presinus region (<3.5mm crest width) = asymmetric shapes
• Subsinus region with insertion depths of <8mm and <4mm crest
width (without sinus lift surgery) = Horizontal maxillary shapes
• In tuber area (rich marrow and prominent palatal undercuts)
reduced or asymmetric residual bone = tuber shapes
• With posterior crest width of <4mm and available bone height
atleast 6 to 8mm above the mandible canal = shallow horizontal
shapes.
• With bone height 1 to 5mm above the mandible canal but >6mm
in the ramus area = ramus shapes.

74. Designs
• Made up of pure Titanium
• Implant body use
• TPF coated
• Available in vertical
implant & horizontal
implant type with type B
neck (trapezoid shape)
• Type A round neck
• Each implant is supplied
with temporary post,
cover screw and final post

76. Advantages
• Can be used in severely resolved ridges.
• Osteointegration is predictable (after 36 weeks)
• Shoulder thickness and neck design of Type B
– helps in small atrophied alveolar ridges

77. BioHorizons Implant System
Indications
• Single tooth replacement (mandibular central lateral incisor,
maxillary lateral incisor)
• Design: Square thread design – imparts 10 times less destructive
stresses, maximize compressive low transfer, Excellent primary
stability
• 3 different thread forms – for different bone density.
• Square thread
• Conventional V thread
• Coronal 2/3rd
parallel walls – initial stability, surgical simplicity.
• Apical taper
• Self tapping apex – simulates convergent roots

78. • Diameter: 3.5, 4, 5, 6mm.
• Length: 9, 12, 15mm
• Threads: D2, D3, D4
• 6mm diameter implant – used in posterior extraction
sites
• 3mm implant – missing laterals mandibular incisors
• Surface treatment – RBM (Resorbable blast media,
Pure titanium oxide)
• Hydroxyapatite – used in soft bone.
• D4 type bone
• D4 implant

79. Advantages
• Less marginal bone loss because of 0.5mm length
polished collar = better esthetics.
• Spiralock technology reduces the chances of screw
loosening.

81. IMTEC
(Endure implant system)
• Has one stage and two stage implantation
process
Design:
• Diameter: 3.5, 4.3mm
• Length: 11,14,17mm
• Triple micro threading - Microthreads
preserve cortical bone at the crestal ridge –
reduces bone stress
• 1mm polished collar
• Abutment implant junction - Internal Hex
plat form
• Natural anatomic tooth form

82. Innova Implant System
Endopore implants
• Unique, truncated cone shaped
design, multilayout porous surface
– 3 dimensional bone ingrowth.
• With threaded implants the fixation
which occurs allow for rotation
movement of the implant with
endopore resistance to vertical,
horizontal, and rotational
movement.

83. • Implant abutment junction
– Internal hex
– External hex
• Abutment platform 4.8mm
• Diameter 3.5, 4.1, 5mm
• Length: 5, 7 ,9, 12mm
• Collar height: 1.8-2.8mm -Smooth coronal region
• Abutment types are UCLA, UMA, Dalla Bona, Over
denture system.
• Surface treatment – Acid wash surface,
hydroxyapatite surface, TPS surface, Machine
surface

84. Advantages
• A secure, three-dimensional interlocking interface
with bone
• Predictable and minimal crestal bone remodelling
• Greater surgical options with shorter implant
lengths
• An uncomplicated surgical sequence
• Minimal instrumentation and inventory

85. UNITI Implant System
• Single or two stage surgical protocol.
• Consists of straight abutment (4.3mm).
• Tapered abutments
• Ball abutments
Design
• Diameter: 3.3, 3.7, 4.3, 5.3, 6mm – Based on
every cervical diameters of natural teeth.
• Length: 10, 13, 15mm
• Anatomic root shape
• Upper 1/3rd
– Cortical component of implant
body is parallel sided with shallow threads one
continuous pitch of 0.9mm – ideal atraumatic
placement in dense cortical bone – optimal load
transfer.

86. • Lower 2/3rd
– cancellous component – anatomic
taper and sharper, deeper threads (0.35mm) are
nearly horizontal – high degree of stability in
cancellous bone.
• Self cutting slots in the apical portion –
accommodates displaced bone volume during
implant insertion - prevents bone chips being
packed at the base of the osteotomy site.
• Implant tip is rounded

87. • Microgrip surface – osteoconductive high porosity
surface 1-5 micron.
• 1mm highly polished collar – better soft tissue
integration.

88. • Implant abutment connection –
twin hexagon internal
connection.
• The twin hexagon is sandwiched
between two solid cylindrical
guides above and below the
hexagon – high degree of
stability and stress distribution
• Microgap free and bacteria proof
joint
• The deep internal connection
with a abutment extending
3.3mm into the implant body –
offers strength and stability.

89. Indications
• Single tooth replacement
• Single tooth replacement
• Multiple teeth replaceemnt
Advantages
• Biological root form suited for immediate extraction cases.
• Wide diameter neck + tapered form = ideal for peri-
implant defect size in sockets (obviates additional
augmentation materials)
• Wide platform – esthetic emergence profile.
• Tapered root – minimizes risk of damaging adjusting teeth
and structures.

90. Astra Tech Implant System
• Two stage implant – manufactured
from pure titanium
• Submerged implant
• Got unique conical seal design
• Surface treatment
• Grit blasting – Ti oxide particles
• Conical head
• Taper is 11°

91. Implant components
• Fixture (length 8-19mm; Diameter 3.5 to 4mm)
– Self tapping
– Parallel sided
• Cover screw
• Abutments
– Healing abutment
– Straight and angled abutment (20-30°)
– Uni abutment (20° & 45°)
• Drills
– Twisted drill
– Tiger drill – Ti N coated with laser etched bands.
Advantages
• Implant abutment junction is conical junction – prevents
microbial contamination

92. IMZ IMPLANT SYSTEM
• Kirsch developed the IMZ implant system
in 1974. Since 1978 it is in clinical use.
• Intramobile cylinder endosseous two stage
osseointegrated implant.
• IME i.e., intramobile element is made up of
polyoxymethylene was used as a shock
absorbing element simulating PDL
• Available in 3.5 to 4mm diameter and
8,10,13,15mm length.
• Surface coating may be titanium plasma
spray or plasma sprayed HA coated
surface.

93. Indications
• Single tooth replacement
• Unilateral free end
• Bilateral free end
• Wide edentulous span
• Fully edentulous arch

94. Summary & Conclusion

95. References
• Block & Kent’s Endosseous Implants For Maxillofacial
Reconstruction.
• Elaine Mc Clarence ’s Close to the edge.
• Hubertus Spikerman’s Color atlas of Dental medicine
(Implantology).
• Malvin E. Ring’s Dentistry An Illustrated History.
• Sumiya Hobo’s oseointegration and occlusal
rehabilitation.
• Ralph V. McKinney, Jr’s endosteal dental implants.
• ADA council on scientific affairs Dental endosseous
implants. An update. JADA, Vol. 135, January 2004.

96. Thank YouThank You