2. -Dental implants (features and materials).
-Medical and dental evaluation before
implant placement.
-Techniques of implant placement.
-Surgical and post-surgical complications.
-Providers of implant supported prosthesis.

3. Features of the ideal implants
:Implants have to
• Induce healing and bone formation .
• Be easily removed if needed .
Have appropriate reactions with •
surrounding living tissues
(biocompatibility) .
• Resist the acting loads and probable
overloads .
Resist the long-term actions like fatigue,•
..corrosion, etc
• Be easily sterilized .

4. Possible problems upon
using the implant materials:
- Inflammation
- Infection
- Rejection

5. First Implant Design by Branemark
All the implant designs are obtained by the
modification of this design.

7. Dental implant materials
Titanium / Alloys
�Easily available.
�Lightweight, corrosion resistant, easily
milled into different shapes, while
maintaining its strength.
�Forms layer of titanium oxide, which
is a stable and reactive interface that
becomes coated with plasma proteins.
�Ti-6Al-4V was alloyed to create a
biocompatible material with added
strength.

8. Dental implant materials
(cont.)
. Zirconium
� An inert material with very low
allergic potential.
� Has outstanding physical and
mechanical qualities.
� Zirconia implants have proven high
level of osseointegration and bone-toimplant contact.

9. Dental implant surface treatment
Dental implants with rough surfaces
have been designed to improve
early healing, especially in areas of
poor bone or insufficient bone
quantity
� Acid-etching.
�More threads.
�Coating implant surface with
different materials that can enhance
the healing:
-Plasma.
-hydroxyapatite.
-Bone morphogenic protein.
-Osteoprotein.

10. Implant
thread
Bone

11. .Astra Tech
ITI
Bicon
More than 350 implant systems
and 145 manufacturers

12. 1- Having no disease or condition
that
interferes
with
proper
healing after implant surgery.
2- Having enough amount and
density of jaw bone, to secure
the implants.

13. 
Cardiovascular

Respiratory

Renal

Musculoskeletal

Neurological

Endocrine
Surgical or anesthetic
? contraindications

14. 






Diabetes.
Coronary artery disease.
Alcoholism.
Drug therapy
- anticoagulants.
- anti epileptics.
- antidepressants.
- others.
Osteoporosis.
Smoking.
Pregnancy.

15. 


Bone Quantity
Bone Quality
Associated structures - inferior alveolar nerve
- mental nerve
- maxillary antrum
- nasal floor
- incisive canal

Pathology
- periapical pathology
- cysts
- other pathology

16. - OPG
Lateral
Cephalogram
Periapicals
- AxialCT Scan
Coronal
3D reconstruction
Dentascan
MR
-
-

20. Bone quantity
Bone width
Bone height

21. Bone quality
D1
DD
DD
D
D2
D3
D4
Bone Quality relates to the degree of bone density present. Type 1 is
dense bone, which provides great cortical anchorage, but limited
vascularity. Type 2 bone is the best bone for osseointegration of dental
implants. It provides good cortical anchorage for primary stability, yet has
.better vascularity than Type 1 bone
.Types 3 and 4 are soft bone textures with the least success in type 4 bone

22. Implant placement
Surgical timing
There are different approaches to place dental
implants after tooth extraction. The approaches
are:
Immediate post-extraction implant placement.
Delayed immediate post-extraction implant
placement (2 weeks to 3 months after
extraction).
Late implantation (3 months or more after tooth
extraction).

23. Implant placement
.( (cont
Surgical procedure:
- Two - stage technique.
- One - stage technique.
Surgical approach:
- Raising a mucoperiosteal flap.
- Flapless technique.

24. Placement of implants by raising a mucoperiosteal flap
INITIAL SURGERY INITIAL
INITIAL SURGERY

25. Two-stage implant placement procedure
Stage one
Stage two

26. One- stage implant placement
1111
5
222
2
4
3
6
7
8

27. One- stage implant placement
.( cont )

28. Flapless technique
A surgical approach of implant placement without
raising a mucoperiosteal flap.
.

29. Advantages:
-Shorter and faster surgical treatment
procedure of implant placement, and by
that, less time is needed for the complete
implant-prosthetic restoration.
.
-Minimal bleeding and postoperative
discomfort for the patient.
- Possibility of immediate loading of the
inserted implant.
-

31. Immediate implantation
An implant can be placed on the
same day as an extraction if
good amount of bone is
available and if there is no any
infection around the existing
. tooth
When teeth are lost, bone will shrink
in several dimensions. Placing an
implant immediately can reduce
this bone loss and provide a
.. better esthetic result

32. Surgical and post-surgical
complications
- Bleeding and bruising
- Post-surgical pain
Post-surgical infection
-Chronic painDelayed healing
- HematomaAbscess
-GingivitisOsteomyelitisSequestrum
- Local or systemic infection- Bone fracture
- Loss of alveolar ridgeFistula to nose or sinus
-Temporary speech problemsTransient or permanent damage to the nerves in thejaw

33. Success Rates

34. Who can provide implant supported
dental prosthesis ?
The general dentist is usually the first
resource for this service. The key is the
implant dentist’s training, experience
and credentials
Competent dentists include
periodontists, prosthodontists and oral
surgeons who perform surgical and/or
restorative procedures.