implant

Ali ashraf mohamed ahmed

202003743
 Introduction
During the last decade the
During the last decade the use
use implants has widely
implants has widely spread
spread among practitioners
among practitioners with
with increasing demand from
increasing demand from
patients and heavy marketing
patients and heavy marketing by
by the companies
the companies
. However, reports about
. However, reports about
implant failures are increasing
implant failures are increasing (
( malpositioning ,
malpositioning , periimplantitis )
periimplantitis ) as a result of
as a result of poor
poor
 diagnosis of implant
2- Clinical examination
The clinical examination include several extra-and intra-oral
aspects
A-Extra oral examination
(1) correct facial proportions (divided into 3 thirds: from
hairline to eyebrow, to the subnasal point, to the chin)
(2) need for lip and cheek support: patients with removable
prosthesis should be evaluated with and without the
existing restoration in place so that a prosthesis flange for
adequate support can be planned if necessary
B- Intra-oral examination
(1) dental examination including existing restorations and reconstructions, decayed
and filled teeth, oral hygiene assessment,
periodontal exam and dental pulp test; detection of malpositioned teeth
(elongation, intrusion, ectopic tooth position); midline
between upper central incisors corresponding to the philtrum position.
(2) edentulous regions: ridge defects (vertical, horizontal, combined)
3) quality/quantity of the mucosa and contour of the underlying bone: any
pathologies and pressure spots are recorded and
the magnitude of the alveolar ridge resorption is examined. The mucosal quality
and quantity with the underlying bone can
be assessed by palpation and/or sounding. A thick keratinized mucosa is easier to
mould for a papillary-like inter-implant
trigonum than a thin, flappy, non-keratinized ridge tissue. Sufficient mucosal
thickness helps to hide the abutment margin and
better facilitates correct emergence profile of the clinical crown.
More advanced technique are used for better diagnosis and treatment planning CT
scan ( computed tomography ) CTBC , (
cone beam
Dental CBCT images provide three-dimensional (3-D) information, rather than the two-
dimensional (2-D)
information provided by a conventional X-ray image. This may help with the diagnosis,
treatment planning and
provide best result for implant position and evaluation of certain conditions
The difference between CT and CBCT is how the x-rays are sent out from the x-ray
source. Traditional CT uses a fan-shaped
beam or spiral scan for medical imaging, but CBCT uses a cone-shaped beam
Using CBCT instead of traditional CT 3D imaging provides more information and detail
At the same time, it
exposes patient to much less radiation and doesn't require the longer periods of time
demanded by a CT scan
Before the modern x ray technique the
method of
selecting implant position , was through the
use of
plastic sheet on which implants of different
lengths
and diameters are printed , this sheet is
placed
over OPG X- ray and moved until the proper
length
of implant is selected in relation to
anatomical
structures ( maxillary sinus , inferior nerve
 History of
dental implants
500 BC: The Ancient Egyptians used gold
ligature wire to stabilize natural teeth that
had been affected by severe periodontitis
500 BC: The Etruscans (Ancient Italians) used gold bands from
animals that were customized by soldering, as well as
fake teeth made from oxen bones to restore missing teeth
 600 AD: The Mayans used shell pieces
implanted into the mandible and are credited
with being the first evidence of dental
implants. Radiographs taken of Mayan
mandibles in the 1970s showed that bone
growth around the Mayan implants was
similar to what we see with modern dental
implants.
1913: Dr. EJ Greenfield developed a hollow
latticed cylinder made from iridio-platinum
soldered with gold. The shape was designed to
fit within a circular incision made in the
jawbone of the patient
Implant Fabrication

1. Materials Used:
• Titanium: Most commonly used; biocompatible and allows osseointegration.
• Zirconia: Metal-free, esthetic alternative, used in some cases.

2. Manufacturing Process:
• CNC Machining: Titanium rods are shaped into implants using computer-controlled
machines.
• Surface Treatment: Increases surface roughness for better bone integration. Common
treatments:
• SLA (Sandblasted, Large grit, Acid-etched)
• Plasma-sprayed coating
• Anodizing

3. Sterilization & Packaging:

• Implants are cleaned, sterilized, and sealed in sterile packaging to maintain quality and
prevent infection.
Techniques of Insertion 2. Immediate vs Delayed 3. Guided Implant
Placement Surgery
1. Flap vs Flapless Surgery • Immediate Placement:
• Uses digital
• Flap Surgery: • Implant placed right
planning and a
• Gingival flap is raised to after tooth extraction.
• Reduces treatment surgical
expose bone.
• Provides better visibility time, but needs good guide/template.
and access. bone quality. • Increases
• Flapless Surgery: • Delayed Placement: accuracy and
• No flap is raised; implant • Implant placed after minimizes errors.
is placed through soft bone healing (usually • Often combined
tissue. after 3–6 months).
with flapless
• Minimally invasive, faster • Safer when there’s
technique.
healing, but requires precise infection or insufficient
planning. bone.
Impression Techniques
2. Digital Impression Technique
1. Conventional Impression Techniques
• Open Tray Technique (Pick-up): • Intraoral Scanners (IOS):
• Used with screw-retained impression • No need for impression materials.
copings. • Captures a 3D digital model of the
• Tray has an open window; screws are mouth.
unscrewed through the tray. • More comfortable for patients and
• High accuracy, especially in multiple
time-saving.
implants.
• Closed Tray Technique (Transfer):
• Uses shorter copings that remain in the Advantages of Digital Scanning:
mouth when the tray is removed. • Higher patient comfort
• Easier and faster for single units but less • Faster lab communication
accurate than open tray. • Precise and repeatable
Thank
You