Implants in orthodontics
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contents
Introduction Historical background Classification of implants Basic terminologies principles
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Historical background
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 Earliest dental implants used were of stone & ivory, cited in archeological records of china & Egypt , before the common era.  Gold & ivory dental implants were used in 16th & 17th century.
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Metal implants device of gold , lead, iridium, stainless steel, cobalt alloy were developed in 20th century. Cobalt – chromium – molybdenum subperiosteal & titanium blade implants were introduced in 1940s & 60s respectively & became the most popular & successful implants device from 1950-80 . www.indiandentalacademy.com
Exaggerated claims in the wake of long term morbidity & unpredictability engendered disbelief & disinterest & even denial on the part of organized dentistry. These implants never really caught.
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Ancient implants – Attempts to replace lost teeth with endosteal implants have been traced to ancient egyptian & south American civilization. A skull from Pre Columbian era in museum shows an artificial tooth carved from dark stone replaced a lower left lateral incisor. Implanted animal & carved ivory tooth cited in ancient Egyptian writings are oldest examples of primitive implantology. www.indiandentalacademy.com
Early implants – 1809 Maggido placed a single staged gold implant without a crown to heal passively in a fresh extraction site ,just above the gingiva the crown was added after healing. The insertions of such tooth roots of gold was added after healing . The insertion of such teeth roots of gold was inevitably followed by intense pain & gingival inflammation www.indiandentalacademy.com
Terminologies
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Implant-: A dental implant is a device of biocompatible material/s placed within or against the mandibular or maxillary bone to provide additional or enhanced support for a prosthesis or tooth.
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Endosteal implantEndo – within Osteal – bone. alloplastic material surgically inserted into a residual bony ridge, primarily to serve as a prosthodontic foundation. Endosteal implants – root forms plant form. www.indiandentalacademy.com
Cylinder fit ( press fit )-: root form implants depends upon microscopic retention & / or bonding to the bone & usually are pushed or tapped into a prepared bone . Screw root form are threaded into a bone site & have obvious macroscopic retentive elements for initial bone fixation .combination root forms are common & have feature of both cylinder & screw root form. www.indiandentalacademy.com
Subperiosteal implants – Because there is often not enough bone in which to place an endosteal implant dentists turned to placing a on & around the bone
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Transosteal implants – 175 Small introduced the transosteal mandibular staple bone plate, a reconstructive device placed through a submental incisions & attached to the mandible with multiple fixation & 2 transosteal screws to support a full arch prosthesis. www.indiandentalacademy.com
CLASSIFICATION
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Implants
Endosteal
Root form
subperiosteal
plate/blade form
transosteal
endodontic stabilizer
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Endoosteal implants – Endosteal implants comprise one broad category of implants . The most commonly applicable abutment providing modalities are endosteal. The endosteal implants are placed within a fully or partially edentulous alveolar ridges with sufficient residual bone available. www.indiandentalacademy.com
Some endosteal implants are attached to components for the retention of a fixed or removable prosthesis. Other implants are equipped with an abutment integral with the implant body, which protrudes into the oral cavity during healing.
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Root form – root form implants are designed to resemble the shape of a natural tooth root. They usually are circular in cross section . As a general rule root form must achieve osseointegration to succeed. Therefore they are placed in a functional state during healing until they are osseointegrated www.indiandentalacademy.com
Most of the root forms are 2 stage implants . Stage 1 – is submersion or semi submersion. To permit a functional healing Stage 2 – is attachment of an abutment or retention mechanism. A root form can be placed anywhere in the mandible or maxilla where there is sufficient bone available. www.indiandentalacademy.com
Plate / Blade form – As the name suggests the basic shape of plate or blade implant is similar to that of a metal plate or blade in cross section . Some plate blade forms have combination of parallel & tapered sides. Plate / Blade forms are unique among implants in that they can function successfully in either osseointegration or osteopreservation mode of tissue integration. www.indiandentalacademy.com
Plate/blade form implants
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Endodontic stabilizer implants
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The endodontic stabilizers function in the osteopreservation mode of tissue integeration
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Ramus frame implants – often intended for treatment of total mandibular edentulism with severe alveolar ridge resorption.
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Transosteal implants – Surgically invasive & technique sensitive. These implants feature a plate that is placed against the exposed inferior border of the mandible with extension that pass from this plate through symphyseal area out of the creast of the alce
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Consultation  Chief complaint  Patients Goals of Treatment
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Clinical Examination
Medical examination Radiography Diagnostic Models
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Diagnosis & Treatment Planning Periodontics Operative Prosthodontics – Abutment support evaluations New implant abutment support – Evaluation of available bone Quality Quantity – Choice of implant modality Endosteal - root form - plate / blade form Subperiosteal
Natural implant abutment support www.indiandentalacademy.com
Goal-oriented case presentation – Other treatment options – Thoroughly informed consent
Acceptance of treatment plan Treatment Maintenance – Professional maintenance Recall examination and prophylaxis Early detection & treatment related complication Patient education
– Home care www.indiandentalacademy.com
Rigid Implant Anchorage to Close a Mandibular First Molar Extraction Site
Age = 34 year Sex = Male Class I mutilated malocclusion Missing: maxillary right first and mandibular left first permanent molars Treatment : Implant-supported anchorage Tx planning : non-extraction to close the asymmetric first molar extraction unidirectional (mesial) space closure. www.indiandentalacademy.com
W. EUGENE ROBERTS, CHARLES L. NELSON, CHARLES J. GOODACRE,
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The use of implants for orthodontic correction of an open bite Beth Prosterman, DDS, Leonard Prosterman, BA, DDS, MS, Cert.Ortho., Ronald Fisher, BSc, DMD, MSD, Mervyn Gornitsky, BSc, DDS
The patient, a 25-year-old healthy man, sustained a traumatic injury to the anterior mandible. A panoramic radiograph revealed nondisplaced horizontal and vertical fractures of the mandibular anterior alveolar processes with displacement of lower right incisors, canine, and premolar. The lower left incisors were avulsed at the time of trauma. He was treated initially with a temporary acrylic splint involving the lower right incisors, and the lower canines and premolar. www.indiandentalacademy.com
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Prediction of mandibular growth rotation A. Björk, Odont. Dr. The technique whereby metal implants are inserted in bone has been used in animals for more than a century. The application of the method in craniometric studies of growth in man is of more recent date. begun in 1951. It comprised study of 100 children of each sex covering the age period from 4 to 24 years. The sample consists of normal children with and without malocclusion and also children with pathologic conditions. www.indiandentalacademy.com
A growth analysis consists essentially of three items, each of which is clinically significant: 1. An assessment of the development in shape of the face which, in the first place, implies changes in the intermaxillary relationship. 2. An assessment of whether the intensity of the facial growth in general is high or low. 3. An evaluation of the individual rate of maturation. This is important in establishing whether puberty has been reached and when the growth may be expected to be completed. www.indiandentalacademy.com
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Osseointegrated titanium, implants for maxillofacial protraction in monkeys
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Forced eruption and implant site development: Soft tissue response Theo Mantzikos, DMD, and Ilan Shamus, DDS
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Roentgen stereometry with the aid of metallic implants in hemifacial microsomia
Bodil Rune, Odont. Dr., Karl-Victor Sarnäs, M.S., Odont. Dr., Göran Selvik, M.D., and Sten Jacobsson, M.D. Malmö and Lund, www.indiandentalacademy.com
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Thank you www.indiandentalacademy.com Leader in continuing dental education
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