CURRENT DENTAL IMPLANT SYSTEMS

DR.K.V.PRATHEEP

CONTENTS

DENTAL IMPLANT SYSTEM

• Dental implant components that are designed to mate together. An implant system can represent a specific concept, inventor, or patent. It consists of the necessary parts and instruments to complete the implant placement and abutment components.(ISO 10451)

Classification of implant systems

Based on placement with in the tissues:• Endosteal: -root forms -plate or blade forms -endodontic stabilizers• Sub periosteal• Transosteal • Epithelial

• Pin concept

Ramus frame

Root form implants

• Screw• Cylinder

Screw vs cylinder

(schimitz et al1991)

• Straight• Tapered• Conical• Ovoid• Trapezoidal• stepped

Implant abutment connections

External hex Internal hex Morse taper

External hex

Internal hex

• more natural appearance to the prosthetic tooth.

• this type of dental implant connection is considered more stable, eliminating or reducing stress on the cold weld as well as any potential for rotation to occur.

Morse taper

• A Morse taper creates a friction fit between the two parts resistant to much higher loosening torque than that found with traditional hexed mating surfaces.

• The micro-gap is much narrower between the two parts having a Morse taper.

• eliminates any lateral movement between the mating surfaces unlike the micro-movement found with hexagonal mating surfaces.

Praful narang et al 2011

Surface topography

Dental implant materials

metals

ceramics

CP Titanium and Ti-6Al-4v alloys

Cobalt alloys

Inert ceramics

Bioactive ceramics

alumina

Carbon

Zirconia

Bioactive glasses and ceramics

Calcium phosphates

Materials used for dental implants

Design characteristics of dental implants associated with clinical success

Important clinical outcomes

• Ease of placement.• Osseointegeration.• Aesthetics.• Marginal bone loss.• Mechanical problems of implant/abutment or

super structure connection.• Mechanical failure of oimplant.

Ease of placement

• Geometry of the implant.• Friberg et al compared the early behaviour of a

Brånemark system modified prototype MkIV implant with that of the standard implants in regions of mainly of type 4 bone in 44 patients.

• The patients were treated with implants for 39 maxillas and 5 mandibles and these were followed up for 1 year.

• The MkIV implants more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant.

Osseointegeration

• Implant body geometry• Implant material• Implant surface topography

Smith et al 2001

• Two different surface treatments of ZL-Duraplant implants in 137 patients were evaluated in a trial over 2 to 6 years.

• Two implant geometries were used, thus creating study groups consisting of surface treated cylinders (n = 30), and screws with (n = 339) and without (n = 58) surface treatments.

• Similar performance was first noted to begin with, but the cylinders demonstrated poorer results than the screws after approximately 1 year.

• Surface treated implants performed better

Esthetics

• Implant and abutment interface geometry• Abutment material and geometry

Jokstad et al (2004)

Marginal bone loss

• Implant body geometry• Implant material• Implant surface topography• Implant and abutment interface geometry• Abutment material, geometry and surface

topography

• Advantages of Platform switching:

• Reducing bone loss increases the bone-implant contact surface

• Enhanced osseointegrated area

• Helps retain peri-implant crestal bone

• Determines gingival aesthetics and the health of the implant-supported restorations

Hi tec

• Internal hex implants: -tapered self thread implants. (3.3,3.75,4.2,5mm). (8,10,11.5,13,16mm)

-smooth fit cylindrical implants. (3.50,3mm),(8,10,13,16mm)

Surface treatment

• Tapered self thread implants: - Acid etched or large grit sand blasted and acid etched.• Smooth fit cylindrical implant: -titanium plasma sprayed or HA coated.

• External hex implants:-3.75mm(8,10,11.5,13,16),-4.2mm(6,8,10,11.5,13,16)mm-5mm (6,8,10,11.5,13,16)mm.

External hex cylinder implant

Noble biocare

External hex connection:• Brånemark System Mk III• Brånemark System Mk IV• NobelSpeedy Groovy• Brånemark System Zygoma

Branemark System MK III Groovy-(narrow,regular and wide platform)

• Implant Apical Features: grooved • Implant Apical Shape : flat apex • Implant Body Features : threaded • Implant Body Shape : cylinder • Implant Body Surface : TPO (Titanium Porous Oxide) anodic

oxidation • Implant Body Thread : V-shaped • Implant Cervical Features: unpolished surface • Implant Cervical Shape : wider than body • Implant Material : commercially pure titanium (grade 4) • Platform to Abutment Connection: external hex

Branemark System MK III-Shorty

• Implant Body Thread: V Shape.• Platform to Abutment Connection: External

Hexagon. • Hexagon Diameter: 2.7mm. • Hexagon Height: 0.7mm. • Sizes: Platform diameter:4.1mm.

Implant diameter:3.75mm,4.0mm. Implant Length:5.5mm,7.0mm.

• Implants with internal conical connection:-Noble active

• Implants with internal tri-channel connection:-Nobel Replace Tapered-Replace Select Tapered-Nobel Replace Straight-Replace Select Straight-Nobel Speedy Replace-Replace Select TC

• Branemark system:very effective in medium to dense bone.

• NobelSpeedy:-more tapered towards the apex.-allows for under preparation.-Good primary stability.-used in all on 4 concept.

Alpha bio implant system

• Ti-6A-4V titanium alloy implants.• Nano tech implant surface.• Sand blasting and acid etched.

• Advantages of nanotech implant surface:-increased early BIC.-increased primary and secondary stability.-shortened healing period.-higher predictability.-increased rate of osteointegeration.

• Screw internal hex implant system.• Arrow press implant system.• Arrow implant system.(provisional)

• Screw internal hex implants:-spiral implants

• Achieves very high primary stability.• Ideal for immediate implantation.• Ideal for immediate loading.• Ideal for bone types III and IV.• One platform for all diameters.

• Dual fit implants

• Arrow press implants: single piece with integerated trans gingival abutment.

Osstem dental implant system

• GS system.• SS system.• US system.• MS system.

• GS system:-submerged type.-internal hex connection.-dual thread for optimal stress distribution.-oxidized treated cell nest surface.-for immediate extraction.

• SS system:-non submerged type.-internal octa and morse tapper type ofConnection.

• US system:-sumerged.-External hex.-RBM surface treatment.

MS system

Zimmer one piece implant

• Implant Apical Features : oblong hole • Implant Apical Shape : domed apex • Implant Body Features : threaded • Implant Body Shape : tapered • Implant Body Surface : blasted with hydroxylapatite • Implant Body Thread : V-shaped • Implant Cervical Features: polished surface • Implant Cervical Shape: straight transition from body • Platform to Abutment Connection: one piece (no

connection)

• Implant Cervical Features: 0.5mm height Machined.• Implant Body Thread: Implant Diameter 3.0mm:Triple-

Lead Thread. 1.2mm pitch. Implant Diameter: 3.7mm,4.7mm: Double-Lead Thread. 1.2mm pitch.

• Sizes:Implant Diameter 3.0mm. Abutment Emergence Profile: 3.5mm. Implant Length: 10.0mm,11.5mm,13.0mm.

• Implant Diameter 3.7mm. Abutment Emergence Profile: 4.5mm. Implant Length: 10.0mm,11.5mm,13.0mm,16.0mm.

• Implant Diameter 4.7mm. Abutment Emergence Profile: 5.5mm. Implant Length: 10.0mm,11.5mm,13.0mm.

• Zimmer One-Piece Implant-17deg.: 17 deg. Abutment

Tapered Screw Vent

• Implant Apical Features : oblong hole • Implant Apical Shape : domed apex • Implant Body Features : threaded • Implant Body Shape : tapered • Implant Body Surface : HA (hydroxyapatite)

blasted with hydroxylapatite • Implant Body Thread : V-shaped • Implant Cervical Features: polished surface • Implant Cervical Shape : narrow • Platform to Abutment Connection: internal hex

Spline twist implant

• external spline type of connection.