Dental Implants

Dental
Implants
DR. SHABNAM RASIKH
LECTURER
D E N TA L M AT E R I A L S
Objectives:
To define implant
To discuss advantages of implant
To enumerate its components
To Classify dental Implant based on:
◦ Implant Designs
 To outline Surface treatments and coatings
 To understand forces applied on implant
 To identify factors affecting selection of implants
Introduction:
Dental implants are the fixtures that serve as replacements for the root of a missing
natural tooth.
They are inserted beneath periosteal layer and / or within the bone.
They are used to replace single tooth, many teeth and support for fixed or removable
prostheses.
Natural tooth vs Dental
Implant:
Advantages:
Overcome the drawbacks of removable prostheses.
Eliminate involvement of adjacent teeth.
Improve psychological health of the patient.
Maintain Bone height and width.
Increase stability and retention of prosthesis during chewing.
Components of Dental
Implant:
Fixture:
The part of the implant that inserted into the bone during surgery. Many designs for the fixture exist.
The bone will grow on to its surface.
Abutment:
1. The part of the implant that breaks through the mucosa(the gum).
2. It is anchored in the fixture by means
of a screw to carry the tooth replacement

Classification based on
Implant Design:
Transosteal
Endosseous Implants:
A device which is placed into the alveolar bone and/or basal bone of the mandible
or maxilla.
The most common type.
A pilot hole is drilled through alveolar and/ or basal bone beneath, then, the implant is
inserted such that either it slightly protrudes through the cortical plate
or flushes with the surface of the bone.

Implant Placement:
Sub Periosteal Implants:
The subperiosteal implant—a design whereby a metal implant framework rests directly
on top of the bony ridge(but doesn't penetrate it), and provides attachment posts, which
extend through the gingival tissue for prosthesis anchorage.
Cast Cobalt-chromium alloys are mostly
used in this case.

Transosteal Implants:
They penetrate completely through mandible.
Osteointegration:
Osseointegration is defined as:
The formation of a direct interface between an implant and bone, without intervening soft
(fibrous or connective) tissue such that the bone can carry loads within physiologic limit
without excessive deformation that may results in:
* Bone resorption,
* Stress shielding,
or* even initiating rejection mechanisms.
Commonly occurs with Titanium alloys

Osteointegration:
Material named after tissue response:
1.Bio tolerant: form a connective tissue capsule developing “distance osteogenesis”
e.g. CO- Cr-Molybdenum alloy, polymers implants.
2. Bioinert: form a direct mechanical contact between the bones and implant (Direct Osteogenesis)
e.g. Titanium and Zirconia implants.
3. Bioactive: form chemical bond between implant and bone "bonding osteogenesis"
e.g. HA, CaP, bioceramics and bioglass coated implants.

Properties of implant
materials:
Any material intended for use as dental implant must meet two basic criteria:
Bio functionality with regard to force transfer
Bio compatibility with living tissue
Implant material should have certain ideal physical, mechanical, chemical and biological
properties to fulfill these basic criteria
Implant properties can be studied under:
1. Bulk properties
2. Surface properties
Bulk Properties:
1- Modulus of elasticity (E):
Ideally a biomaterial with elastic modulus comparable to bone (18GPa) should be

selected
This will ensure more uniform distribution of stress at implant bone interface as under
stress both of them will deform similarly. Hence the relative movement at implant bone
interface is minimized (prevent stress shielding)
2.Tensile, Compressive, Shear
and Yield strength
Forces exerted on implant material consists of tensile , compressive ,
shear components
An implant material should have high tensile, compressive, shear strength

to prevent fractures and improve functional stability
3- Fatigue strength:
Fatigue strength is stress at which material fractures under repeated loading
An implant material should have high fatigue strength to prevent brittle fracture under
cyclic loading
4- Ductility and Toughness:
Refers to relative ability of a material to deform plastically under a tensile stress before it
fractures
ADA demands a minimum ductility of 8% for dental implant

5-Coefficient of thermal
expansion and contraction
Should be similar to that of bone to prevent thermal incompatibility

Surface Properties:
Wettability of implant by wetting fluid (blood)
Cleanliness of implant surface
Surface energy of > 40 dyne / cm
Hardness – resistance to permanent surface indentation or penetration
Wear resistance to mechanical loss of the material

Biocompatibility:
Nowadays total inertness is not needed
Ability of a material to perform, with an appropriate host response in a specific

application, mainly a surface desirable reaction in implant material.
Most important requirement for a biomaterial depends on corrosion resistance

Types of Implant Materials:
Metallic:
Titanium
Titanium alloys (Ti6Al4V)
Cobalt-Chromium-Molybdenum alloy
Austenitic steel or Surgical steel (Iron-Chromium-Nickel alloy )
Precious metals (Gold, Platinum, Palladium)

Ceramic and Carbon:
Aluminum oxide
Alumina
Sapphire
Zirconium oxide (zirconia)
Titanium oxide (titania)
Calcium phosphate ceramics (CPC)
• Hydroxyapatite (HA )
• Tricalcium phosphate( TCP )
Glass ceramics
Vitreous carbon (C), Carbon-silicon(C-Si)
Polymers:
Poly methyl metha acrylate (PMMA)
Poly tetra fluoro ethylene (PTFE)
Poly ethylene terapthylate (Dacron )
Dimethyl polysiloxane (Silicone rubber)
Ultrahigh molecular weight polyethylene(UHMWPE)
Poly sulphone
Composite:
Combination of polymer and other synthetic biomaterials
Carbon – PTFE (Polytetrafluoroethylene)
Carbon- PMMA
Alumina- PTFE (Polytetrafluoroethylene)
The most widely & commonly used dental implant material is
commercially pure (Cp Ti) titanium and titanium alloys. Titanium has
excellent biocompatibility. However, Zr (Y-TZP) dental implants are now a
viable substitute for Ti, although not yet recommended for routine clinical
practice.
References:
McCabe 13th edition
Craig.R.G, Restorative Dental Materials, 12th edition, Elsevier

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Dental

2. It is anchored in the fixture by means

of a screw to carry the tooth replacement

The most common type.

or flushes with the surface of the bone.

Cast Cobalt-chromium alloys are mostly

used in this case.

or* even initiating rejection mechanisms.

Commonly occurs with Titanium alloys

1.Bio tolerant: form a connective tissue capsule developing “distance osteogenesis”

e.g. CO- Cr-Molybdenum alloy, polymers implants.

e.g. Titanium and Zirconia implants.

e.g. HA, CaP, bioceramics and bioglass coated implants.

Bio functionality with regard to force transfer

Bio compatibility with living tissue

Implant properties can be studied under:

Ideally a biomaterial with elastic modulus comparable to bone (18GPa) should be

An implant material should have high tensile, compressive, shear strength

ADA demands a minimum ductility of 8% for dental implant

Should be similar to that of bone to prevent thermal incompatibility

Cleanliness of implant surface

Surface energy of > 40 dyne / cm

Hardness – resistance to permanent surface indentation or penetration

Wear resistance to mechanical loss of the material

Ability of a material to perform, with an appropriate host response in a specific

Most important requirement for a biomaterial depends on corrosion resistance

Titanium alloys (Ti6Al4V)

Austenitic steel or Surgical steel (Iron-Chromium-Nickel alloy )

Precious metals (Gold, Platinum, Palladium)

Craig.R.G, Restorative Dental Materials, 12th edition, Elsevier

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