By: Josué Ramírez Hernández

• "Dental implantology is a new branch of dentistry which involves the reconstruction of missing teeth and their supporting structures with natural or synthetic (alloplastic, allogenic or autogenous) substitutes."

• Implants do not involve preparation of the adjacent teeth, they preserve the residual bone, and excellent aesthetics can be achieved.

• However, it is expensive, the patient requires surgery, time consuming, and technically complex.

1. Mucosal Insert

2. Endodontic Implant (Stabilizer)

3. Sub-periosteal implant

4. Endosteal or Endosseous implant Plate-form implant Ramus-frame implant Root-form implant

5. Transosseous implant

1. Implant biocompatibility2. Implant design3. Implant surface4. Implant bed5. Surgical technique6. Loading condition

• Materials used are:

Cp titanium (commercially pure titanium)

Titanium alloy (titanium-6aluminum-4vanadium)

Zirconium Hydroxyapatite (HA), one type of

calcium phosphate ceramic material• Osseointegration interface:

Osseointegration Biointegration

• Cylindrical Implant Some investigators explain the

lack of bone steady state by overload due to micromovement of the cylindrical design, whereas others incriminates an inflammation/infection caused particularly by the very rough surfaces typical for these types of implant.

• Threaded Implant In contrast, Threaded implants have

demonstrated maintenance of a clear steady state bone response.

To enhance initial stability and increase surface contact, most implant forms have been developed as a serrated thread.

Pitch, the number of threads per unit

length, is an important factor in implant osseointegration. Increased pitch and increased depth between individual threads allows for improved contact area between bone and implant.

Moderately rough surfaces with 1.5µm also, improved contact area between bone and implant surface.

Reactive implant surface by anodizing (Oxide layer) ,acid etching or HA coating enhanced osseointegration

• Quality I Was composed of homogenous compact bone,

usually found in the anterior lower jaw.

• Quality II Had a thick layer of cortical bone surrounding

dense trabecular bone, usually found in the posterior lower jaw.

• Quality III Had a thin layer of cortical bone surrounding dense

trabecular bone, normally found in the anterior upper jaw but can also    be seen in the posterior lower jaw and the posterior upper jaw.

• Quality IV Had a very thin layer of cortical bone surrounding

a core of low-density trabecular bone, It is very soft bone and normally found in the posterior upper jaw. It can also be seen in the anterior upper jaw.

According to Lekholm and Zarb.,1985