Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
3. IntroductionIntroduction
The goal of modern dentistry is to restoreThe goal of modern dentistry is to restore
the patient to normal contour, function,the patient to normal contour, function,
comfort, esthetics, speech and health.comfort, esthetics, speech and health.
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4. Factors effecting increased need and use ofFactors effecting increased need and use of
implant related treatments:implant related treatments:
1)1) Increased in aged populationIncreased in aged population
2)2) Tooth loss related to ageTooth loss related to age
3)3) Anatomic consequences of edentulismAnatomic consequences of edentulism
4)4) Poor performance of removable prosthesisPoor performance of removable prosthesis
5)5) Psychological aspect of tooth lossPsychological aspect of tooth loss
6)6) Predictable long term results of implantPredictable long term results of implant
supported prosthesissupported prosthesis
7)7) Advantages of implant supported prosthesisAdvantages of implant supported prosthesis
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5. Advantages of implant supported prosthesis:Advantages of implant supported prosthesis:
1)1) Maintenance of boneMaintenance of bone
2)2) Maintenance of occlusal vertical dimensionMaintenance of occlusal vertical dimension
3)3) Tooth positioned for estheticsTooth positioned for esthetics
4)4) Proper occlusionProper occlusion
5)5) Improved psychological healthImproved psychological health
6)6) Regained proprioceptionRegained proprioception
7)7) Increased stabilityIncreased stability
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6. 8)8) Increased phoneticsIncreased phonetics
9)9) Increased retentionIncreased retention
10)10) Reduced removable prosthesis sizeReduced removable prosthesis size
11)11) Improved success rate of prosthesisImproved success rate of prosthesis
12)12) Increased survival time of restorationIncreased survival time of restoration
13)13) Improved function of prosthesisImproved function of prosthesis
14)14) Maintenance of muscle of mastication &Maintenance of muscle of mastication &
facial expressionfacial expression
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7. DefinitionDefinition
According to GPT 8According to GPT 8
Dental implant is a biologic or alloplasticDental implant is a biologic or alloplastic
material surgically inserted into soft ormaterial surgically inserted into soft or
hard tissue of mouth for function andhard tissue of mouth for function and
esthetic purposes.esthetic purposes.
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9. Acc. To Weiss and WeissAcc. To Weiss and Weiss
IMPLANTS
ENDOSTEAL
SUBPERIOSTEAL
INTRAMUCOSAL INSERTS
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10. Endosteal ImplantsEndosteal Implants
An alloplastic material surgically insertedAn alloplastic material surgically inserted
into a residual ridge primarily asinto a residual ridge primarily as
prosthodontic foundationprosthodontic foundation
Comprise broad category of implants theyComprise broad category of implants they
are the most commonly applicableare the most commonly applicable
abutment providing modality.abutment providing modality.
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11. In mainstream casesIn mainstream cases
endosteal implantsendosteal implants
are placed within fullyare placed within fully
or partially edentulousor partially edentulous
alveolar ridges withalveolar ridges with
sufficient residualsufficient residual
ridge volumeridge volume
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12. Advantages of endosteal implants:Advantages of endosteal implants:
1)1) A high degree of predictability inA high degree of predictability in
attainment of osseo-integrationattainment of osseo-integration
2)2) Versatile surgical and prosthodonticVersatile surgical and prosthodontic
protocolsprotocols
3)3) Design features that facilitate ease ofDesign features that facilitate ease of
treatment & estheticstreatment & esthetics
4)4) A low complication rate & ease ofA low complication rate & ease of
maintenancemaintenance
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13. Success criteria (Albertsson et al:Success criteria (Albertsson et al:
1986)1986)
1)1) An individual, unattached implant isAn individual, unattached implant is
immobile when tested clinicallyimmobile when tested clinically
2)2) A radiograph does not demonstrate anyA radiograph does not demonstrate any
evidence of peri implant radiolucency.evidence of peri implant radiolucency.
3)3) Vertical bone loss is less than 0.2 mmVertical bone loss is less than 0.2 mm
annually following implant’s first year ofannually following implant’s first year of
serviceservice
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14. 4)4) Individual implant performance isIndividual implant performance is
characterized by an absence of persistentcharacterized by an absence of persistent
and/or irreversible signs & symptoms such asand/or irreversible signs & symptoms such as
pain, infection, neuropathies, parasthesia orpain, infection, neuropathies, parasthesia or
violation of mandibular canalviolation of mandibular canal
5)5) In the context of the above, a success rate ofIn the context of the above, a success rate of
85% at the end of 5 year observation period &85% at the end of 5 year observation period &
80% at the end of 10 year period are minimum80% at the end of 10 year period are minimum
criteria for successcriteria for success
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15. According to Misch:According to Misch:
1)1) LongevityLongevity
2)2) PainPain
3)3) Rigid fixationRigid fixation
4)4) PercussionPercussion
5)5) Bone lossBone loss
6)6) Radiographic evaluationRadiographic evaluation
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17. Implant failureImplant failure::
1)1) Horizontal mobility beyond 0.5 mm orHorizontal mobility beyond 0.5 mm or
any clinically observed verticalany clinically observed vertical
movement under less than 500gm forcemovement under less than 500gm force
2)2) Rapid progressive bone loss regardlessRapid progressive bone loss regardless
of stress reduction & peri-implant therapyof stress reduction & peri-implant therapy
3)3) Pain during percussion or functionPain during percussion or function
4)4) Continued uncontrolled exudates inspiteContinued uncontrolled exudates inspite
of surgical attempts at correctionof surgical attempts at correction
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18. 5)5) Generalized radiolucency around anGeneralized radiolucency around an
implantimplant
6)6) More than one half of the surroundingMore than one half of the surrounding
bone is lost around an implantbone is lost around an implant
7)7) Implants inserted in poor position makingImplants inserted in poor position making
them useless for prosthetic supportthem useless for prosthetic support
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20. ENDOSTEAL IMPLANTS
BLADE FORM CYLINDRICAL SCREW SHAPED
PINS DISC LIKE
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21. Osseo-integrationOsseo-integration
““direct bone anchorage to an implant bodydirect bone anchorage to an implant body
which can provide a foundation to supportwhich can provide a foundation to support
a prosthesis”a prosthesis”
““at least some direct contact of living boneat least some direct contact of living bone
with surface of an implant at lightwith surface of an implant at light
microscope level of magnification”microscope level of magnification”
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23. 3)3) Submerged and non submergedSubmerged and non submerged
protocolsprotocols
4)4) Bone factorsBone factors
5)5) Loading conditionsLoading conditions
6)6) Prosthetic loading considerationProsthetic loading consideration
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24. Root form implantsRoot form implants
It is major subcategory of endostealIt is major subcategory of endosteal
implantsimplants
They are the most often used design formThey are the most often used design form
They are designed to resemble the shapeThey are designed to resemble the shape
of natural tooth rootof natural tooth root
As a rule root form must achieveAs a rule root form must achieve
osteointegration to succeedosteointegration to succeed
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25. Most are 2 stage implantsMost are 2 stage implants
Can be placed any where in mandible orCan be placed any where in mandible or
maxilla where there is sufficient availablemaxilla where there is sufficient available
bonebone
Can be threaded, smooth, stepped,Can be threaded, smooth, stepped,
parallel sided or tapered, with or withoutparallel sided or tapered, with or without
coating, with or without grooves or ventcoating, with or without grooves or vent
and can be joined to a wide varity ofand can be joined to a wide varity of
components for prosthesis retentioncomponents for prosthesis retention
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31. Fixture / BodyFixture / Body - Surgically placed into- Surgically placed into
the bonethe bone
Cover screwCover screw –– placed on top of theplaced on top of the
fixture to prevent invasion into thefixture to prevent invasion into the
threaded internal area of the fixturethreaded internal area of the fixture
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32. Second stage permucosal extensionSecond stage permucosal extension
Extends the implant above the softExtends the implant above the soft
tissuestissues
Results in development of a permucosalResults in development of a permucosal
sealseal
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33. AbutmentAbutment
Portion of implantPortion of implant
that serves to supportthat serves to support
and/ or retain aand/ or retain a
prosthesis or implantprosthesis or implant
superstructuresuperstructure
20 degree 45degreewww.indiandentalacademy.comwww.indiandentalacademy.com
34. Transfer copingTransfer coping
Implant bodyImplant body
copingcoping
Abutment transferAbutment transfer
copingcoping
Direct transferDirect transfer
copingcoping
Indirect transferIndirect transfer
copingcoping
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42. Abutment for cement retentionAbutment for cement retention
Advantages :Advantages :
1)1) PassivePassive
2)2) Occlusal surface remains intactOcclusal surface remains intact
3)3) Loosens lessLoosens less
4)4) Improved estheticsImproved esthetics
5)5) Fewer occlusal porcelain fracturesFewer occlusal porcelain fractures
6)6) Can be easily correctedCan be easily corrected
7)7) Easy manipulation in posterior regionEasy manipulation in posterior region
8)8) Less expensiveLess expensive
Disadvantages:Disadvantages:
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43. Abutments for screw retentionAbutments for screw retention
Advantages:Advantages:
1)1) Greater prosthetic flexibilityGreater prosthetic flexibility
2)2) Permits use of short or low profile abutmentsPermits use of short or low profile abutments
3)3) Easy retreivabilityEasy retreivability
Disadvantages:Disadvantages:
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44. Attachment of abutments toAttachment of abutments to
implantsimplants
For flat surfaced implantsFor flat surfaced implants
For implants with anti-rotational featuresFor implants with anti-rotational features
External hexExternal hex
Internal hexInternal hex
Spline attachmentSpline attachment
Morse taper (cold weld)Morse taper (cold weld)
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48. Implant recommendation relatedImplant recommendation related
to tooth anatomyto tooth anatomy
Cemento enamel junction minus 2mm is aCemento enamel junction minus 2mm is a
good location to assess the average sizegood location to assess the average size
of a tooth root and determine the optimalof a tooth root and determine the optimal
implant size for replacing the toothimplant size for replacing the tooth
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49. Principles of implant positioningPrinciples of implant positioning
Vertical positioning – depthVertical positioning – depth
Buccolingual positioning – widthBuccolingual positioning – width
Mesiodistal positioning – lengthMesiodistal positioning – length
Trajectory or angleTrajectory or angle
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50. plate/ blade formplate/ blade form
Supplied as one-stage and two-stageSupplied as one-stage and two-stage
Can be tapered or parallel sidedCan be tapered or parallel sided
Can be used in combination with naturalCan be used in combination with natural
tooth as co-abutmenttooth as co-abutment
Required bone:Required bone:
>8mm of bone height>8mm of bone height
>3mm of width>3mm of width
>10mm bone length>10mm bone length
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51. PLATE./ BLADE FORM IMPLANTS
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52. As with root form implants plate/bladeAs with root form implants plate/blade
form implants can be placed anywhere inform implants can be placed anywhere in
the mandible or maxilla wherever there isthe mandible or maxilla wherever there is
sufficient bone available. Howeversufficient bone available. However
because of the narrower buccolingualbecause of the narrower buccolingual
width of blade/plate form, they are morewidth of blade/plate form, they are more
applicable in wider range of available boneapplicable in wider range of available bone
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53. AdvantagesAdvantages ::
1)1) Succeeds in both osteointegration & osteo-Succeeds in both osteointegration & osteo-
preservation modepreservation mode
2)2) Low treatment costLow treatment cost
3)3) Low treatment timeLow treatment time
4)4) Low traumaLow trauma
5)5) Requires conventional prosthodonticRequires conventional prosthodontic
proceduresprocedures
6)6) Easy to place and simple armamtariumEasy to place and simple armamtarium
7)7) Increased implant interfaceIncreased implant interface
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54. Parts of blade/plate form implant:Parts of blade/plate form implant:
AbutmentAbutment
Safety stopSafety stop
NeckNeck
ShoulderShoulder
VentsVents
Shoulder set pointsShoulder set points
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56. Prosthodontic related advantages of rootProsthodontic related advantages of root
form implants compared with plate form:form implants compared with plate form:
1)1) Provide independent supportProvide independent support
2)2) Greater surface area for stress distributionGreater surface area for stress distribution
3)3) Permits better estheticsPermits better esthetics
4)4) Wide range of abutment optionsWide range of abutment options
5)5) Greater retention and resistanceGreater retention and resistance
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57. 5)5) Greater flexibilityGreater flexibility
6)6) Requires less skillRequires less skill
7)7) May be inserted at the level or below theMay be inserted at the level or below the
crest of the ridgecrest of the ridge
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58. Endodontic stabilizerEndodontic stabilizer
They are used toThey are used to
extend the functionalextend the functional
length of an existinglength of an existing
tooth roottooth root
Improve prognosisImprove prognosis
and crown root ratioand crown root ratio
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59. Parallel sided orParallel sided or
taperedtapered
Smooth or threadedSmooth or threaded
““sluice ways”sluice ways”
Nomenclature:Nomenclature:
Major diameterMajor diameter
Minor diameterMinor diameter
PitchPitch
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60. Functions in osteopreservation modeFunctions in osteopreservation mode
Need for atleast 5mm of available boneNeed for atleast 5mm of available bone
beyond apex of the toothbeyond apex of the tooth
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61. Disk like implantsDisk like implants
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