GENERIC IMPLANT BODY TERMINOLOGY

SUNEEL AGARWAL JR III

IMPLANT

A PROSTHETIC DEVICE MADE OF ALLOPLASTIC MATERIAL IMPLANTED INTO THE ORAL TISSUE BENEATH THE MUCOSAL OR /AND PERIOSTEAL LAYER, AND ON/OR WITHIN THE BONE TO PROVIDE RETENTION AND SUPPORT FOR A FIXED OR REMOVABLE DENTAL PROSTHESIS,A SUBSTANCE THAT IS PLACED INTO OR /AND UPON THE JAW BONE TO SUPPORT A FIXED OR REMOVABLE DENTAL PROSTHESIS(GPT 8).

INTRODUCTION

ROOT FORM IMPLANTS ENDOSTEAL IMPLANT THAT ARE DESIGNED TO USE VERTICAL COLUMN OF BONE SIMILAR TO THE ROOT FORM OF A NATURAL TOOTH. THE BODY DESIGN CAN BE : 1) CYLINDRICAL 2) THREADED 3) SOLID ,HOLLOW OR VENTED 4) PERFORATED

INTRODUCTION

DESIGN: SUBMERGIBLE NONSUBMERGIBLE

TYPES OF IMPLANTS

IMPLANT BODY REGIONS

An implant body is the portion of the dental implant that is designed to be placed into the bone to anchor prosthetic components. It is divided into mainly 3 parts: a) crest module b) body c) apex.

IMPLANT COMPONENTS

IMPLANT BODY (ROOT FORM)

It is the component placed within the bone during first stage surgery. Solid screw with a blunt apex. Length of10-16 mm are the most widely used. Maybe plasma sprayed with titanium or coated with hydroxyapetite. Usually made of titanium or titanium alloys. It may be threaded or non threaded and tapered.

IMPLANT BODY (contd)

External hex headed Original Brnemark has machined surface. Some newer versions have roughened surface. Lengths 7-20 mm in regular platform Widths / Platforms:

Narrow: 3.3mm Regular: 3.75 and 4.0 mm Wide: 5mm

CREST MODULE

Portion designed to retain the prosthetic component in a two piece system. Platform for the abutment. Smooth to inhibit plaque retention. Apical dimension - 0.5 mm to 5 mm. Usually a hexagonal form is employed for high precision fit. Upper portion of the crest module is known as implant collar and it is usually 0.5mm to 1mm in height.

APEX

THE APEX AREA IS USUALLY A BLUNT AREA WITH A CIRCULAR HOLE SO THAT BONE CAN BE DEPOSITED SUCH THAT RETENTION IS INCREASED. THE SHAPE OF THE HOLE CAN BE OF DIFFERENT SHAPES.

COMPONENT OF THE SURGICAL STAGES

HEALING PLUG( PLASTIC)

Cover/healing Abutment

During the healing phase of stage I surgery, the screw is normally placed in the superior surface of the body. Facilitate suturing Prevent tissue ingrowth

Healing abutment

Protects the implant during treatment phase. Helps control soft tissue ingrowth

HEALING ABUTMENT (contd)

Healing abutments are dome shaped screws placed after 2 nd stage surgery and before insertion of the prosthesis. It helps in the development of a permucosal seal around the implant Usually made of titanium or titanium alloy. It is kept for mostly 2 weeks but may be extended to 5 weeks in case of esthetic zone.

ABUTMENT

ABUTMENT ATTACHMENT CAN BE 1) SCREW RETAINTION 2) CEMENT RETENTION (shouldered & non shouldered) 3) PROVISION FOR ATTACHMENT DEVICE

Abutments (contd)

Restorative Abutment allows connection of the restoration to the implant. The many different types of abutments facilitate the restoration of implants.

Basic Abutments
Standard Abutment

Titanium Cylindrical Shape Internal hex on bottom matches hex on fixture to prevent rotation. Designed to be supragingival and non-esthetic No emergence profile Useful for Hader Bars .

Basic Abutments(contd)

Angulated Abutment Titanium Corrects screw access for mal-aligned implants, but doesnt improve implant loading. Internal positions on bottom matches hex on fixture to prevent rotation and give multiple angle correction possibilities. Can be difficult to use esthetically. Same healing cap / gold cylinder .

CONICAL ABUTMENT

Custom Abutments

Three Basic Types

1. 2. 3.

UCLA All Ceramic Provisional to fixture

Custom Abutments (contd)

UCLA Abutment

Allows connection of the restoration directly to the fixture. Combines abutment, gold cylinder and restoration into one. Uses include: Esthetics Limited Interocclusal space Angulation Correction Custom Substructures

Custom Abutments
UCLA Abutment

Original UCLA Abutment was a plastic castable pattern. Improved consistency of fit was developed with the introduction of a precast and machined abutment with a waxing sleeve. Two types Hexed / non-rotational for a single tooth Non hexed for bridges

CUSTOM ABUTMENT(contd)

CUSTOM ABUTMENT

Clinical Procedure
Custom Abutment -Substructure and One Piece Restoration
Optional (Recommended for WP)

Wax/Invest

Gold alloy

Casting

Bake porcelain directly to Abutment

ScrewretainedOne Piece Restoration

HYGIENE COVER SCREW

For screw retained abutments a hygiene cover screw is required to prevent debris and calculus from invading the internally threaded portion of the abutment.

Impression in implants

TRANSFER COPING

Facilitate the transfer of the intraoral location (of the implant or abutment) to a similar position on the cast. Two types 1) direct transfer coping 2) indirect transfer coping

DIRECT TRANSFER COPING

Hollow transfer component and use as a pickup impression coping After the impression material is set the direct transfer coping is unthreaded and come directly with the impression.

INDIRECT TRANSFER COPING

In this case the coping is screwed into the abutment or implant body and remained in place when the set impression is removed from the mouth. Flat sided or smooth undercuts are present to facilitate reorientation in the impression after removal.

ANALOG

A replica of the entire dental implant not intended for human implantation(GPT 8) These are machined structures which represent the body of the implant. They are placed on the lab cast in order to fabricate an implant supported prosthesis.

Analogs allow the accurate transfer of a facsimile of the intraoral component to a working model.

PROSTHETIC COPING

It is a thin covering,usually designed to fit the implant for screw retention and serve as the connection between the abutment and the prosthesis or suprastructure.

PROSTHESIS SCREW

It penetrate the fixed restoration and secure it to the abutment. Usually made of titanium ,titanium alloy or gold alloy.

Implant fixture Screw type

(with external hex)

Press fit type

(with external hex)

Illustrated Glossary

Abutements Healing

Standard
UCLA type Conical Custom

Impression copings Transfer type Pick-up type Fixture level

Illustrated Glossary

Abutement level
Analogues Abutement Fixture