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History And Present Status Of Implant Dentistry PowerPoint Presentation

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Slide 1-

History and Present status of Implant Dentistry Trakol Mekayarajjananonth, D.D.S., M.S., F.A.C.P.
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Ancient Implants 16 th Dark stone ( Egyptian-South American) 17 th Carved ivory teeth
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Early Implants 1809 Gold implant e.20th Lead, iridium, tantalum, stainless steel, and cobalt alloy 1913 hollow basket iridium + gold wires (Greenfield)
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Early Implants 1937 Adams’s submergible threaded cylindrical implant with round bottom 1938 Strock’s (long term) threaded vitallium implant (cobalt+chrome+molybdenum) The modern implants appear to be variants or composites of some of the designs of early implants
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Subperiosteal Implants Placing implants on and around bone rather than in it 1943 Dahl of Sweden placed with 4 projecting posts Direct bone impression Cobalt-chrome-molybdenum casting CT-generated CAD-CAM model
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One-stage pins and screws Early 1960s pin, screw, and cylinder shaped implants One piece and not submerged Did not osseo-integration Fibrous peri-implant membrane Shock-absorbing claim
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Blade Implants 1967 Linkow blade implant-in narrow ridge Required shared support with natural teeth 1970 Roberts and Roberts - Ramus blade implant (titanium)
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Transosteal Implants 1975 Small introduced transosteal mandibular staple bone plate Limited to mandible only
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Transosteal Implants 1970 Cranin - single transosteal implant 1989 Bosker - transmandibular implant
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The First Dental Implant Consensus Conference, sponsored by the National Institutes of Health (NIH) and Harvard University in 1978, was a landmark event. “ Dental Implants: Benefits and Risks”
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The Toronto Conference opened the door to prompt widespread recognition of the Branemark implant. The discovery of osseointegration has been one of the most significant scientific break throughs in dentistry.
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Endosteal root-form implants 1978 Two-stage threaded titanium root-form implant was first presented in North America by Branemark (Toronto conference) Terms “fixture” First fixture was placed in 1965 Well-documented, long term prospective study
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Present Status Three Basic: “ In Bone” “Through Bone” “On Bone”
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“In Bone” 1. Ramus concepts (Harold and Ralph Roberts) 2. Pin concepts (J. Scialom Michelle Chercheve) 3. Disk concepts (Gerard Scorteci) 4. Plateform concepts (Harold + Roberts/Linkow) 5. Cylindrical or root form concepts
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Present Status Many other root-forms have been introduced. Body shaped competition Surface competition – roughness Varieties competition Connection competition
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Material for Implant Trakol Mekayarajjananonth DDS, MS, FACP
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Dental Implants Implant material should have suitable mechanical strength, biocompatibility, and structural biostability in physiologic environments.
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Dental Implants The development of biomaterials sciences has resulted in classification schemes for implantable materials according to chemical composition and biologic response.
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Biologic classification Based on tissue response and systemic toxicity effects of the implant Biotolerant Bioinert Bioactive
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Long term effects Biotolerant materials, such as polymethylmethacrylate (PMMA), are usually characterized by thin fibrous tissue interface. Chemical product irritate surrounding tissues.
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Long term effects Bioinert materials, such as titanium and aluminum oxide, are characterized by direct bone contact, or osseointegration, at the interface under favorable mechanical conditions. Non-reactive
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Long term effects Bioactive materials, such as glass and calcium phosphate ceramics, have a bone-implant interface characterized by direct chemical bonding of the implant with surrounding bone. Free calcium and phosphate compounds at the surface.
Slide 23-

Tissue response to implant materials Most commonly used biomaterials: Commercially pure (CP) titanium Titanium-aluminum-vanadium alloy (Ti-6Al-4V) Cobalt-chromium-molydenum (Co-Cr-Mo) alloy is most used for subperiosteal implants.
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Tissue response to implant materials Calcium phosphate ceramics, Hydroxyapatite (HA), used for augmentation material or coating on surface.
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