7th November 2004 Friday…

Tooth preparation for conventional crown = opening up 40 000 to 70 000 dentinal tubules per mm2 + the heat production if inadequate cooling fries the pulp...

Approximately 10% of all vital abutments will have lost vitality after 10 years(Bergenholtz & Nyman 1984; Pjetursson et al. 2004b; Tan et al. 2004)

Dental Implant

functional

tooth saving

comfortable

reliable

esthetic

Toothfairy

for adults

Dental Implant

• It is a replacement option for the missing tooth• where a device is placed on naturally or surgically

created socket• to mimic a natural tooth.

Types (mainly):• Root Form• (Endosteal) Plate Form• Subperiosteal• Transosteal

History

Egyptians: Sea shells hammered unto the jaw worked as an implant

Mayans: Date back to over 1400 years ago

A lower jaw from the Mayan civilization c. 150AD showing obsidian stones used to replace teeth

Leonard Linkow in 1952, weeks after graduating from New York University. By 1992, placed over

19,000 and stopped counting. Retired from private practice in 2002 leaving a body of work

that included 12 books and 36 patents.

Per-Ingvar Brånemark

1952: Swedish orthopedic surgeon, was studying bone healing and regeneration by placing a chamber made up of Titanium into the rabbit femur. After the experiment was

over, he tried to retrieve the expensive titanium apparatus but was astonished to find that the bone had grown on to the titanium, bone loved titanium. After many animal and

human study, it was proven.

Per-Ingvar Brånemark

• He called it osseointegration.

•Wanted to use this findings into knee and hip surgery, but decided on replacement of teeth due to easy access and the high number of edentulism.

• 1965: he placed his first dental implant.

•Worked for 15 years to validate his findings and finally published his work in 1981.

• After scientific scrutiny, Clinical Dentistry Conference in Toronto in 1982 set up a guideline for implantology.

Science of Osseointegration

"a direct functional and structural connection between living bone and the surface of a load carrying implant"

(Branemark et al 1969)

"process whereby clinically asymptomatic rigid fixation of alloplastic materials is achieved and maintained in bone during functional loading"

(Zarb and Albrektsson 1991)

How successful are dental implants?

The 6–7-year survival rate for single implant crowns correspond to 97.5%, while the survival

rate of implant- supported FPDs is 93.6%

Lindh, T., Gunne, J., Tillberg, A. & Molin, M. (1998). A metaanalysis of implants in partial edentulism. Clinical Oral implants Research 9, 80-90

10-year implant survival rate of 98.8% and a success rate of 97.0%

Buser, D., Janner, S. F. M., Wittneben, J.-G., Brägger, U., Ramseier, C. A. and Salvi, G. E. (2012), 10-Year Survival and Success Rates of 511 Titanium Implants with a Sandblasted and Acid-Etched Surface: A Retrospective Study in 303 Partially

Edentulous Patients. Clinical Implant Dentistry and Related Research, 14: 839–851. doi:10.1111/j.1708-8208.2012.00456.x

Radiographic Assessment

Height

Distance to the anatomical landmarks

Bone mapping

Teamwork"My model in business is the BEATLES; they were four guys that kept each other's negative tendencies in check; they balanced each other. And the total was greater than the sum of the parts. Great things in business are not done by one person, they are done by a team of people."

Steve Jobs, Ex- CEO Apple

“implants are here to replace missing teeth, they are not supposed to replace teeth”

Nelson Mandela

After climbing a great hill, one finds that there

are many more hills to climb.