Dental Implants and Osseointegration: Everything You Need to Know

Understanding Osseointegration Of Dental Implants

Write short note on dental implant.
Answer. Dental implant is an integral component of oral implant complex which also consists of supportive bone, interposed keratinized and mucosal oral soft tissues and prosthetic suprastructure.

Structures of an Osseointegration Implant System

It consists of two types of structures, i.e.

• Implant
  • Endostructure or primary element or implant
• Superstructure
  • Mesostructure or secondary element or abutment
  • Exostructure or tertiary element or superstructure

Endostructure or Primary Element or Implant Osseointegration

 Osseointegration Implant Apex

The implant apex is the lower (apical) part of the implant body, through which the vertical force exerted on the implant is transmitted to the jaw bone. Screw implants transmit the vertical force via the thread into the bone.

Osseointegration Implant Body

The part of a root replacement that is positioned in the bone (intraossal) is known as implant body. The coated, perforated implant body is of two types, i.e. hollow body and solid body.

Osseointegration Implant Neck

The implant neck is located between the implant body in the jaw bone and the implant shoulder. An implant neck with a machine treated surface prevents plaque accumulation. Given the subgingival placement of the implant neck, the mucous membrane may adapt without irritation. Implants inserted into the alveolar ridge do not require a pronounced implant neck.

Osseointegration Implant Shoulder

The implant shoulder is the transition between the implant neck and the implant post. The implant shoulder is narrow with a machine treated surface and may be bevelled to improve the aesthetic appearance.

Osseointegration Implant Head

The implant head is the most coronal part of the implant and it represents the connection to the implant post or directly to the superstructure. There are implant heads with antirotation (for single crowns) and without antirotation lock (for bridges). If an antirotation lock is present, it can be integrated within or outside the implant head.

Implant Osseointegration Superstructure

It consists of every component which is retained by the implant and protrudes in oral cavity. These are secondary elements and tertiary elements:

Osseointegration Dental – Mesostructure or Secondary Element

• Abutment: The abutment is the part of a one or two phase implant system which is connected to the implant or fixed to it. It is the build-up that protrudes into the oral cavity, which is either directly included into the superstructure or which serves as a connection element between the implant and the superstructure.
• Implant abutment screw: Implant screw also called abutment screw, is used for a rigid, mechanically stable screw connection between the implant, abutment, and superstructure.

Osseointegration Dental – Tertiary Element or Exostructure

• Superstructure: The superstructure is the prosthetic restoration that is either directly or, in most cases, indirectly connected with the implant. It may be retained on implants and natural abutment teeth at the same time. Depending on the type of connection, superstructures are classified into fixed, partly removable, and removable superstructures.
• Horizontal transocclusal screw: With this screw, superstructures are screwed down transocclusally or horizontally to form partly removable structures.

Osseointegration Of Dental Implants – Classification of Osseointegration  Implants

• Based on shape and position in jaws
  • Subperiosteal implant
  • Transosteal implant
  • Endosseous implant
• According to the body shapes
  • Threaded implants
  • Threadless/Smooth implants
• According to surface characteristics
  • Additive surface treatment
    • Titanium plasma spraying
    • Hydroxyapatite-coating surface
  • Substractive surface treatment
    • Blasting with titanium oxide/aluminum oxide
    • Acid etched surface
  • Modified surface treatment
    • Laser-induced roughened surfaces
    • Ion implantation
    • Oxidized surface treatment

Dental Implant Indications

• Edentulous patient: One of the first indications for dental treatment is to treat complete edentulism.
• Partially edentulous patient.
• Single tooth loss: Implant maintains bone volume after tooth extraction.
• Anchorage for the maxillofacial prosthesis: Patients with maxillofacial deformities uses implant for the maxillofacial prosthesis.
• For rehabilitation of congenital and developmental defects like cleft palate, ectodermal dysplasia, etc.
• For orthodontic anchorage.

Dental Osseointegration Implant Contraindications

Immunologically compromised patients: Systemic diseases such as developing cancer and AIDS.

Cardiac diseases: Implant surgery should be carefully considered in patients with heart valve replacement and should not be performed on patients having suffered from recent infarcts, i.e. within the latest six months period.

Deficient hemostasis and blood dyscrasias.

Anticoagulant medications.

• Certain psychiatric disorders: Patients with psychological disorders have difficulties in cooperating and maintaining sufficient oral hygiene.
• Uncontrolled acute infections, as in the respiratory tract, may negatively influence the surgical procedure or may affect the treatment result and are thus a contraindication for surgical treatment.
• Recent history of orofacial irradiation: Irradiation of the jaw may be another potential risk factor for implant treatment, specifically if the jaw has been exposed to irradiation over the level of 50 Gy.
• Heavy smoking and alcohol abuse.
• Various intraoral contraindications are Xerostomia, macroglossia and unfavorable intermaxillary occlusal relationship.