Implants

I'm the forensic much on Team India's conquered let's let's go to the basics about the implantology and implants so so this is doctor brain mark he was considered the father of implantology oral implantology and he discovered the term he coined the term osseointegration so this is the titanium Chamba the experiments of brain ma this is the titanium genre Aquila bodies he introduced the titanium chamber into the rabbit's foot rabbits femur tibia fibula and later he tried to retrieve the titanium chamber from the from the rabbits food but he couldn't able to retrieve then he came to know that the the entire titanium has been hacia integrated or integrated with the bone rabbits bone so that it's it's become difficult for the titanium Chamba to retrieve so that he applied the same concept on to the humans as well and introduced the titanium implants so let's let's go to the basics about the titanium implant ology why implants there are a variety of options to replace the missing missing tooth like removable partial denture fixative partial mention but why but why the implantology came to the implants came to the existence because it's difficult to maintain the removable partial denture and they tend to dislodge and all there are many difficulties with the maintenance as well so the removable partial denture has been replaced by the fixed partial denture the what's the problem fixed partial denture is - to replace missing - they decent natural teeth has to be cutted - to make a bridge or it so the natural tooth has been damaged to make to replace a missing tooth so these are the variety of implications of implants one is crown in a single and a single missing teeth you can introduce the implant into the bone and then place a crown over the implant this is called this called as crown and bridge as well this is the implant supported an hour denture I mean like the root supported root supported our denture we can in their complete a dental patients we can place implants into the bone and with the help of those implants we can place an entire denture or that these called as implants upward or danger before going in detail in detail into the implantology it's very important to know about the bone DIMMs types of bone bone densities what is d1 d2 d3 d4 and where it is present it's most important critically both clinically and theoretically it's the most important thing to learn it is it is given by mish in 1988 so there are four types of bone densities called as d1 d2 d3 and d4 and the density is measured industry of the d1 d2 d3 d4 has been measured with the houseful Union hit house where units that is achieved in d1 bone there is a dense cortical bone as you see there is a dense cortical bone with minimal cancellous bone if at all this is a cancerous one that is this minimal cancerous wound present in here in the the most common location of the presence of d1 bonus anterior mandible so d1 bone it's dense cortical bone with very less with very minimal cortical bone so cancerous boom Leeds prison in anterior mandible and the house failure is greater than one two five zero twelve thousand and twelve hundred and fifty house fire units d2 boonies there is a porous cortical bone cortical bone is prison this is not as thick as in the d1 but there is a porous cortical bone and but the cancellous bone is present which is course and trabecular the cancerous bone Troezen dissecans spoon isn't indeed ooh the the cancerous wound is very the Trebek relations of the canister spoon is very coarse and the outer court this is a cortical plate definitely there is a cortical world plate but it won't be as thick as in the d1 the cortical plate is a little bit poorest most common locations are sometimes anterior mandible posterior mandible and sometimes antyram Xillia might contain d2 bone mandible anterior mandible and posterior mandible and the anterior maxilla might contain the d2 bone as well most commonly the posterior mandible is considered to have d2 bone sometimes I until maxilla also the HH units 850 to 1250 it's the rain between eight five zero two one two five zero housefull units let's come to d3 in d3 there is a cortical plate see as you see this cortical plate but very thin cortical plate the cart will listen here is very thin and between the cortical plates there is a cancellous bone as you see as you see in d2 the cancellous bone prison is very coarse and dense but in d3 the and the cancellous bone is not course but they're very fine trabecula prison they are not densely compact as indeed ooh they're very thin comp thin cortical plate the cancellous bone is very porous and very thin most common locations of posterior mandible and anterior maxilla most commonly aunt is maxilla posterior mandible and posterior mandible posterior maxilla the HU units are 350 to 850 it's very important to learn this d1 1 to 5 greater than 1 2 5 0 D to 850 to 1250 d3 350 to 850 and d4 DeForest the cortical billets are very thin very fine the there's very fine particle played with in between the Carter people's there is a cancerous bone cancelable very fine very fine yes you see yes you compare this this cancellous bone is very compact elitism there's less compact this very fine trabecular portion of prism there is present in posterior maxilla the height units are 130 150 to 350 it's very important to learn this d1 1 greater than 1250 d-28 52 or 53 350 to 850 and d4 5150 to 350 and e1 is most commonly visit an anterior mandible d2 in posterior mandible anterior mandible and anterior maxilla d3 is posterior and anterior and posterior mozilla d4 is posterior maxilla so why do we need to learn this d1 d2 d3 d4 what are the clinical implications because if we place an implant in d4 bone they're very the driver the cancerous bone is very fine it takes lots of time to ask you integrate the the and the placed implant if you played any place an implant over here in d4 that is a posterior maxilla as the bone is very thin and very fine revelations are present it takes longer time to heal then compared to d1 or d2 so according to this d1 has to be considered as best bone for the implant placement because there is dense cortical plane there very very thin cancerous born very very strong very strong bone is present in d1 hence it should be the implant plane the success of implant placement is better with the d1 bone but the most of the implant success is present with d2 boom d2 bone has highest success rate because as there is a decent amount of cortical bone with very coarse cancerous boom cancerous bone provides the cancellous bone provides us with the best clarity so that the implant uptake is very good with d2 bone d2 bone gives us the map indeed upon the middle maximal success of implant placement because there is a decent amount of cortical bone the cortical bone with cancellous bone that provides the vascularity and the cancerous wound is not very fine are very thin as in d3 or Defoe but the cancellous bone is very coarse the Traverse vascularity hence the success is highest with d2 let's proceed to this rooster is next so this is important day only to d2 d3 d2 d3 d2 before as like misclassifications over let's let miss classic mish classification of bone densities there's another classification like like Amon job in aid in 1985 quality one is compact money as you see this is the compact bone there is very homogeneous compact bone in quality to there's a thick layer of compact bone this is a compatible this thick layer of compact bone surrounding core of dense tan trabecular bone this is a trabecular bone I mean cancerous one it has dense traffic relations with a thick layer of compact bone as well but in third quality quality three the cortical bone is very thin as you see this there is a this is a thickness of cortical bone this is the thickness of forty law this is the thickness of cortical bone there's a very thin cortical bone surrounding a trap cancer spoon with dense trabeculae shion's calculations are done so you see there's a density evacuations and the bone strength is favorable because the can stress bone is present there is a minimum amount of cortical bone there's a kinda stressful but the cancerous portion bone has density violations hence it is the fabula is a travel strength this is a one this is quality for yes you see there's a very thin cortical bone thin cortical bone there's a cannister spoon but again the tribulations are of low density very fine very widely spaced rabbit relations are present in the cancellous bone there is a load in straightaway flyball hence it's unfavorable this is this one is this one is this one is somewhat viable okay let's go into the classifications how the implants are classified as as we see previously proves to straights we classified the bones depending on densities of bones amount of cortical bone amount of cancellous bone between the cancerous moon the trabeculae shins the is the final cause according to them the bone has been classified the bone onto which the implant has to be placed has been has been classified now this is the classification of implants based on implant design implants can be classed classified based on implant design implant attachment mechanism is it's called as histological his philosophy in implant attachment mechanism means the attachment between the implants and the bone based on a macroscopic design of the implant body and the surface of the implant and the type of the material with which the implant has been made so this is the classification based on implant design it's one of the common classification that I've been used see the in first one is industrial industrial built into the bone when I implant material has been placed into the bone it's called as industrial subperiosteal subperiosteal here we are not placing the implants into the bone but we are placing the implants beneath the periosteum transversal it means trends Austria we are traversing the bone through and through here in industry we are placing the implant into the bone not through and through but in trance Austria we are placing the implant through and through interim mucosal means just into the mucosa then others in thick mucus are present in flabby register now when there is a then when we need sufficient Anchorage we can place the implants into the mucosa and take the Anchorage from the mucosa that's interim mucosa within industry they are further three it can be classed before the three types one is ramus frame as you can see this is that I must remain plan it looks like ramus of the body it looks like Rams of the body here and plate like thing Aramis plate leg thing isn't introduced into the sim faith in the symphysis area it is called as Lamas flame root for meals implant display the shape of the implant is just like the true blade from implants are present let us see what are the blade film clips see this is the blade from implant this is the root form implant it just like the root you placed into the bone it is like a blade industrial it traverses only the superior alveolar cortex and penetrates into the middle Larry bone when we are placing the implants this is the superior alveolar cortex and between the buccal and lingual core templates you can see the medullary bone so you Travis in one cortical bone into the middle thirty-one alveolar cortex you are traversing the albion cortex and penetrating into the middle Larry boom most commonly among the ramus form implants nderstand the ramus found in plants root from implants bed blade from England among the among this three most commonly used a root form implants let's come to transosseous implants as I said transosseous implants traverses both the alveolar cortex if you see this is the alveolar cortex and this is the lower cortex it is penetrating from the lower border onto the upper border it is traversing through and through its traversing from the lower border onto the upper border traversing both the AL Ural cortex and the bed lo lo context the mo most important thing most importantly acid cushion is what is tab limb plants transosseous implants are called as apple implants like you see if you stay pin it passes it enters from one side and emerges out from the other side like this hence it is called a stab limb plants it penetrates the integer as I said intelligent to imagine how pose it's a type of entry using a site of entries from base of the chin advantage is most commonly when it is used most commonly because these two can be used as abutments for the immediate bench it placement most commonly used as immediate bench placement and function okay next is superior Spillman's it's not more not widely used implant but this is a superior seal means we just elevate the periosteum we made it we make a framework according to the we customize the framework I got him to the bone form and we elevate the perience team and place the the customized implant design under the periosteum most commonly used for implant supported our dentures in our second classification classification based on attachment mechanism it's more of histological I mean there are two kinds posture integration and fibrous integration osseointegration the most important question is that also integration was coined by brain mark he's considered as father of implantology he coined the term brain mark as I said in the second slide while he placed some titanium chamber into the rabbits tibiofibular this there has been a very difficulty in I removed the implant right that he considered that as osseointegration the term osseointegration the term has been coined by brain mark the definition is its direct contact between the bone and the surface of the implant when you place an implant into the bone there is no intervening thing between the bone and the implant the bone directly contacts the implant and bone are in direct contact without no intervening tissue that's called as osseointegration osseointegration is considered to be a success of when you place an implant it has to be also integrated then only it can be called as a success of the implant fibrous reintegration or fibrous integration it was proposed by this concept of fibrous integration as proposed by Charles Hollis vase unlike in the unlike you see in the Asha integration there has been intervening tissue this is the bone this is the bone and this is this is an implant material between the implant material in the bone you could see some fiber like things present there is no direct contact between the bone and the implant this called as fibrous integration this is this is not considered to be a success of the implant there has been soft issues present between the bone and implant this is not considered to be a success because whenever there is a direct contact between the bone and implant they there won't be any mobility of implant or the long period of time but when there is a soft tissue intervening between this there are chances that implant might mobile might get mobile implant might get failure implant might get might not be able to take the occlusal loads larger amount of occlusal loads in the posterior mandibular areas and out so it's considered not considered to be a success it is considered to be success see this is the bone this is the bone and this is the implant there is no intervening tissue between the implant and the implant and the bone this is called as osseointegration this is fibers integration it's given by Charles waves Charles waves it's not considered to be a success there is a soft tissue interface between the bone and the implant just like the presidental five-person of the natural deal