Dental Implants

By Author: Vishruti Sinha
Total Articles: 1
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A dental implant is one of the treatments to replace missing teeth. Their use in the treatment of complete and partial edentulism has become an integral treatment modality in dentistry. Dental implants have a number of advantages over conventional fixed partial denture.

A high success rate (above 97% for 10 years)
A decreased risk of caries and endodontic problems of adjacent teeth
Improved maintenance of bone in edentulous site
Decreased sensitivity of adjacent teeth
A dental implant is a structure made of alloplastic materials implanted into the oral tissues beneath the mucosa and/or periosteum and/or within or through the bone to provide retention and support for a fixed or removable dental prosthesis.

Implant dentistry the second oldest dental profession; exodontia (oral surgery) is the oldest. Around 600 AD, the Mayan population used pieces of shells as implants to replace mandibular teeth. In 1809, J. Maggiolo inserted a gold implant tube into a fresh extraction site. In 1930, the Strock brothers used Vitallium screws to replace missing teeth. A post-type endosseous implant was developed ...
... by Formiggini (the father of modern implantology) and Zepponi in the 1940s. The subperiosteal implant was developed in the 1940s by Dahl in Sweden. In 1946 Strock designed a two-stage screw implant that was inserted without a permucosal post. The abutment post and individual crown were added after this implant completely healed. The desired implant interface at this time was described as ankylosis. In 1967, Dr. Linkow introduced blade implants, now recognized as endosseous implants. Dental implants became a scientific cornerstone after the serendipitous invention of Dr. Branemark who helped in the evolution of the concept of osseointegration (direct, rigid attachment of the implant to the bone without any intervening tissue in between two implants) [1][2][3].

Anatomy and Physiology
A proper knowledge of anatomical landmarks and its variations prior to implant placement is indispensable to ensure a precise surgical procedure and safeguard the patient against iatrogenic complications. The precise evaluation of distinct anatomical factors such as the position of the mandibular canal, maxillary sinus, the width of the cortical plates, the existing bone density, etc. is very important in appropriate implant selection and planning the most appropriate implant position in the existing clinical condition. Important anatomical structures in the maxilla are a nasal floor, nasopalatine canal anteriorly and maxillary sinus posteriorly. Iatrogenic sinus perforation is commonly encountered complication. This problem can be taken care of by selection of short implants and Sinus lift and bone augmentation procedure.

The most important anatomical consideration while placing an implant in the mandibular arch is the location of the inferior alveolar canal which contains inferior alveolar nerve and artery. Injury to these vital structures during implant placement can cause pain, altered sensation, excessive bleeding, etc. Hence it is important to determine the location as well as the configuration of the mandibular canal prior to implant placement.

Indications
Partial edentulous patients who have intermediate gaps or free-end edentulism (Kennedy class 1).
When a patient is not satisfied with the existing unstable and nonretentive conventional complete dental prosthesis.
To preserve existing removable partial prostheses.[6][7]
Contraindications
Absolute Contraindication

Acute illness, the magnitude of defect or anomaly, uncontrolled metabolic disease, bone or soft tissue pathology/infection

Relative Contraindications

Diabetes, osteoporosis, parafunctional habits, HIV, AIDS, bisphosphonate usage, chemotherapy, irradiation of head and neck, behavioral, neurogenic, psychosocial, psychiatric disorders

Acute illness
Relative Contraindications