General Articles Implantology

Implant Types – Endosteal Implants

Endosteal Implants

We begin with a general introduction to the available implant types and the physical conditions required for their placement. Although their basic characteristics are presented in this chapter, the reader should refer to Chapter 5 for optimal prosthetic use; it would be best to read Chapter 5 after completing this chapter, because one of the key guides to implant selection is the patient’s prosthetic requirements.

Root Form Implants
If the available bone has sufficient width and height, root forms (e.g., submergible, single stage, two stage, and one piece) are the
first choice in selecting an implant. The types available are:

Press-fit (unthreaded but covered with a roughened hydroxyapatite [HA] or titanium plasma spray [TPS] coating) ( Fig. 2-1 )
Self-tapping (threaded) ( Fig. 2-2 )
Pretapping (threaded) ( Fig. 2-3 )

Prosthetic options: Prostheses may be supported by fixed, fixed-detachable, overdenture, or single-tooth devices (antirotational design required).
Bone requirements:
Bone height (vertical) > 8mm
Bone width (buccal to lingual) > 5.25mm
Bone breadth (mesial to distal) per implant, including the interproximal spaces mesially and distally > 6.5mm

Figures 2-1/2/3

Endosteal Implants - figure2-1
Endosteal Implants - figure2-2
Endosteal Implants - figure2-3

Crête Mince (Thin Ridge) and Other Mini-Implants
Crête Mince implants are threaded, self-tapping, titanium spirals ( Fig. 2-4 , A ).
Prosthetic options: Crête Mince thin-ridge implants add retention to a long-term, fixed bridge prosthesis by pinning it through the pontics to the underlying bone. Th ey also may be used to support
transitional prostheses ( Fig. 2-4 , B and C ). When placed in confi ned areas between teeth or implants, these implants add long-term additional buttressing to superstructures.

Blade Implants
Blade implants are available as submergible, single-stage and two stage, and one-piece devices ( Fig. 2-5 ) in three forms:

• Prefabricated
• Custom cast
• Alterable (by cutting, bending, and shaping at chairside)

Prosthetic options: Single or multiple abutments. The suggested use for blade implants is for fixed bridge prostheses in combination with natural tooth abutments, although they may be used in multiples for full arch edentulous reconstructions. If the height of the available bone is adequate for root forms but the width is
not, and osteoplasty is not an option, blade implants are the second choice in implant selection. Th e design of the blade chosen should follow that of the anchor philosophy, in which the shoulder does not meet the cervix at right angles, but rather dips in a semicircular configuration at the site of the neck.
Suitable arch: Maxillary or mandibular, completely or partially edentulous.
Bone requirements:
Bone height (vertical) > 8mm
Bone width (buccal to lingual) >3mm
Bone breadth (mesial to distal except for single-tooth designs, which require less) >10mm

Ramus Blade and Ramus Frame
The ramus implant is a one-piece blade made for use in the posterior mandible when the body of the mandible has insuffi cient bone ( Fig. 2-6 ). Th e ramus frame is a three-blade, one-piece device designed for relatively atrophied mandibles. It is used when a subperiosteal implant is not desirable because of cost or operator preference.

Prosthetic option: Overdentures.
Suitable arch: Mandibular, completely edentulous.
Bone requirements:
Bone height (vertical), symphysis, rami >6mm
Bone width (buccal to lingual) >3mm

Figures 2-4/5/6

Endosteal Implants - figure2-4 Endosteal Implants - figure2-5 Endosteal Implants - figure2-6

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