[Master Course - BASIC] Implant PART 1

Summary

Dr. Pak Jong Cheol’s lecture explores the evolution, design, and materials of dental implant fixtures. He explains the three main implant types—external, tissue level, and internal submerged—highlighting their advantages, limitations, and clinical applications. The lecture details how fixture shapes, such as straight and tapered, affect stability and healing, and emphasizes the importance of biocompatible materials like titanium and titanium alloys. Dr. Pak also discusses surgical and prosthetic considerations, illustrating how modern designs like internal submerged implants and tapered fixtures improve outcomes. Overall, understanding implant design and material selection is crucial for achieving long-lasting and successful dental restorations.

Takeaways

• 😀 There are three main types of implant fixtures: external type, tissue level implant, and internal submerged implant, each with unique design characteristics.
• 😀 External type implants have an outside connection between the fixture and abutment, which can lead to microleakage and marginal bone resorption.
• 😀 Tissue level implants integrate the abutment cuff into the fixture, reducing micro-movement and screw loosening, resulting in better marginal bone stability.
• 😀 Limitations of tissue level implants include restricted prosthetic options, challenging aesthetics, and difficulty in vertical positioning when bone height is inconsistent.
• 😀 Internal submerged implants feature internal connections with platform switching, improving surgical convenience, prosthetic options, aesthetics, and marginal bone stability.
• 😀 Internal submerged implants can have disadvantages, such as higher risk of fixture fracture, potential sinking of abutments, and bone resorption in shallow placement with thin biotype.
• 😀 Implant fixture bodies can be straight or tapered; tapered implants provide higher initial stability, better bone contact, faster installation, and reduced risk to adjacent teeth.
• 😀 Titanium is the most widely used implant material due to its biocompatibility, corrosion resistance, and ability to support osseointegration.
• 😀 Titanium implants are classified from grades 1 to 5; higher grades offer increased strength but slightly reduced biocompatibility, with grade 5 alloys used for high-strength requirements.
• 😀 Proper understanding of fixture type, body design, and material selection is essential for achieving long-term implant success and optimal surgical and prosthetic outcomes.
• 😀 No single implant type is universally 'best'; success depends on appropriate use, surgical technique, and adaptation to patient-specific conditions.

Q & A

What are the three main types of dental implant fixtures discussed in the lecture?

The three main types are: 1) External type implants placed at bone level, 2) Tissue level implants placed at the gingival level, and 3) Internal submerged implants placed below the bone level.

Why were external type implants replaced by newer designs?

External implants had limitations such as microleakage leading to marginal bone resorption and surgical challenges when bone height was inconsistent. These issues necessitated improvements in implant design.

What are the main advantages of tissue level implants?

Tissue level implants reduce microleakage, improve soft tissue management, stabilize marginal bone, and incorporate an internal abutment connection which reduces micro-movement and screw loosening.

What are the limitations of tissue level implants?

Limitations include restricted prosthetic options, difficulty in aesthetic adjustments, and challenges in determining the correct vertical position when bone height is uneven, potentially leading to deep placement and bone resorption.

What features distinguish internal submerged implants from other types?

Internal submerged implants have an internal abutment connection with platform switching, offer better surgical convenience, wider prosthetic options, excellent aesthetics, and improved marginal bone stability compared to external and tissue level implants.

What are the potential disadvantages of internal submerged implants?

Disadvantages include a higher risk of fixture fracture due to thinner walls, lack of a stop in the abutment connection leading to potential sinking, and the risk of severe bone resorption if placed shallowly in patients with thin biotype.

Why are tapered implant bodies preferred over straight ones?

Tapered implants provide higher initial stability due to increased bone contact, allow self-tapping insertion for faster placement, reduce risk to adjacent tooth roots, and are advantageous for early loading and immediate placement.

What is the primary material used for dental implants and why?

Titanium is the primary material because it is biocompatible, forms a stable oxide layer that prevents corrosion, and enables osseointegration without adverse reactions in the body.

How do different grades of titanium affect implant performance?

Grades 1–4 are pure titanium with higher biocompatibility but lower strength, while grade 5 is an alloy with higher strength but slightly reduced biocompatibility. Grade 5 is used for high-strength requirements like small-diameter implants or abutments, while grade 4 is used for standard implants.

What role does platform switching play in implant design?

Platform switching in internal submerged implants helps stabilize marginal bone, particularly in areas with inconsistent bone height, by shifting the abutment interface inward and reducing stress on surrounding bone.

What are the key factors to consider when selecting an implant fixture?

Key factors include understanding the advantages and limitations of each design type, the shape of the implant body (straight or tapered), the material and grade of titanium, and clinical considerations such as bone quality, aesthetics, and prosthetic requirements.

Can good clinical outcomes be achieved with any type of implant?

Yes, if implants are used appropriately and according to their specific advantages and limitations, all three major types of implants—external, tissue level, and internal submerged—can result in successful long-term outcomes.