1: Definition, evolution and state of the art in dental implantology.
Dental implants are devices designed to create either the maxilla or mandible, stable, strong, effective, non-iatrogenic, durable, over which fits a removable prosthesis or fixed to return the patient partially or completely edentulous or edentulous proper function, comfort and aesthetics fulfillingcompatible with all its social function.
A dental implant is an artificial substitute for a missing tooth root is made of biocompatible materials that allow their union to the bone.
HISTORY OF IMPLANTS
The dental implant has a lengthy history, beginning with ancient Egyptians, who implanted teeth in corpses in accordance with religious beliefs regarding the afterlife. According to evidencediscovered in underground burial chambers in what is now modern Italy, early Etruscans replaced missing teeth with artificial teethcarved from the bones of oxen. The Romans conquered the Etruscans and employed their dental techniques until the fall of Rome. The earliest endosseous implant was discovered in a mandible fragment of Mayan origin dating from about A.D. 600. Radiographs showed compact boneformation around three tooth-shaped pieces of shell implanted in sockets of missing lower incisors, similar to the bone surrounding a modern blade implant. Innovations in dentistry dwindled following the fall of the Roman Empire, but they were revived during the Renaissance. By the 1800s, fixed bridges and partial dentures were successful methods of tooth replacement. In 1885, Dr. J.M. Youngerimplanted a natural human tooth into an artificial socket. Younger’s procedure included filling the pulp chamber of the tooth with gutta percha and the apical opening with gold. A tooth from any source was acceptable, according to Younger, provided that asepsis was maintained. Although his work was largely unsuccessful, it spurred many later attempts at implantation. Technical advances include implantedtubes of gold and iridium, lead and porcelain posts, and bovine incisor teeth into natural or artificially created sockets. In 1948, two American dentists, Gershoff and Goldberg, surgically placed a subperiosteal implant created by Dr. Gustav Dahl of Sweden. The subperiosteal implant was prefabricated based on a study model. This method of implantation met with limited success and proved overtime to have a high failure rate due to infection. In 1965, Swedish orthopedist P. I. Brånemark placed the first titanium implant and coined the term “osseointegration.” Osseointegration—incorporation of the implant with the bone—is one of the greatest achievements in implant dentistry. In 1967, Dr. Leonard Linkow of New York City placed the first blade implant, and by the 1970s, this was the mostfrequently employed implant design.
2: Classifications of dental implants systems.
TYPES OF IMPLANTS
A subperiosteal implant is not placed within alveolar bone, but under the periosteum, against the bone. This type of implant is custom-made from a direct bone impression. This requires two surgeries the first for fabrication and the second for implant placement. The subperiosteal implantis rarely indicated except for severely resorbed edentulous areas. Atrophic changes in the edentulous jaw are common, causing implant mobility and decreased stability, and facilitating infection. Subperiosteal implants are rarely seen today because they were commonly removed due to complications. The pacient with the subperiosteal implant must be continuously monitored and the implant must beremoved upon infection to prevent extensive damage to the alveolus. Endosteal implants have proven successful in single-tooth replacement as well as in the edentulous arch. One or two surgical interventions may be required for placement. One-stage implants are placed in a single surgery, and a healing collar is placed at or above the gingiva. This eliminates a second surgical procedure to expose the...