ImplantParts

A Radford Heath Guide

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Disclaimer
Theinformationgiveninthisdocumenthasbeenprovidedingoodfaithforbasic informationpurposesonlyandtheinformationissubjecttoallclinicalsituationsbeingmet. Innowayisitintendedtoreplaceadvicegiventoyoubyadentalprofessional. Youusethiscontentatyourownriskandassumefullresponsibilitytojudgewhetheror notitisaccurateorcompletebeforeusingitforwhateverpurpose. InnoeventshallRadfordHeathDentalCeramicsbeliableforanyconsequential,incidental ordirectdamagessufferedinthecourseofusingthecontentfromthisdocument. Alwaysconsultyourlocaldentistifyouhaveanyquestionsregardingyourdentalhealth.

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Disclaimer ______________________________________________________________ 2 Introduction_____________________________________________________________ 4 BasicParts______________________________________________________________ 4 Crown _________________________________________________________________ 5 Abutment _______________________________________________________________ 6 ImplantorFixture _______________________________________________________ 8 ImpressionCoping _______________________________________________________ 9 AnalogueorImplantReplica ______________________________________________ 10 RetentiveAnchors _______________________________________________________ 11 BarRetainers __________________________________________________________ 14 References _____________________________________________________________ 16

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Introduction
ThequestionWhatisadentalimplant?isoftenaskedbyallthosenewtothesubject. Well,thereisaplethoraof informationavailableontheinternetfrom thevarious manufacturersofimplantswhichshouldberesearchedifyouplantoworkwith them oropt tohavethem bywayofdentaltreatment. Butwithsomanymanufacturersandparts,whatifyouwantamoregeneraloverviewof whatimplantsareandhowtheyaremade?Wellwehopetoaddressthesequestionsinthis simpleguide.

BasicParts

Thebasicpartsofadentalimplant

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Crown
Oxford dictionary definition:

1Thepartofatoothprojectingfromthe gum. 2Anartificialreplacementorcoveringforthis. Crownsarethetoppartofarestorationandarethepartthatweseeinthemouth.They replicatetheoriginalteethtoprovideabitingsurfaceandaestheticappearance. Theyare handmadeby thetechnician. Thesupportingsubstructure forthecrown maybehandmadeormachined(onsiteor offsite).Thecompletedcrowniseithercementedorscrewedontoanabutment.

NobelBiocareProceraCrowns

MaterialUsed:Porcelains(metalsupportedormetalfree)or metal(normally gold) Considerations:Bite,wear,materialchoice(duetogreaterforcesapplied)andaesthetics.

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Abutment
Oxford dictionary definition:

1Thelateralsupportingstructureofabridge,arch,etc. 2Thepointofjunctionbetweensuchasupportandthethingsupported. Anabutmentprovidessupportforthecrown(orseveral crownsi.e.abridge).Itisalsotheinterfacebetweenthe crownandtheimplant. Rotation(twist)iscontrolledbylugsshapedonthe abutmentsstem.Theselugsrestricttheabutmentsrotational placementtosetincrementalsteps.Differentmanufactures usedifferentsystemswithmoreorlessadjustments.

A3iOsseotiteCertainimplant

NobelBiocareReplaceSelectAbutments

Olderstyleabutmentsuseexternalloadingwith thenewerstyles tendingtowardsthestrongerinternalloadingfitment.Numerous designsareavailablefrommanycompanies.

NobelBiocaresinternalandexternalloadingdesigns

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Abutmentscomepreformed atsetangulationsfrom manufacturersindifferent platformsizes(interface diameter)andmaterials,or theymaybecustomcastby specialistmanufacturers e.g.NobelBiocare(offsite).

Theyareshaped(milled)bythetechnicianusingspecial toolstoprovideabespokefitforthecrown.Theprepared abutmentiseventually screwed(withatorquewrench)to theimplantusingitslocatorstoguideitintoposition.

TL:NobelBiocareangledabutments TR:NobelBiocarecustomabutment BL:MillingNobelBiocareabutments

MaterialsUsed:Titanium. Considerations:Shape,angle,length,andplatformsize.

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ImplantorFixture
Oxford dictionary definition:

1Aninsert(tissue,asubstance,adevice,etc.)intothebody. Animplantprovidesthe anchororfoundationfora restoration.Itisscrewedinto theboneofthejawproviding afixedplatformonwhichan abutmentcanbescrewed. Bonetissuecangrowaround theimplantregeneratingand strengtheningthejaw reducingthebonelosswhich occurswhennaturalteethare lost.

Straumannimplants

Implantscomeinmanydifferentlengths,shapes(e.g.tapered),andwidths(orplatform size).Eachmanufacturerhastheirownimplantdesignswhichhaveuniquefeatures.

Theseuniquefeaturesrequirebothdentistandtechnicianto adherestrictlytotheindividualmanufacturersproceduresand guidelineswhenplacingandconstructingimplantborne prosthetics.Manufacturersprovidecertifiedtrainingcourses wherethisinformationisobtained.

MaterialsUsed:Titanium. Considerations:Mostlymedicalincludingbonesuitabilityandspacingissues.A consultationwithadentalprofessional isrequired.

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ImpressionCoping
Impressioncopingsareusedbythedentisttoreplicatethepositionoftheimplantin the patientsmouth.Thedentistscrewstheimpressioncopingtotherealimplantandthen, usingaspecificimpressiontechnique,takesan impression ofthedentition.Theimpression techniquecanbeopenorclosed: Opentray techniqueallowsthedentist toremovetheimpression completewith impressioncoping(s)from thepatients mouthbyallowingexternalaccessto the copingsretainingscrew(s)i.e. the impressioncoping(s)remainfixedinthe impressionmaterial.Thedentististhen requiredtoaddtheanalogue(s)priorto dispatchingtothelab. Closedtraytechniquerequiresthatthe dentistfirstremovestheimpressionthe patientsmouththenunscrewsthe impressioncoping(s)toremovethem fromtheimplant.Theimpression coping(s)arethenplacedbackinto positionbythedentistintheimpression material andtheanaloguesareadded priortodespatch.
3iImpressionCopingsinanimpression

NobelBiocareNarrowPlatformimplantset

MaterialsUsed:Titanium,plastic,andanodizedaluminium Considerations:Correctplacement(topreventimpressionmaterialcreepingbetween surfacesandtoensurecorrectlocationforabutment).Ensureallpartsaredispatched (impression,coping(s),screws,andanalogues).

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AnalogueorImplantReplica
Analoguesareusedbylaboratory technicianstoreplicateimplantsand theirpositionin apatientsmouth. Amodelofthepatientsdentitioniscast usinganimpression.Theanalogue, screwedontotheimpressioncoping,is setintotheplastermodelduringcasting.

3iimplantcopingwithanalogueattached

Theyprovideanexactfixedreference platform(areplicaofthepositionofthe implant)fromwhichthetechniciancan placeandshapetheabutmentandbuild thecrownorbridge.

3iimplantanalogues

MaterialsUsed:Stainlesssteel (sometimesbrass) Considerations:Ensuringallpartsaredispatched(impression,coping(s),screws,and analogues).

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RetentiveAnchors
Retentiveanchorscomeinvarioustypesofdesign:Ball Abutment(withretainingclip), MagneticAbutment(withretainingmagnet)andTower Abutment(Locatorwhich comeswitharetainingclip). Allcomeintwomainparts:Theshapedabutmentpartandthefemale whichclipsoverit (knownasaMatrix). Oncetheanchorabutmentsarescrewedinto theimplants, they providesupportforafullora partialdenture(whichare clippedon).Thisprovidesaverystableplatformand preventsunwantedmovementoftheprosthesis.

StraumannBallAnchorabutmentsandmatrices

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Twoballabutmentssupportingafulldenture(femalematricesvisiblein thedenture)

StraumannLocatorandmatrix

3iimplantwithLocatorabutment Inbackgrounddenturewithfittedmatrixcups

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StraumannTitanmagneticabutments

Amagneticretainedprosthetic(left)withanimplantmountedcustomgold bridge(right)magnetsareinsetintocastbar

MaterialsUsed:Titanium andgold(withplasticmatricesormagneticmaterial) Considerations:Mostlymedicalincludingbonesuitabilityandspacingissues(vertical height).Aconsultationwithadentalprofessionalisrequired.

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BarRetainers
Constructedbylaboratorytechnicians,barretainersmountdirectlyontoimplants (screwed).Aclipmechanism then securesadenturetothescrewretainedbar. Therearetwowellknowntypes,DolderandHader.

Thesebarsprovideastrongsupportoption forretainingdentures.Theymaybe mountedonseveraldifferentmanufacturers implantsystems.

BasicDolderbaronStraumannimplants

Dolderbar,StraumannSynOctaabutmentsandStraumannimplants

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AStraumannSynOctamountedDolderbar

3iimplantsupportedHaderbarInbackgrounddenturewithfitted retainingclips

MaterialsUsed:Titaniumorgold(clipsareplasticorbrass) Considerations:Mostlymedicalincludingbonesuitabilityandspacingissues(vertical height).Aconsultationwithadentalprofessionalisrequired.

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References
Biomet3i NobelBiocare Straumann http://www.3implant.com http://www.nobelbiocare.com http://www.straumann.com

Allimagesusedinthisdocumentarecourtesyoftherespective manufacturerslistedbythem.

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