DENTAL IMPLANT

MATERIALS

Dental Material
Block 4
 CONTENT
1) Dental Implant
2) Components
3) Anchorage system
4) Requirement of Implant Material
5) Classification of Dental Implant
6) Classification of Implant Materials
 WHAT EXACTLY IS A DENTAL IMPLANT?
 It is simply a metal or ceramic device that replaces the
root of the natural tooth
 After an implant is placed into the underlying bone,
artificial teeth are attached to it, enabling normal
function

COMPONENT
 Implant = fixture
 Healing cup
 Abutments
 Surgical armamentarium
Gambar ni dalam slide asal tak ada label pun. Jadi tak perlu hafal kot.
 IMPLANT ANCHORAGE SYSTEM
Osseointegration
“A direct structural & functional union of
ordered, living bone to the surface of a load-
carrying implant”
“The formation of a strong intimate contact
between an implant surface & the surrounding
bone tissue”

 The interface that results from osseointegration is

capable of withstanding the physiological forces of
mastication
Biointegration
“Is the benign acceptance of a foreign object by
living tissue”
“Biointegration of bone with an implanted
material indicates the bond of bone to
hydroxyapatite”
 REQUIREMENT FOR IMPLANT MATERIALS

1) Biocompatibility
 Ability of any foreign material to coexist in a living
organism without causing damage or being damaged
 For metallic materials, compatibility depends on the
quantity of ions released & their toxic effects on the
living organisms
 Metallic materials achieve corrosion resistance either
By nobility of metals or
By formation of a protective passive oxide layer
which prevent further oxidation
2) Physical & Mechanical Properties
 Anchorage system of implant differs significantly than
that of teeth
 Tooth is anchored to bone by elastic PDL; whereas
implant anchorage depend on a mechanical retention
or ankyloses created by the closeness of the bone to
implant system
 Implant material should have a
i. High yield strength – to bear loads without buckling or
undergoing excessive permanent deformation & to
prevent distortion under occlusal force
ii. High modulus of elasticity – to distribute forces to
surrounding bone tissue
iii. Fracture toughness
 CLASSIFICATION OF DENTAL IMPLANTS

1) Anatomic Location
 Endosteal implants (endosseous) – the 1st & most
commonly used type which is surgically placed within
the alveolar bone (transects one cortical plate only)
 Subperiosteal – employ an implant substructure &
superstructure (placed beneath periosteum & overlies
cortical bone)
 Transosteal – combines both subperiosteal +
endosteal component; penetrate both cortical plate &
alveolar bone [design primarily for edentulous arch]
 Epithelial implant – inserted into the oral mucosa
2) Device Design
3) Implant properties
4) Implant attachment mechanism
 CLASSIFICATION OF IMPLANT MATERIAL
[#1 - METALS]
1) Stainless steel
 Composition:
i. Iron (main) - with 0.5% carbon
ii. Chromium 18% - forms a passive chromium-
oxide layer
iii. Nickel 8% - stabilize austhenitic structure of steel
iv. Steel – high modulus strength & elasticity, high
ductility
 Used in subperiosteal & transosteal implant & ramus
frames
 Low cost
 Not widely use nowadays due to:
i. Potentially allergic response to nickel
ii. Susceptibility to crevice & pitting corrosion

Note:
 Both stainless steel & Cr-Cr-Mo are tolerated by bone but
do not osseointergrate (distant osteogenesis) resulting in
the formation of a thick fibrous layer of connective tissue
between the implant and the bone
 Studies shows that there was no significant effect of
surface treatment (coating) or Co-Cr-Mo alloys utilizing
ceramics on the biological acceptibility
2) Co-Cr-Molybdenum Alloy
 Composition:
i. 63% Cobalt
ii. 30% Chromium
iii. 5% Molybdenum
iv. Carbon, manganese & nickel (small amount)
 Posses high modulus elasticity & high yield strength,
low ductility
 Corrosion resistance by formation of a passive
surface oxide layer when exposed to atmosphere
 Used in: Subperiosteal, transosteal & ramus frames
3) Titanium
 High strength to weight-ratio, low density (4.5g/cm2)
 Modulus of elasticity is about ½ of St. St or Co-Cr-Mo
about 5x that of bone. High adherent
 Titanium is a high reactive metal spontaneously forms
a protective surface oxide layer of 3-5 nm thick
 The titanium alloy has slightly greater strength &
modulus elasticity than pure titanium
 Advantage of titanium oxide layer:
i. Protect titanium against further oxidation &
chemical attack in body fluid (make it inert)
ii. When this surface oxide lost by starching, titanium
re-passivates instantaneously to render it resistant
to further oxidation
 cpTi is the commercial pure form
 Grade 1-4 are unalloyed & considered
commercially pure (CP)
 Generally the tensile & yield strength goes up
with grade number for these pure grade
 The difference in their physical properties is
primarily due to the quantity of interstitial
elements
 They are used for corrosion resistance
application where cost & ease of fabrication &
welding are important
 Ti-6Al-4V is an alloy
 Grade 5, also known as Ti 6-4. Most commonly
used alloy
 Extensively used in aerospace, medical, marine &
chemical processing
 Significantly stronger than CP titanium while
having the same stiffness & thermal properties
(excluding thermal conductivity, which is about
60% lower in grade 5 Ti than in CP Ti)
 Among its many advantages, it is heat treatable
 This grade is an excellent combination of
strength, corrosion resistance, weld &
fabricability
 Newer titanium alloy Ti-13Nb-13Zr & Ti-15Mo-
2.8Nb
 Composition:
i. 6% aluminium
ii. 4% vanadium
iii. 0.25% iron
iv. 0.2% oxygen
v. Titanium - remaining
 CLASSIFICATION OF IMPLANT MATERIAL
[#2 - CERAMIC]
 Composition:
i. Hydroxyapetite
ii. Beta tri-calcium phosphate (B-TCP)
iii. Tetra calcium phosphate (TTCP)
 Used in coating on metal implant – due to do not
satisfy the mechanical property requirement for use as
tooth supporting implant
 Generally brittle (low ductility) & low toughness
 Advantage: they can stimulate the adaptation of bone
giving a more intimate bone-to-implant contact
compared with a metallic surface
 CLASSIFICATION OF IMPLANT MATERIAL
[#3 - OTHER]
 Carbon (C) & carbon compound (SiC) – also known
as vitreous carbon or glossy carbon which combine
glassy & ceramic properties
 One of the most biocompatible materials
 More inert under physiological condition
 Has modulus of elasticity similar to that of dentin &
bone. Thus, carbon deforms at a rate similar to those
tissues, enhancing the transmission of biomechanical
forces.
 Disadvantage of C & SiC
 Carbon is susceptible to fracture under tensile &
stress condition (due to its brittleness)
 Its susceptibility to fracture under tensile stress is
the presence of surface flaws, which is usually
generated as a component of flexural loading
 That why carbon-based biomaterials have been
used for ceramic like coatings on metallic
implants