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WHAT IS A DENTAL IMPLANT? - PowerPoint PPT Presentation

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WHAT IS A DENTAL IMPLANT?. Dental implant is an artificial titanium fixture (similar to those used in orthopedics) which is placed surgically into the jaw bone to substitute for a missing tooth and its root(s). Alternative Solutions. Partial and Full Dentures Crowns Bridges.

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  • Dental implant is an artificial titanium fixture (similar to those used in orthopedics)
  • which is placed surgically into the jaw bone to
  • substitute for a missing tooth and its root(s).

Alternative Solutions

Partial and Full Dentures




History of Dental Implants

In 1952, Professor Per-Ingvar Branemark,

a Swedish surgeon, while conducting research

into the healing patterns of bone tissue, accidentally discovered that when pure titanium comes into direct contact with the living bone tissue, the two literally grow together to form a permanent biological adhesion. He named this phenomenon "osseointegration".

biocompatibility of material
Desired MechanicalProperties

High yield strength

Modulus close to that of bone’s

Built-in margin of safety: Changes in environment around implant



Ion release

Surface modifications

Biocompatibility of Material
metallic implant surface
Metallic Implant Surface


Implant surface change with time due to oxidation, precipitation…

Possible solutions:

  • Oxide layers ( minimize ion release)
  • Prosthetic component from noble alloys
  • Phase stabilizers other than Al & V (eg. Ti-13Nb-13Zr, Ti-15Mo-2.8Nb )
  • Surface Modifications
types of implants
Types of Implants

Screw Implants

(Left to Right: TPS screw, Ledermann screw, Branemark screw, ITI Bonefit screw)Cylinder Implants

(Left to Right: IMZ, Integral, Frialit-1 step-cylinder, Frialit-2 step-cylinder)


First Surgical Phase (Implant Placement)

Under Local anesthetic the dentist places dental implants into the jaw bone with a very precise surgical procedure. The implant remains covered by gum tissue while fusing to the jaw bone.

Second Surgical Phase (Implant Uncovery)After approximately six months of healing. Under local anesthetic, the implant root is exposed and a healing post is placed over top of it so that the gum tissue heals around the post.Prosthetic Phase (Teeth)Once the gums have healed, an implant crown is fabricated and screwed down to the implant.

  • Wide variability in costs
  • Single implant costs anywhere from $500 - $6000
  • Average ~ $1250 - $5000
  • $80,000 for full mouth reconstruction
  • Nobel Biocare currently the leader
  • US market grows ~ 20% annually, though it has historically been weak
growing dental market
Growing Dental Market
  • Potential Market Size:
    • 10% over 18 missing a tooth1
    • 69% of those aged 35-44 missing at least 1 tooth
  • 2% of market penetration2
  • 10% of worldwide dental market3
  • US market for implants is growing ~20% annually
  • US Department of Health
surface modification for metallic implants
Surface modification for metallic implants
  • Passivation
  • Ion implantation
  • Texturing

This work was supported by grants from University of Ferrara, Italy (F.C.), Fondazione CARIFE (F.C.), Guya-bioscience, Ferrara, Italy (F.P.), Fondazione CARISBO (F.P.), Finalized Project ‘‘Materials Tailored for Advanced Technologies’’, National Research Council (C.N.R.), Rome, Italy (A.P.), and Ministry of Education, University and Research (M.I.U.R.), Rome, Italy (A.P.).


Contract grant sponsors:


Guya-Bioscience (Ferrara, ITALY)



This work was supported by grants from Unife 60%(F.C.) and

Guya-bioscience (F.P.).

  • Hematoma occurs near screw threads
  • After 3 weeks – Osteoblasts begin forming spongy bone
  • After 4 months – spongy bone replaced by compact bone Lamellar bone – strongest type of bone, most desired next to implant
  • Osseointegration failure

Endorsing an intuition of a potential future successful application on mankinds, it was started a trial on rabbits using Biolok titanium dental implants, previously treated to obtain a surface coating with nanocrystalline film of metallic dioxide.

Three groups of dental implants has been manufactured and surgically inserted in rabbits tibia:

1. uncoated dental implants (control);

2. TiO2 surface coated dental implants;

3. ZrO2 surface coated dental implants.


After thirty days bone sections have been analyzed in correspondance of the contact bone-implant zone and different osseointegration rates have been evaluated among the three groups above. The difference has been based on the presence of marks identifying small bone trabeculae.

The results concerning osseointegration were extremely interesting: while in the cortical portion there are no differences among the three types of implants, around the implants embedded in the medullary portion, clearly appeared outstanding new bone apposition around TiO2 coated implants (55%) and ZrO2 coated implants (43%) if compared to the results obtained by uncoated implants (31%).


Medullary portion in endosseous uncoated dental implant section.

new bone apposition = 31%

Medullary portion in endosseous TiO2 coated dental implant section

new bone apposition = 55%

Medullary portion in endosseous ZrO2 coated dental implant section

new bone apposition = 43%


Anatase surface nanoscopic topography (300 x 300 nm), produced according to the patented method .