Académique Documents
Professionnel Documents
Culture Documents
Designs, and
Surface
Topographies
Dr. Abdullah Alkeraidis
BDS, Prostho (cert), Msc, Dental Implant (Cert), FICOI
Consultant in prosthodontics, RDC
Implant materials
Biotolerant
not
Bioinert
close
Bioactive
the
Osteoconductive
Titanium toxicity
Although titanium ions have been shown to enter
Implant design
Shape
Cylinder: press-pit
straight cylinder
trapezoid cylinder with step or thread
straight wall
finned taper design
Thread : self tap
V shape
Reverse buttress thread
microthread
round thread
Implant surfaces
manufacture
procedure
shape
material
surface
Branemark
Nobelbiocare (sweden)
screw
Pure Ti
machined
ITI
Strauman
(swiss)
1
2
Screw
cylinder
Pure Ti
TPS, SLA
Steri-Oss
Nobel
biocare
1
2
Screw
cylinder
Ti6Al4V
TPS
HAP coat
Sulzer
Sulzer(USA)
1
2
screw
Pure Ti
HAP coat
blast
Astra
Astra
(Sweden)
1
2
screw
Pure Ti
Tioblast
Endopore
Innova(Canada)
cylinder
Ti6Al4V
Porous coat
Bicon
Bicon(USA)
pine
Ti6Al4V
Machined
TPS
3i
Implant
innovation(USA)
Screw
cylinder
Pure Ti
Machined
Acid etching
Success
Branemark
ITI
3i
Astra
Sulzer(calcitek)
Scope
Implant-tissue interface
Effect of surface properties on cell response
Surface properties and composition
Surface modifications
Mechanical,chemical, combination, laser
Surface coatings and properties
Hydroxyapatite, Titanium
Coating Methods
Plasma-sprayed, electrodeposition,
precipitation
Implant
Surfaces
Machined
Surface
Rough
Surface
HA
TPS
Uncoated=Subtracted
Acid Etched
Sandblast
TiO2-blast
SLA
Why a
Rough surface ?
1. Wettability ;
increased
2. Surface & Bone-to-implant contact ; increased
3. Mechanical interlocking of bone into implant ; promote
4. Resistance to compression;
increased
5. Tension & Shear strength;
increased
6. Cellular adhesion ;
increased
Surface modification:
Chemical
Acids
HNO3 (Passivation)
HCl/H2SO4
HF/HNO3
Alkali and heat treatment
NaOH
Surface Modifications:
Mechanical
Grit-blasting with abrasives
Glass bead
Silica (SiO2)
Alumina (Al2O3)
Apatitic abrasive (Principally HA, Ca10
(PO4)6 (OH)2)
Laser texturing
Surface modifications:
Coating
Plasma-sprayed HA
Coating composition: HA+Amorphous
Calcium Phosphate (ACP)
Plasma-sprayed Ti
Hybrid: coated and uncoated
Surface modifications:
Combination of mechanical &
chemical
Sandblasting with medium grit (0.12-
Electro-polished
60
50
40
30
TPS (coat)
20
SLA
10
HA(coat)
HA
Ti alloy
CP Ti
100
50
0
Maxilla
Mandible
Potential disadvantages of HA
coated implants
Low adhesion strength of coating to
metal substrate
Coating-bone bond stronger than
coating-substrate bond
Disadvantages of plasma-spray
method for depositing apatite
coating
Variability in coating composition
Alternatives to plasma-spray
coating method
Electrochemical deposition
Precipitation
Advantages:
Homogenous composition
ability to coat complex geometry
ability to incorporate bioactive
molecules
Machine surface
Milling
Mark III, IV. 3i, Restore(basic type)
Roughness of surface
0.53-0.96m
Titanium oxide layer
Increasing bone generation and
antiinflamation
Astra(sweden) machined surfce originally
change to blasted surface
TPS, HA coating
HA coating
Hydroxyapatite powder plasma spray
Initial osteointegration
1.59-2.49m
TPS coating
Coated titanium particle(0.05-0.1mm)with argon
plasma in 1500C, 600m/sec
1.82-2.5m
Irregular rougness
Separate titanium particle in dense bone
Acid etching
Acid etching
Steri-oss, Biohorizon, 3i
3i(double acid etching)
:1.3m
acid etched(1mm)
Low part acid etched after grit blasting
Blasting
Astra TiO2 blasting
1.3m
Less bone resorption
0.48mm bone resorption in 5years
Makkonen et al, COIR, 1997
Blasting
ITI SLA
acid etching after blasting
Small dimple in large dimple
Blood clot Easily attach
mesenchymal cells differentiate well
Early loading system(6wks)
Machined + SLA
110
100
70
80
60
Bone to implant
contact
40
20
0
TiUnite
D-A-E
60
50
40
30
TiUnite
20
D-A-E
10
0
Coronal
Apical
Percentage(%) bone to
implant contact at
6weeks in rabbit
femoral bone
0.8
Early stability
0.6
0.3
0.4
0.2
0
TiUnite
D-A-E
Resonance
frequency(kHz)
change between 0 to 6
weeks in rabbit
femoral bone
PORE
Endopore (3 dimensional bone
growth)
150-300m
Sintering spherical particle(44-150m)in
1250C
Type III-IV and short bone height
Loading with short fixture
Mx posterior area. External connection
system
size
Estimated surface
area(mm2)
Endopore
4.1X12mm
781
Branemark
4.0X12mm
248
PORE
Ti-Unite
Electrochemical oxidation
Increasing pore size toward apex
Roughness: coronal: 1-2m
apical:7-8m
External connection
The MTX process does not weaken the titanium implant body,
ensuring that the strength of the implant is maintained.
Furthermore, implant threads are not rounded by the MTX process,
and cutting grooves remain intact for efficient self-tapping
Zimmer Dentals MTX surface allows for increased bone
apposition for long-term success
MTX is a non-coated, microtextured surface created by gritblasting the machined titanium implant surface with Calcium
Phosphate particles, followed by washing in non-etching acid
and distilled water baths to remove residual blasting material.
system
Surface
Branemark MK III, IV
Machined surface
3i
Restore RBM
ITI
TPS coating ,
Bicon
Ankylosis
Blasting surface
Biohorizon
D1:RBM
D2:acid etching after RBM
D3:TPS coating
D4:HA coating
Paragon
Top1mm:machined
Astra
1.5 m roughness
Steri-oss
Replace
Acid etching
HA coating
Frialit-2
TPS-coating
HA coating
DPS(deep profile surface) grit-blasted and
etched coating
Endopore
Porous surface
Branemark Ti-unite
SLA
periodontium to bacteria
High free-surface energy
to smooth surface
Recommend;
Plastic cup and rubber cup; no change to the surface
Cavitron Jet airpolishing;
Restriction
Ti curettes / Gracey curette
Ultrasonic scaler
Reiner Mengel et al ;IJOMI 1998;13:91-96
IMPLANT COMPONENTS
SURGICAL &
RESTORATIVE
Implant Classification
Body geometry
Surface and coatings
Stage
Loading
Scalloped implant
The Abutment Connection
Categories of Restorations
Cement-retained: All-ceramic, PFM, cast gold
Overdenture restorations:
Companies
Noble Biocare
3i
Straumann (ITI)
Innova (Endopore)
Astra
Nobel Biocare
FIXTURE : straight
NP, RP, WP : 10,11.5,13,15mm
RP (4.3mm) : + 18mm
Replace select straight 3mm collar: only
3i
surgical
Fixture
Internal : TG, Certain
External : osseotite , oss xp, oss NT
Shape
Straight (Osseotite)
Tapered (NT)
Supracrestal placement
of A two stage implant system
Protocol
Eliminating the countersink procedure
Then, placing the implant app. 1.5mm
3i
Restorative
UCLA wax up
Gingihu prepable
zireal prepable
Anterior Screw-retained :
UCLA
Posterior cement-retained:
UCLA
Gingihue
Posterior screw-retained :
Angled abutment
UCLA
ITI
Surgical
ITI
Restorative
Abutment
Solid abutment
Octa abutment
Synocta abutment
Option A: Impression of no
modification
35 Ncm
Solid abutment screw
Once abutment removed, take a new
impression
Impression procedure
two options
Snap on version :standard version
Screw-retained version
ITI : TE
Collar : 1.5 mm H
Insertion depth: 8,10,12,14mm
NP : D 3.5 mm collar H 1.5 mm
RP : D 4.3 mm
WP : D 5.0 mm
Innova
Endopore
Entegra