2. • INTRODUCTION:

3. NOWADAYS
osseointegrated implants are used, which
have been proven to be totally biocompatible.

4. Dental implant: is a "root" device, usually
made of titanium (or may use zirconium),
used in dentistry to support restorations
that resemble a tooth or group of teeth to
replace missing teeth.
Osseointegration: is a process refers to the
direct fusion between mental implant
surface and the healthy surrounding bone.

5. • PARTS OF IMPLANT
1. Implant body
2. Healing screw
3. Healing caps
4. Abutments
5. Impression post

6. • CLASSIFICATION
A. Depending on placement within the tissue
Endosteal implant subperiosteal implant transosteal implant

7. B.Depending on materials used
Metallic ex: Non metallic ex:
titanium ceramic
C. Depending on design : screw shaped

8. Dental implants
will fuse with
bone; however
they lack the
periodontal
ligament , so
they will feel
slightly different
than natural
teeth during
chewing.

9. 1. Uncontrolled diabetes
2. Cardiovascular disorders
3. Psychological disorders
4. Systemic hematological disorders
5. Smoking Drug and alcohol abuse
6. Local pathology (root fragment, cyst, foreign
body, granuloma)
7. Problematic occlusal and functional
relationships
8. Irradiation of jaws
9. Osteoporosis/ low bone mineral content

10. position of the incisive canal
bone
resorption
in both a
labial and
The vertical
influence direction
of the lip
position
midline

11.  Analysis
of appropriate and
adequate radiographs.
 Analysis of mounted study models.
 Measurement of bone and mucosal
thickness.

12. 1. Analysis of appropriate and adequate
radiographs.
Panoramic radiograph with template Lateral cephalometric radiograph

13. Computed tomography

14. 2. Analysis of mounted study models.

15. 3. Measurement of bone and mucosal
thickness.
using sterile needle with
vernia
rubber stop
X-ray ruler

16. 1. Width and height of available
bone.
2. Soft tissue condition.
3. Smile line.
4. Color of teeth.
5. Symmetry.
6. Position of the implant.

17. SMILE LINE
smile line is defined as the relationship between the
upper lip and the visibility of the gingival tissue and
teeth. Its imaginary line following the lower margin of
the upper lip and usually has a convex appearance ;
it could be classified in to:
high average low

18. • The other line is formed by the bottom
edge of the upper teeth. Ideally this line
should follow the curvature of the lower
lip.
• A straight flat line is
less pleasing.
• A reverse curve where
the front teeth appear
to be shorter than the
canines gives a look of
aging and wear and
can be quite
unattractive.

20.  Preoperative measures
 Flap less and Flap Designs
Crestal flap 3 sided flap

21. Crestal flap

22. 3 sided flap

23. For single tooth replacement, and If there is sufficient bone
available also for esthetic reasons the mucoperiosteal flap
should leave a 1mm margin of sound interdental papilla
tissue to insure that it maintain fine . length of
mucoperiosteal must not exceed two times its width in
order not to compromise the blood supply.

24. Dr. PAUL A. FUGAZZOTTO (1998) noted the precise
flap design should be governed according each
individual situation, and not by an overall generic flap
design. He categorized implant sites for single-tooth
maxillary anterior placement as follows:
Class I: Minimal or no ridge atrophy buccolingually or
apicocoronally.
Class II: Minor buccolingual atrophy with no
apicocoronally .
Class IIA: Both minor buccolingual and apicocoronally
atrophy.

25. Class III: Moderate buccolingual ridge atrophy with
no apicocoronal deficiency dehiscence and/or
fenestration.
Class IIIA: The same as Class III, accompanied by
moderate apicocoronal ridge atrophy.
Class IV: Moderate-to-severe buccolingual ridge
atrophy with or without an apicocoronal component;
as a result, the hard tissue atrophy precludes ideal
implant positioning and necessitates hard tissue
augmentation prior to implant placement.

26. • First using round as Pilot bur.
• Twisted bur with triangular end to determine the
length.
• Master bur which is round bur with blind end to
determine the width of the bone.
• During bone preparation, the temperature most not
exceeds 43c because it causes osteocyte necrosis.
• Insertion of implant body and suture this will end the
first stage fixture have to stay about 3 month in
mandible and 5-6 month in maxilla.
• After that 2nd stage start which is exposed implant
body again remove the cover screw and insert healing
cap for up to 20 days after that the crown sealed and

30. ISRAA ABD ALKAREEM AWADH