Maxillofacial Surgery
Dental Implantology
aka Osseointegrated Implants
Placement of titanium or zirconia fixtures into alveolar bone to replace missing teeth via the biological phenomenon of osseointegration first described by Brånemark.
§ figuresFigures (3)
Fig. 1The x-ray controlling from 1976/77 shows an subperiosteal implant (according Cherchéve) in the maxilla. Two implant tripods (according Pruin) in the lower canine region and two stabilized blade Implants (according Heinri
“Panoramic radiograph of historic dental implants” · Dentistxxx · CC BY-SA 3.0 · Wikimedia Commons
Fig. 2Dental radiograph depicting both platform switching and platform matching dental implants
“Platform switch” · DRosenbach · CC BY-SA 3.0 · Wikimedia Commons
Fig. 3Dental radiographs demonstrating different emergence profiles on a lower left implant crown.
“Emergence profile” · w:user:DRosenbach · Public domain · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Dental Implantology figures pending faculty review.
§ overviewOverview
Restoration of missing teeth using alloplastic root-form implants that osseointegrate with alveolar bone to support prosthetic crowns, bridges or dentures.
§ classificationClassification
- 01By timing: immediate, early, delayed placement
- 02By loading: immediate, early, conventional loading
- 03By surface: machined, SLA, anodised, hydrophilic
§ planTreatment Planning
- 01Medical & dental history, smoking, bruxism, occlusion
- 02CBCT with radiographic guide/digital planning
- 03Assess bone volume (ITI SAC classification: Straightforward, Advanced, Complex)
- 04Prosthetically driven implant position
- 05Consider grafting: GBR, sinus lift, ridge split, block graft
§ surgicalSurgical Management
- 01Aseptic technique, copious irrigation (keep bone <47°C)
- 02Sequential drilling per manufacturer protocol
- 03Primary stability ≥ 30 Ncm for immediate loading
- 04One-stage (transmucosal) vs two-stage (submerged) protocol
- 05Guided surgery with surgical stents for accuracy
§ complicationsComplications
- 01Early: haemorrhage, nerve injury (IAN, mental, lingual), sinus perforation, primary instability
- 02Late: peri-implant mucositis, peri-implantitis, fracture, screw loosening, aesthetic failure
§ prognosisPrognosis
10-year survival ≈ 95% in healthy non-smokers; reduced by smoking, uncontrolled diabetes, radiotherapy, poor hygiene and bruxism.
§ examKey Examination Points
- 01Assess bone width/height & inter-arch space
- 02Identify vital structures on CBCT (IAN, sinus, incisive canal)
- 03Manage soft-tissue phenotype
§ revisionQuick Revision Summary
- 01Osseointegration (Brånemark) · CBCT planning · 2 mm from IAN · torque ≥30 Ncm for immediate loading
§ vivaBDS Viva Questions
- 01Define osseointegration.
- 02Contraindications to implants?
- 03Peri-implantitis management?
§ mcqsMCQs — Assessment (3)
Question 1
Concept of osseointegration was introduced by:
Question 2
Safe distance from inferior alveolar nerve:
Question 3
Minimum insertion torque for immediate loading:
§ evidenceReferences & Evidence
Current Classification
WHO Classification of Tumours Online — Head and Neck
IARC / WHO · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Evidence summary
Highest level of evidence linked to this page: WHO / Official Classification.
- L1 · Classification — 1
- L6 · Textbook — 4
1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.
Content last reviewed
September 2026
Evidence last reviewed
September 2026
Next scheduled review
September 2027
Review status
EVIDENCE REVIEWED
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Hupp JR, Ellis E, Tucker MR. Elsevier · 2019
Core surgical textbook covering exodontia, infection, trauma and preprosthetic surgery.
Additional sources cited on this page
- Brånemark PI. Scand J Plast Reconstr Surg 1969
- ITI Treatment Guide Series
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.