AtlasSurgeryDental Implantology

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.

Concept
Osseointegration
Imaging
CBCT
Survival 10 y
≈95%

§ 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:

References

  1. Brånemark PI. Scand J Plast Reconstr Surg 1969
  2. ITI Treatment Guide Series

Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.