Generalities and terminology in implantology
Introduction : Replacing lost teeth with a prosthetic device has been a human concern since the dawn of time. Numerous archaeological discoveries attest to this, throughout human history and in all places. Devices are of varied origins: mineral, animal and human.
-History: Six distinct periods characterize the evolution of implantology (Mckinney, 1991:
1-Ancient period (BC to 1000 AD): the first tooth implantations were carried out during the dynasties of ancient Egypt and pre-Columbian cultures. Traces of this period have also been found in Latin and Central America (Mayans, Aztecs, Incas) and the Middle East.
The teeth used are those of animals or carved from ivory.
In Egyptian culture, the toothlessness of the deceased was treated before mummification.
2-Medieval period (from 1000 to 1800): during this period implantology was limited to transplants.
In Europe, the transplantation is carried out from one patient to another. The teeth are taken from individuals belonging to the underprivileged social classes.
3-fundamental period (from 1800 to 1910): endosseous implantology really begins at this time in North America. The materials used were gold, wood and metals (platinum, silver, tin).
The prosthesis is made only after tissue healing.
The principles of biocompatibility and stability are developed.
Berry in 1888 insisted on the need for immediate stability of the implant and the use of safe materials, avoiding any transmission of disease.
4-Premodern period (1910 to 1930): Payne and Greenfield are the precursors of implantology. In North America, gold and porcelain were used.
Greenfield introduced a technique suggesting a delayed start of the implant (6 to 8 weeks). He established the first scientific protocol around 1910 and insisted on the importance of close bone-implant contact.
The concepts of clean surgery and deferred operation are discussed.
5-modern period (from 1930 to 1978): this period is characterized by the study of different biomaterials as well as the introduction of surgical and prosthetic innovations. In Europe and North America, porcelain, vitallium and titanium were used. Three types of implants are developed.
1-Endosteal implants I : Adams advocates a buried implant in the form of a screw with a healing cap. In 1939, Strock created a screw implant in vitalium and then developed, with his brother, the endodontic implant.
2-subperiosteal implants : they were developed in 1941 by Dahl in Sweden. They have standard shapes of large extent after taking surgical impression. They are locally adapted according to the bone situation encountered.
3-Endosteal implant II : from the 1940s, different forms of implants were created. The helical spiral implant in stainless steel or tantalum (Formiggini 1947). Chercheve in 1962 developed a double helix spiral implant accompanied by a surgical kit for its insertion.
Scialom is the promoter of a tripod implant (needle implant). The three parts of the tripod come together to support the prosthesis.
-in 1967, Linkow introduced the titanium and then titanium alloy blade implant.
-in the early 1970s, sintered ceramic and vitrified carbon implants were produced
Implantology from the 1950s to the 1970s was a time of trial and error.
At that time, obtaining a peri-implant fibrous interface was desired. The goal was to mimic the alveolo-dental ligament in order to absorb shocks at the interface. As a result, ankylosis, with its direct bone-implant contact, was considered a handicap in the implant prognosis.
July develops the three-dimensional implant which requires lateral placement through the vestibular cortical table.
6-contemporary period (osteointegration or Branemark period):
North America, Europe
Materials used: titanium, titanium alloy, hydroxyapatite, ceramic
The first research on tissue integration of materials was carried out in Sweden in the early 1950s. A first clinical protocol was developed for animals to test the restoration of a tooth loss using a fixed prosthesis. Partially edentulous dogs were treated using an implant-supported prosthesis. The fixtures were previously placed in a wet nurse to obtain a bone healing period of 3 to 4 months.
7-Post Branmarkian period: some clinical and animal studies published in the early 1990s show that immediate loading of implants can lead to a high rate of osseointegration.
Generalities and terminology in implantology
-Terminology
- Osteointegration: it is defined by Branemark et al (1985): as being a direct anatomical and functional junction between the remodeled living bone and the surface of the loaded implant.
The implant structure is generally made up of two parts:
An endosseous part called an implant
A part emerging into the oral cavity, called abutment. This is connected to the implant by an attachment system
- Dental implant: the implant consists of 3 parts:
1- implant neck
2-body of the implant
3-apex
This separation into different parts makes it possible to simplify the description of an implant and to classify them into different families.
1-The implant neck is the part of the implant that makes the connection with the abutment. The neck constitutes a junction zone and its function is to harmoniously organize the transition between adjacent elements.
2-the implant body: the implant body is the most extensive part of the implant, between the neck and the apex. It defines the outline of the implant and contains the coils that ensure its primary stability.
3-the apex is the terminal part of the implant, it extends and ends the body. This part can be either active (secant) or passive (rounded).
-Bibliography:
– Manual of clinical implantology
Concept, protocols and recent innovation 2nd edition
M. DAVARPANAH, S.SZMUKLER-MONCLER, PMKHOURY, B. JAKUBOWICZ-KOHEN, H. MARTINEZ.
– Access to implantology
Patrick MISSIKA Anne BENHAMOU Isabelle KLEINFINGER edition Cdp Collection JPIO continuing education for dental surgeons.
Generalities and terminology in implantology
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Bad breath can be linked to dental or gum problems.
Bad breath can be linked to dental or gum problems.
Dental veneers improve the appearance of stained or damaged teeth.
Regular scaling prevents the build-up of plaque.
Sensitive teeth can be treated with specific toothpastes.
Early consultation helps detect dental problems in time.