Different implant forms and implant types
The implants used today have in most cases the shape of a screw, more rarely that of a cylinder. Helical implant types have prevailed in Germany. The shape, length and diameter of an implant vary depending on the intended use and the clinical situation of the patient.
The biomechanical behavior of oral implants is determined by their shape, size and load distribution on the interface between the implant surface and the surrounding bone tissue. For a long-term anchoring of the implants and a balanced distribution of forces, implants must have different lengths and diameters.
The individual standard implant diameters of different manufacturers vary and lie between 3.3 mm to 5 mm, standard lengths 8 mm, 10 mm, 12 mm, 14 mm and 15 mm. The type of planned denture, bone supply or skeletal peculiarities determine the length and diameter as well as number and positioning / distribution of the implants. For a sufficient anchoring depth in the local bone usually about 10 mm to 15 mm long implants are sufficient. With favorable bone supply (bone morphology and bone density) shorter implants can be placed if the indication requires it. Basically, the maximum possible implant length should be exploited.
The direct anchoring of the implant in the bone is called osseointegration. According to Prof. Per Ingvar Branemark, this is the direct, functional and structural bond between the organic, living bone and the surface of the healed, loaded implant. The osseointegration is bound to a sufficiently sized and properly structured bony bearing tissue, to the freedom from inflammation of the peri-implant soft tissue and an adequate purchase functional loading of the implant.
Depending on the oral situation and selected surgical procedure, different implant types and systems are available.
Because of the positive biomechanical properties of a screw, the following implant shapes (root implants) are nowadays preferred.
stepped implants (as a screw implant)
conical implants (as screw implants or as step cylinder implants)
Screw implants (with self-tapping or pre-cut thread, good primary stability through the thread)
Only rarely: Cylinder implants (without thread, primary stability by press fit)
Implants for one-time, transgingival healing: One-piece implants are placed that protrude through the mucous membrane / gums
Implants for subgingival implantation: Two-part implants are used for subgingival implantation. The implants heal covered by the mucosa. After healing, the implant heads are exposed in a second intervention. They are lengthened with so-called spacers, which protrude through the mucous membrane. On the spacers, the prosthetic restoration.
Special implant designs for immediate and early implantation
Interim implants for temporary (limited to the healing time) inserts
Design principle of an implant:
Implant body (endosseous part)
Abutment / spacer (also called abutment, abutment)
Connection between the implant body and the superstructure
Superstructure (implant crown / abutment)
Supra constructions on implants may be tight, e.g. As single crowns or bridges, or conditionally made removable, z. B. steggelagerte complete dentures.
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