4th.

year class

Dental implant

Lecture 4
Definition: Biomaterials:
Materials that are compatible with the living hard and soft tissues. The
physical properties of the biomaterials, their potential to corrode in the tissue
environment, their surface configuration, tissue induction, and their potential
for eliciting inflammation or rejection response are all-important factors
under this area.

Dental implant known as an endosseous implant or fixture is a surgical

component that interfaces with the bone of the jaw or skull to support a dental
prosthesis, such as a crown, bridge, denture, facial prosthesis or to act as an
orthodontic anchor.

The basis for modern dental implants is a biologic process called

osseointegration where materials, such as Titanium (Ti), form an intimate
bond to bone.

Biomaterials and their dental applications, the advantages and

disadvantages of each biomaterial.
Biomaterials used for Dental Implant

Biomaterials used for fabrication of dental implants can be classified

according to chemical composition into:

1. Metals and Alloys.

2. Ceramics and Carbon.
3. Polymers and Composites.

1) Metals and Alloys

Most used alloys in dentistry is: Titanium alloy, such as (Ti – 6Al – 4V)
alloy include: Titanium (Ti) -6 Aluminium (Al) - 4 Vanadium (V).

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 Porous Titanium alloy

Sold Titanium alloy

Advantages of Metals and Alloys:

A. This reactive group of metals and alloys form oxides layer in

air and oxygenated solutions.
B. This oxidized surface reduced bio corrosion, this important property of
titanium made it the metal of choice for oral implants.
C. Titanium show a relatively low modulus of elasticity and tensile strength
when compared with other alloys. The strength values are approximately
1.5 times greater than the strength of compact bone.

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D. The Titanium alloy (Ti – 6Al – 4V) is approximately six times stronger

than compact bone, and in this manner affords more opportunities for

designing it with thinner sections, such as plate form.

Disadvantages of Metals and Alloys :( Titanium )

A. Titanium is said to be generally safe, but some doubts have been raised
regarding the use of titanium for medical purposes.
B. Titanium might slowly degrade and increase the concentration of the
metal in the bloodstream. Concerns exist regarding possible long term
effects of titanium in the blood.
C. Though a rare phenomenon, titanium implants may be rejected by the
patient’s immune system.
D. Some forms of titanium are said to have a harmful effect on health. For
example, titanium tetrachloride is associated with skin irritation. It is also
said to cause severe damage to the lungs if inhaled.

Cobalt – Chromium – Molybdenum- based alloy:

The cobalt based alloys are most often used in castable condition, this
permits the fabrication of implants as custom designs, such as sub periosteal
frames.
The major elements of this alloys includes Cobalt, Chromium and
Molybdenum. Cobalt provides the strength which is 4 times that of the
compact bone and surface abrasion resistance. The Chromium provides
corrosion resistance through the oxide surface. The Molybdenum provides
strength and corrosion resistance.
This alloy included minor concentration of Nickle, Manganese, and
Carbon. Nickle has a bio corrosion products and Carbon maintain the
mechanical properties.
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Iron – Chromium – Nickel – based alloys

The stainless-steel alloys is used most often in ramus blade,

ramus frame and stabilizer pins. The iron-based alloys have a
galvanic potential and corrosion characteristic if interconnected
with Titanium, Cobalt, Zirconium or Carbon implant biomaterial.

Gold – Platinum and Palladium

These metals are relatively low strength which place limits on

implant design, in addition to the cost per unit weight.

2. Ceramics and Carbon

Ceramics are nonorganic, non-metallic, nonpolymeric materials
manufactured by compacting and sintering at elevate temperatures. They can
be categorized according to tissue response as: Bioactive, Bioglass, Glass
ceramic Bioresorbable: Calcium phosphate Bioinert: Alumina, zirconia and
carbon.
Ceramics were introduced for surgical implant devices because of their
inertness to biodegradation, high strength and physical characteristics, such
as minimal thermal and electrical conductivity with a wide range of material
specific elastic properties. Ceramics are chemically inert, care must be taken
in handling and replacement due to its low ductility and inherent brittleness
has resulted in its limitations. A good example of Ceramics that has Dental
Application is Zirconia (Artificial Diamond), which is hard and allotropic in
nature.
Porcelain is another Ceramic with Dental Application. It is a glass- like
material formed into fillings or crowns using models of the prepared teeth.
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The material is tooth- colored and is used in Inlays, veneers, crowns and fixed
bridges.
Zirconium Oxides advantages:

1) Zirconium dental implants behave just like titanium implants. It is a

ceramic substance that is white in color, flexible, strong and is ideal for
use as dental implant material.
2) This material is reported to be highly resistant to corrosion and is
considered by some to be a better implant material than titanium.
3) Zirconium implants are suitable for osseointegration process and are easily
accepted by the body.
4) Zirconium implants have excellent tensile strength, so they are more
durable with less risk of breakage. Moreover, the material is also capable
of holding up to drastic changes in temperature.
5) Being white in color, zirconium implants have a definite advantage or
aesthetics over titanium dental implants. These will be welcome to those
patients who don’t like the thought of a dark colored implant. Any
possibility of a gray color like that of titanium showing through the gums
is ruled out with zirconium implants.
Disadvantages of Zirconium Dental Implants

1) Zirconium is a radioactive material and might contain radioactive isotopes.

However, the implants made of this material give out only a minute level
of radio activity and are certified to be non- dangerous by the
manufacturers.
2) They are substantially more costly than the titanium variety. Being new
products, they have yet to establish a successful track record like their
titanium counterparts.

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 Ceramics based on Calcium Phosphates advantages:

1. Chemical composition like ingredients of normal biological tissue.

2. Excellent biocompatibility.
3. Provide attachment with hard and soft tissues.
4. Minimal thermal and electrical conductivity.
5. Moduli of elasticity closer to bone.
6. Color like bone, dentin and enamel.

Disadvantages:
1. Low mechanical tensile and shear strength under fatigue loading.
2. Low attachment between coating and substrate.
3. Variable solubility
4. Variable mechanical stability of coating under load bearing condition.
Carbon and Carbon Silicon Compounds
Carbon compounds are often classified as ceramics because of their
chemical inertness and absence of ductility.

Uses:
1. Excellent Extensive applications for cardiovascular devices.
2. Biocompatibility profiles and moduli of elasticity close to that of bone
have resulted in clinical trials of these compounds in dental and
orthopaedic prostheses.
Advantages:
1. Tissue attachment.
2. Can be used in the regions that serve as barrier to elemental transfer of
heat and electrical current flow.
3. Control of color and provide opportunities for the attachment of active
biomolecule or synthetic compounds.

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Disadvantages:
1. Mechanical strength properties are relatively poor.
2. Biodegradation that could adversely influence tissue stability.
3. Time dependent changes in physical characteristics.
4. Minimal resistance to scratching or scraping procedures associated
with oral hygiene.
3) Polymers and Composites
The use of synthetic polymers and composites continues to expand for
biomaterial applications. Fiber-reinforced polymers offer advantages that
they can be designed to match tissue properties, can be coated for attachment
to tissues and can be fabricated at relatively low cost.

Biomedical Polymers

The more inert biomedical polymeric biomaterials include: Poly tetra fluro
ethylene (PTFE), Poly ethyleneterephthalate (PET), Poly methy
lmethacrylate (PMMA), Ultra high Molecular weight polyethylene
(UHMW-PE), polypropylene (PP), Poly sulfone (PSF), and Poly dimethyl
siloxane (PDS) or Silicone rubber (SR).
Disadvantages of Biomedical Polymers

• In general, polymers have lower strengths and elastic moduli, and higher
elongation to fracture compared with other class of biomaterials. They
are thermal and electrical insulators, and when constituted as a high
molecular weight system without plasticizers, they are relatively
resistant to biodegradation compared with bone; most polymers have
lower elastic moduli with magnitudes closer to soft tissues.

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