BASIC DENTAL IMPLANT SURGERY

Helmi Fathurrahman Hanafie

DENTAL IMPLANT PROCEDURE

STEP 1: INITIAL SURGERY

STEP 2: OSSEOINTEGRATION PERIOD
STEP 3: ABUTMENT CONNECTION
STEP 4: FINAL PROSTHETIC
RESTORATION
 FIBRO-OSSEOUS INTEGRATION
• Fibroosseous integration
– “tissue to implant contact with dense collagenous
tissue between the implant and bone”

• Seen in earlier implant systems.

• Initially good success rates but extremely

poor long term success.

• Considered a “failure” by todays standards

 OSSEOINTEGRATION

• Success Rates >90%

• Histologic definition
“direct connection between living bone and load-bearing
endosseous implants at the light microscopic level”
 OSSEOINTEGRATION

• 4 factors that influence:

- Biocompatible material
- Implant adapted to prepared site
- Atraumatic surgery
- Undisturbed healing phase
 CLINICAL ASSESSMENT

• Assess the CC and Expectations

• Review all restorative options:

- Risks and Benefits

• Select option that meets functional and esthetic

requirements
 PATIENT EVALUATION

• Medical history
 vascular disease
 immunodeficiency
 diabetes mellitus
 tobacco use
 SURGICAL PHASE- TREATMENT
PLANNING
• Evaluation of Implant Site

• Radiographic Evaluation

• Bone density

• Bone Height, Bone Width and Anatomic

considerations
 Bone Density

Misch Classification 1988

 ANATOMIC CONSIDERATIONS

• Ridge relationship
• Attached tissue
• Interarch clearance
• Inferior alveolar nerve
• Maxillary sinus
• Floor of nose
 RADIOLOGICAL/IMAGING STUDIES

• Periapical radiographs
• Panoramic radiograph
• Site specific tomograms
• CAT scan (Denta-scan, cone beam CT)
WIDTH OF SPACE AND DIAMETER OF
IMPLANT

Attention must be paid to both the coronal and

interradicular spaces
 ∅ Ball pada Ro = 5mm

Tinggi Tulang pada Ro = 20mm

NB: ∅ Ball yang ada = 4mm

∅ 𝑩𝒂𝒍𝒍 𝒚𝒂𝒏𝒈 𝒂𝒅𝒂

𝑻𝒊𝒏𝒈𝒈𝒊 𝑻𝒖𝒍𝒂𝒏𝒈 𝒑𝒂𝒅𝒂 𝑹𝒂𝒉𝒂𝒏𝒈 = × 𝑻𝒊𝒏𝒈𝒈𝒊 𝑻𝒖𝒍𝒂𝒏𝒈 𝒑𝒂𝒅𝒂 𝑹𝒐
∅ 𝑩𝒂𝒍𝒍 𝒑𝒂𝒅𝒂 𝑹𝒐

4𝑚𝑚
Tinggi Tulang pada Rahang = × 20𝑚𝑚 = 16mm
5𝑚𝑚
 2mm

4mm

6mm 16mm

6mm
 4mm

6mm

1mm
6mm 1mm

16mm

2mm
 DENTAL IMPLANT SURGERY

• Aseptic technique
• Minimal heat generation
• slow sharp drills
• external cooling
 DENTAL IMPLANT SURGERY

• Adequate time for integration

• Adequate recipient site
 soft tissue
 bone
• Bone tention
• Kind & Gentle technique
SUBMERGED (2 PHASE) DENTAL IMPLANT
SURGERY