Guided by Dr.

Ranjukta Sar
Dr. (Mrs.) Jyoti undurwade P.G. Student
Dept. of prosthetic dentistry Dept. of prosthetic
H.O.D. G.D.C. & H Mumbai dentistry
GDC & H Mumbai
DENTAL IMPLANT
DESIGN
 Oral &
Maxillofacial
Implants
 Implants can

either be:
 Oral
 Maxillofacial
 Introducing
Dental Implants
 What is it ?
DENTAL IMPLANT is a
tooth root substitute

It provides support to a
prosthesis
 Definition
Dental implant is a
prosthetic device
made of an
alloplastic
material implanted
into the oral
tissues beneath
the mucosal &/ or
periosteal layer &
on/or within the
bone to provide
retention &- 8
GPT
Depending upon anatomical sites or
relationship to the bone:

 Endosseous Root Form implants

 Endosseous Blade Form implants
 Sub periosteal implants
 Transosseous implants
 Mini (Transitional) Implants
Endosseous root form
implants
These are the
implants that
were originally
designed by Dr.
P. I. Brånemark
and his fellow
researchers in
Sweden.
 CLASSIFICATION
 Basic Implant Design:
1. Threaded
2. Non-Threaded (Cylinders)
 Specific Micro-Surface Design:
3. Machined
4. Acid Etch
5. Shot Blasted
6. Titanium Plasma Spray
7. Hydroxyl Apatite (HA) Plasma Spray
8. Porous Sintered Surfaces
The
microscopic
features are
most
important
during initial
implant
healing & the
initial loading
period.
The macroscopic implant body design
is most important during early loading
& mature loading period.
 Non-Threaded (Cylinders)

Less surface area
than threaded
implants so they
require a coating to
increase surface area.
 placed by drilling a
hole slightly smaller
than the diameter of
the implant and then
tapping in the implant
with a mallet.
 Advantages
 They are very easy and
quick to insert
 friction fit insertion. So.
Less risk of pressure
necrosis.
 No need to bone tap ,
even in dense bone.
 Disadvantages

 10yr survival rate

50%
 Less bone implant
contact % & the
bone implant
interface is
subjected to large
shear load –
overload failure
 Threaded
Most common type of implant
design today

 Advantages
1. They stabilize the implant
when it is initially placed.
2. They increase surface area.
3. They provide a great
means of proprioception for
the dentist placing the
implant giving lots of
information about the
implant site.
 Disadvantages
-Require pre-tapping for
placement into very dense
bone.
 Implant Types -
Prosthetic Attachment
1. External Hex
2. Internal Hex
3. Internal Taper
4. Spline
 External Hex

 Original prosthetic connection

for the dental implants
-designed by Dr. Brånemark
.
Prosthetic Advantages
-Most common type of
prosthetic attachment.
 Prosthetic Disadvantages
-Poor technique will allow for
loosening of this attachment and
premature wear of the hex.
There has also been reports of
broken screws.
 Internal Hex
 Description
-the antirotational feature
of abutment is designed
within the implant body
Prosthetic Advantages
 It is very stable and
retentive
 easier to cover with soft
tissue during surgery.
 Prosthetic Disadvantages

-Possible fracture of the

head of the implant.
 Internal Taper
 Description
-Internal tapered attachments
for implants allow for an
abutment to be friction seated
into the head of the implant.
-Screws are optional
 Prosthetic Advantages

simpler to use because there are

no screws involved.
 Prosthetic Disadvantages

-There is no way to accurately

re-seat an abutment that has
come loose or has been
removed for any reason.
-Limited Prosthetic options.
 Description Spline
-The head of the implant has
projections which stick up.
The abutment is keyed to fit
into these projections.
-idea is to prevent rotation
and loosening.
 Prosthetic Advantages
-more stable than any others.
-stable in terms of anti-
rotation, but not in terms of
lateral forces.
 Prosthetic Disadvantages
-Spines can fracture and
lateral forces can be a
problem.
 force direction & its
influence
 Bone is weaker when
loaded under an angle
force.
 Greater is the angle of
load , the greater the
stresses to the implant-
bone interface.
 Ideally, implant body long
axis should be
perpendicular to the curve
of Wilson & curve of spee
to apply a long axis load to
the implant.
 Force type & its
influence
 Bone is strongest when loaded in
compression, 30% weaker when
subjected to tensile forces, & 65%
weaker when loaded in shear.
 Like bone implant Materials are also
strongest under compressive loads &
weakest to shear loads.
 Implants should be designed so to
convert occlusal loads into more
favorable compressive loads & reduce
shear load when possible.
Science behind threads of
implant
Implant body design with threaded
features have the ability to convert
occlusal loads into more favorable
compressive loads at the bone interface.
 Four basic thread shapes
V- shaped Reverse
buttress
thread

Buttress thread Square

thread
 In conventional engineering
applications…
 Called as fixture
 Used for fixturing
metal parts
together – not load
transfer.
 In conventional engineering
applications…
 Power thread
 Optimized for pull
out loads.
 It provides an
optimized surface
area for intrusive,
compressive load
transmission.
When a long axis
load is delivered to
the implant crown,
shear component
per unit length is
same, but the face
angle modify the
occlusal axial load
 e shear component on a v – shaped face is
pprox. 10 times greater than on Square threa
 significance
Reduction in shear loading at the square
thread to bone interface provides for
more compressive load transfer,
important in compromised D3 & D4 bone.
 Functional vs. theoretical
surface area
 Surface area is inversely proportional to
stress in implant system.
 As bone is 65% weaker to shear forces &
35% weaker to tensile forces , functional
surface area is defined as the area that
actively serves to dissipate compressive loads
to the implant bone interface.
 Functional thread surface area , is that
portion of the thread that participates in
compressive load transmission under occlusal
load .
 Functional vs. theoretical
surface area
 Total surface area includes
functional & passive area
 Passive area does not participates in
load transferor has features so small
bone cant adapt to load transfer.
 Functional vs. theoretical
surface area
 Plasma spray coating
reported to provide up to
600% more total surface
area for the potential bone –
implant contact . But the
size of each plasma spray
particle < 8 m and the
120 m bone cell does not
receive a transfer of
mechanical stress from this
feature . The amount of
actual bone- implant
contact that can be used for
compressive loading may be
<30% of total theoretical
surface area.
 significance
 Most stress to the implant bone
interface in D1 to D3 bone is in the
Crestal 5-9mm of implant. So design of
the implant body in coronal 9mm is most
important to appropriately distribute
occlusal stresses to the bone.
 Functional surface area requirements
increase from a minimum for an implant
in D1 bone to maximum for D4 bone.
 Threads designed to maximize enhance
suface area & facilitate dissipation of
loads at the bone – implant interface.
 Functional suface area per unit length
depends on thread pitch, thread shape,
thread depth
 Thread pitch
Distance between adjacent
threads.
Thread pitch
 Height of threaded
portion of the implant
body / pitch
= threads per unit
length
 The Smaller or finer

the pitch , the more

threads on the implant
body for a given unit
length & greater
surface area
 significance
 Implant pitch
should be smaller
when occlusal
load greater than
usual.
 The Greater
thread number –
higher BIC
 Thread depth
 It is the distance
between the major &
minor diameter of
thread.
 Tapered implant has
similar minor
diameter , but the
outer diameter
decreases in relation
to taper, thread depth
decreases toward the
apical region
 Thread depth
 A straight minor diameter , results in
uniform cross-sectional area throughout
the implant length.
 Non uniform stress transfer throughout
the length of the implant - high
contiguous bone strain in Crestal region
 Nonuniform bone contact along the
implant length – nonuniform stress
distribution – maladaptive bone
remodeling – Crestal bone loss
 Thread depth
 Significance
 An implant with fewer threads &
less deep threads makes them ease
for surgical insertion, but it leads to
less functional surface area ,
increase the risk of occlusal overload
to the bone-implant interface.
 Crest module
 It is the 0.5mm
machined
transosteal region collar
of an implant
body & often
incorporates the
antirotation
components of
the abutment-
implant
connection.
 Crest module
 Determinant of overall
implant body design

It has
 – surgical influence

 - a biological width

influence
 A loading profile

consideration
 Prosthetic influence
 surgical influence
 During surgical phase the crest module design
benefits the Crestal- implant interface.
 Crest module should be slightly larger than
the outer thread diameter of the implant body,
so can completely seal the osteotomy,
providing a barrier & deterrent for ingress of
bacteria or fibrous tissue during initial healing
 The seal also provides greater initial stability
of implant following placement, especially in
softer unprepared bone, bcz it compress the
Crestal bone region
 a biological width
influence
 Smooth collar reduce
plaque accumulation &
improve hygiene.
 But there is increased
bone loss risk when
smooth metal is placed
below the bone. is
directly related to its
length
A 0.5 mm collar length may provide for a desirable smooth surface
close to the pergingival area , while preserving the biomechanical
performance of the remaining portion of the crest module.
 loading profile
consideration
 Stresses are
highest in Crestal
region, so,
greater surface
area decreases
stress to the bone
& increases
strength of the
implant body.
 loading profile
consideration
 A smooth parallel
sided crest module
will increase the risk
of bone loss after
loading. Bcz.
 Smooth metal
promotes shear
stress in the adjacent
bone interface
 Bone cell contact is
less
 Magnitude of Crestal
bone loss is directly
related to the distance
between crest module &
the 1st thread distance.
 Bone loss stops at the
1st thread bcz the 1st
thread changes the
shear load created by
smooth crest module to
a component of
compressive loading.
 Prosthetic influence
 Prosthetic features of crest
module affect the implant
design.
 Eg: threads progress more

crestally with external hex than

external hex
internal hex.
Greater smooth metal & shear
forces are observed above the
1st implant body thread in
internal hex compared with
implant of external hex
internal hex
 Apical design
consideration
 Apical portion
mostly tapered
 Easy surgical
placement
 Patient does not
need to open the
mouth wide,
beneficial in
posterior regions
of dentate patients.
 Apical design
consideration
 Circular in cross section
 Antirotational feature
- Hole
- Vent
- flat sides or
grooves
 incorporated into the
implant body or apical
region to prevent
rotation or torsion.
 Antirotational feature

Advantages:
 Hole or vent increase the surface area available to
transmit the compressive loads to the bone
 Grooves enhance the self-tapping aspect of implant
design
 The recess area of the apical portion allow bone
fillings from the cutting threads to fill the area.
Otherwise, these bone cheaps may fall to the apical
floor & prevent the implant from complete seating or
compress into the trabecular bone & contribute to a
pressure or resistanceto rotational insertion.
 The recess area may be designed to decrease the
angle of the cutting thread - less torque is required
to thread the implant.
 Antirotational feature

disadvantages:
 When the implant is placed through the

sinus floor or becomes exposed through a

cortical plate , apical hole may fill with
mucous & become a source of retrograde
contamination or likely fill with fibrous tissue
 Region filled with fibrous tissue decreases

bony contact
 Implant body size & design
related to fracture
 The ability of implants
& components to resist
fracture from bending
loads is directly related
to component’s
moment of inertia.
 # resistance / moment
of inertia of solid
cylinder α
the fourth power of
radius
 # resistance of
Annulus (hollow)
cylinder α (outer
diameter radius ) 4 –
(inner diameter radius )
4
4
 significance
 Resistance to fatigue
# controlled by wall
thickness of implant
 An increase in outer
diameter has a more
significant effect on
body wall strength ,
even though metal
thickness same in two
scenarios.
 Space around abutment screw
increase risk of # at that location
 External hex implant has space
above the implant body, so, high risk
of # within the abutment
 Internal hex has space within the
implant body so, high risk of # at the
crest module of implant.
 Finally….
A favorable implant design may
compensate for risk for occlusal
loads in excess of normal, poor bone
densities, less than ideal implant
position or number, or less than an
ideal implant size.
Thank you