Dental Implants for Hygienists and Therapists

Ulpee R. Darbar

• Publisher: Wiley-Blackwell
• Year: 2022
• Print ISBN:
  9781119763826
• eBook ISBN:
  9781119763840
• Edition: 1
• Topic: Medicine
• Subtopic: Dentistry

An essential handbook for dental hygienists and therapists seeking a comprehensive resource covering dental implants

Dental Implants for Hygienists and Therapists delivers an accessible and informative exploration of the fundamental principles of tooth replacement with dental implants, as well as the science and theory that underlies modern implants, and the factors impacting their success and survival. The book offers robust guidance on the assessment of peri-implant tissues in health and in disease, an evidence-based approach to their management, and instruction on when a referral should be made. It also covers function and anatomy in health and disease around dental implants and the supporting tissues as well as the factors that influence predictability and patient management. This book includes:

• Thorough introductions to the history of dental implants and osseointegration, including the difference between success and survival
• Comprehensive exploration of one-piece and two-piece implant systems, patient selection and indications for implant treatment
• Practical discussions of surgical (including augmentation) and prosthodontic protocols and peri-implant tissues
• In-depth examinations of maintenance care, including the management of peri-implant disease with non-surgical and surgical treatment, and the role of the hygienist

Dental Implants for Hygienists and Therapists is invaluable to dental hygienists and therapists seeking a one-stop resource on dental implantology.

1
History of Dental Implants

The concept of dental implants dates as far back as 2000 BC when carved bamboo pegs were originally used to replace missing teeth. A dental implant is a prosthetic device made of alloplastic material implanted either into the oral tissues beneath the mucosal and/or the periosteal layer and/or within the bone to provide retention and support for a fixed or removable prosthesis. When inserted into the bone, the implants are called endo-osseous implants.

Around 3000 years ago, Egyptians used metal pegs to replace teeth, and it was not until the 1930s the concept of modern implantology came into existence with progressive development of methods used to replace missing teeth (Table 1.1). The materials from which dental implants are made should be biocompatible, corrosion resistant, and encourage bone ingrowth and biofunctionality.

Table 1.1 Progressive Development of Methods used for Tooth Replacement.

500–2500 BC	300–600 AD	800 AD	1500–1800s	1809	1913
– Egyptians tried splinting teeth using gold ligature wires – Eustracians used customised soldered gold bands from animals and oxen bone	– Phoenicians used Ivory to carve teeth used as bridge replacements – Mayans introduced the concept of implants when they tried to use ‘Pieces of Shells’ as implants to replace mandibular teeth; Radiographs taken in the 1970s of such mandibles show compact bone formation around the implants (bone similar to that around blade implants)	Hondurans used a stone implant and placed this in the mandible	Europeans used cadaver teeth for allotransplantation	J Maggiolo inserted a gold implant tube into a fresh extraction socket and after healing a crown was added; other materials used were silver capsules, corrugated porcelain	Dr Greenfield placed a ‘24-gauge hollow latticed cylinder of iridio-platinum soldered with 24-karat gold’ as an artificial root to ‘fit exactly the circular incision made for it in the jawbone of the patient’

During 1939–60s the concept of the ‘in the bone’ (endosteal) implant arose with the first cylindrical endo-osseous solid screw implant with threads both internally and externally with a smooth gingival collar and healing cap being placed. Following this during the 1940s, a spiral stainless steel post type endosseous implant with a design that allowed bone to grow into the implant emerged and Dahl in Germany, around the same time, introduced the concept of the subperiosteal implant with mucosal inserts (Figure 1.1). This implant was made of cobalt-chromium molybedenum with a direct impression of the struts on the ridge crest taken to construct the denture. Throughout the 1940s–50s variations on the original Dahl design emerged in an attempt to make the provision of implants simpler and included the use of vitallium implants in 1948, the Linkow endo-osseous blade vent implant in 1966 with different designs for the maxilla and mandible (Figure 1.2), the ramus frame implant in 1970, made of stainless steel (Figure 1.3) and mandibular transossteal implant which engaged the lower border of the mandible with inserts projecting into the mouth to support a prosthesis (Figure 1.4). The ramus frame and tranossteal implants were predominantly designed for patients with atrophic mandibles who had difficulties wearing dentures and were used to aide denture retention to improve function.

Figure 1.1 Subperiosteal implants in the mouth.

Figure 1.2 Blade vent implants.

Figure 1.3 Ramus implants.

Figure 1.4 Mandibular tranossteal implant.

The key challenge with these older implant systems was biocompatibility, the lack of fusion to the jawbone resulting in recurring infections after a period of time and the complex surgical techniques needed to insert the implants leading to limited use aimed at specific patient groups. Additionally, the infections led to secondary issues with bone resorption compounding the existing issues.

In the 1950s, an orthopaedic surgeon, Per Ingvar Branemark, accidentally found, during the study of bone healing and regeneration, that a titanium cylinder fused...

Table of contents

• Cover
• Title page
• Copyright
• Table of Contents
• Glossary
• 1 History of Dental Implants
• 2 Osseointegration
• 3 Implant Systems
• 4 Patient Selection and Indications for Treatment
• 5 Surgical and Prosthodontic Protocols
• 6 Peri-Implant Tissues
• 7 Maintenance Care around Dental Implants
• 8 Role of the Hygienists/Therapists
• Index
• End User License Agreement