General considerations of implant surgery Körmöczi Kinga
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1 General considerations of implant surgery Körmöczi Kinga Semmelweis University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery
2 The planning of implant rehabilitations happens with the priority of the prosthetic aspects, but in close harmony with the surgical ones.
3 Treatment plan in implantology (backward planning) Protetical planning: - Type of toothless - Type of the prothesis - The protetical possibility for transfer the force optimaly Sugical planning: - Place of implants - Number - Size, shape - Date of implantation
4 Model analysis before the surgery 4.0mm 7.0mm
5 The ideal mesio-distal position of implants
6 The ideal positioning of implants
7 Fabrication of X-ray, surgical template
8 Clinical aspects: Implant placement Sterility Speed of drilling Cooling Surgical technique
9 Clinical aspects: Implant placement Sterility Speed of drilling Cooling Surgical technique 800 rpm 600 rpm 500 rpm 400 rpm 300 rpm
10 Clinical aspects: Implant placement Sterility Speed of drilling Cooling Surgical technique 800 rpm 600 rpm 500 rpm Report of bone cells death at temperature 40 C /Eriksson AR.,Albrektsson J.: J.Prosth.Dent. 50:101,1983/ 400 rpm 300 rpm
11 Surgical unit for implant placement: Adjustable speed and torque control Integrated cooling system Surgical hand-piece with cooling
12 Clinical aspects: Implant placement Sterility Speed of drilling Cooling Surgical technique Outer, 5 C sterile NaCl solution
13 Clinical aspects: Implant placement Sterility Speed of drilling Cooling Surgical technique Intermittent drilling
14 Surgical steps of implant placement Flap design Marking drill Pilot drill Control measurements Widening drill Countersinking Thread cutting Implant placement
15 Various flap designs
16 The flapless surgery can be predictable and safe at ideal anatomic conditions and proper diagnostic evaluations. /Campelo L.D., Dominguez Camara J. R., Int. J. Oral Maxillofac. Impl. 2002; 17: /
17 Flapless implant placement /Straumann ///
18 Surgical steps of implant Flap design placement Marking drill rpm Pilot drill Control measurements Widening drill Countersinking Thread cutting Implant placement
19 Marking drill 2.3mm 3.1mm 4.2mm
20 Surgical steps of implant placement Flap design Marking drill Pilot drill rpm Control measurements Widening drill Countersinking Thread cutting Implant placement
21 Pilot drill /Ø 2.2 mm/ 4.2mm 2.2mm
22 Surgical steps of implant placement Flap design Marking drill Pilot drill Control measurements Widening drill Countersinking Thread cutting Implant placement
23 Controls Depth gauge Drill guide Parallel gauge
24 Controls Depth gauge Drill guide Parallel gauge
25 Controls Depth gauge Bur guide Parallel gauge
26 Surgical steps of implant placement Flap design Marking drill Pilot drill Control measurements Widening drill rpm Countersinking Thread cutting Implant placement
27 Widening drill / 2.8 mm/ 4.2mm 2.8mm
28 Surgical bone condensation with Osteotom
29 The technique of bone condensation with Osteotom
30 Surgical steps of implant placement Flap design Marking drill Pilot drill Control measurements Widening drill Countersinking /case dependent/ Thread cutting Implant placement 300 rpm
31 Geometry of the profile drill Funnel-shaped neck of the Implant Drill
32 Countersinking, with profile drill 4.2mm 4.2mm 2.8mm 2.8mm
33 Surgical steps of implant Flap design Marking drill Pilot drill placement Control measurements Widening drill Countersinking Thread cutting /case dependent/ Implant placement 25 rpm
34 Thread cutting Depends on the bone quality and the implant design
35 Surgical steps of implant Flap design Marking drill Pilot drill placement Control measurements Widening drill Countersinking Thread cutting Implant placement
36 Implant placement I.
37 Implant placement II.
38 Implant placement III.
39 Placement of cover- screw and suturing
40 Healed implant before second surgery
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