Dental implants have experienced in the last 20 years significant changes. They have been designed to cover certain needs and properties, varying in several aspects, such as: shape, place of anchorage (inside the bone or on the bone, composition, coating, etc.
Oral implants in general can be catalogued within three main groups.
1. Endosseous implants.
2. Subperiosteal implants.
3. Transosseous implants.
Endosseous implants, are the ones surgically inserted into jaw bone.
Subperiosteal implants, are typically placed on mandibular bone but under gum tissue. Do not penetrate bone. Transosseous implants, are similar in its definition to endosseous implants, but they totally penetrate jaw and emerge from the opposite site in the lower part of the chin.
Nowadays, The most used implants are Endosseous implants, and they have several subcategories based on their shape, function, surgical placement and surface treatment.
Subperiosteal Implants
These implants are not anchored into bone like endosseous ones, they are shaped to be mounted over residual bone ridge as well in the upper and low mandible. They are not considered as osseointegrated implants. These implants are used in total or partial edentulous patients.
Subperiosteal mandibular implant
Transosseous implants
These implants are not used anymore due to they need an extra oral surgery to be placed, that is, general anesthesia, hospitalization and greater costs.
These implants are only placed in the jaw and fixed in the low ridge of the chin by bone plates. Originally, they were designed to have a safe implant system even for lower mandible with much resorption.
Transosseous implants also can be catalogue within endosseous implants, nevertheless, most of the doctors prefer to use one of the implant modalities mentioned before instead of a transosseous system.
Ramusframe implants
These implants belong to the endosseous implants category and they are only designed for lower mandible totally edentulous and they are surgically inserted into the mandibular bone.
Generally, they are placed with severe bone resorption which does not offer enough bone height to place root shaped implants.
An advantage of tripoidal stabilization in the lower jaw, once it is integrated, it also stabilized and protect the jaw from any fracture.
Once it is inserted, a bar is visible from one side of the jaw where the denture is placed.
Ramusframe implant
Blade form Implants.
These implants are almost not used, they are considered into endosseous implants category, they are used in areas where residual bone ridge is too thin due to resorption. Nowadays, if the bone area is too thin, it is recommended to perform a bone graft procedure.
Blade implant
Root shaped implants
Since introduction of Osseointegration concept and titanium screw by Dr. Branemark, these implants have become to be the most popular in today’s world. There are catalogue as endosseous implants and they are presented in a variety of shapes, sizes and materials manufactured by many worldwide companies. Many doctors consider them as those of grater success in oral Implantology.
These implants can be placed, as well in one or several lost teeth, when there is enough available bone, in the opposite case, a bone graft procedure is performed to be capable of being benefited with these implant types. They have been tested and presented in different materials composition including, Aluminium oxide, Vitallium, titanium Commercially pure (CP), titanium alloys and even in Sapphire. Nowadays the most accepted Dental implant material is Titanium in high degree or CP titanium or an alloy from this one.
Some implants have an outer hydroxiapathite layer (HA), at first it was demonstrated they were integrated faster in some way, although after a period of time the HA surface came off the bone and for that reason, they failed.
Implants nowadays used have an altered surface by mean of titanium plasma spray (TPS), which they have great success in long term as well as dual acid etched surface, obtaining greater contact strength of implant to bone and allows the prosthesis placement, because osseointegration time is reduced (implant to bone attached)
The micro topography of the OSSEOTITE® implant, combined with a discreet deposit of nanometric scale calcium phosphate crystals (CaP), creates a more complex surface topography. This causes NanoTite implant to have a surface attached to bone by the interweaving of cement line matrix bone of the new formations with the implant surface.
