EAS Journal of Dentistry and Oral Medicine

Abbreviated key title: EAS J Dent Oral Med

ISSN: 2663-1849 (Print) ISSN: 2663-7324 (Online)
Published By East African Scholars Publisher, Kenya
Volume-1 | Issue-3| May-Jun-2019 |

Review Article

Current Trends in Implant Dentistry: A Review

Dr. Ambuj chandna1, Dr. Mansi Mehta2, Tanvi Kalra3, Abu Nedal4, Praful Das Gupta5
1Sr.Lecturer D J Dental College, Ajit Mahal, Modinagar - Niwari Rd, Modinagar, Uttar Pradesh, India
2Private Practitioner, India
3Se. Lecturer D J Dental College, Ajit Mahal, Modinagar - Niwari Rd, Modinagar, Uttar Pradesh, India
4Private Practitioner
5Private Practitioner

*Corresponding Author
Dr. Ambuj chandna

Abstract: Tooth loss is a very common problem; therefore, the use of dental implants is also a common practice.
Although research on dental implant designs, materials and techniques has increased in the past few years and is
expected to expand in the future, there is still a lot of scope involved in the use of better biomaterials, implant design,
surface modification of surfaces to improve the long-term outcomes of the treatment. This paper describes the types of
implants that have been developed, and the parameters that are presently used in the design of dental implants. It also
describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis
and design of the implants and future trends.
Keywords: Dental implants, Design, Surfaces, Osseointegration.

INTRODUCTION deposition techniques, Sol-gel and dip coating methods,

Tooth loss is very common and it can be due to hot isostatic pressing, Electrolytic process.
disease or trauma; therefore, dental implants are widely
used to provide replacement of missing teeth has a long Carbon and Polymeric Implant Surfaces
and multifaceted history. Carbon compounds are often classified as
ceramics because of their chemical inertness and
Progress in implantology has been focused at absence of ductility
increasing patient's comfort by reducing the treatment
time and achieving esthetic and functional rehabilitation Advantages:
as early as possible. Research on dental implant (i) Tissue attachment
designs, materials and techniques have increased in the (ii) Can be used in the regions that serve as barrier to
past few years and is expected to expand in the future elemental transfer of heat and electrical current
due to the rising in the demand for cosmetic dentistry flow
and high expectations by the patients. (iii) Control of color and provide opportunities for the
attachment of active biomolecule or synthetic
ADVANCES IN IMPLANT MATERIALS compounds.
Ceramics implant material1
The ceramic coating available includes the Limitations:
bioactive type, such as the calcium phosphates and inert  Mechanical strength properties are relatively poor.
type ceramics, such as aluminum oxide and zirconium  Biodegradation that could adversely influence
oxide. The bioactive ceramics include the bioglasses, tissue stability.
have been documented to produce a calcium phosphate  Time dependent changes in physical
layer on the unmodified surface when used in vivo or in characteristics.
a simulated physiological solution. Various types of  Minimal resistance to scratching or scraping
methods of coatings are: Plasma spraying, Vacuum procedures associated with oral hygiene.
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Creative Commons Attribution license which
Article History permits unrestricted use, distribution, and
Received: 15.04.2019 reproduction in any medium for non
Accepted: 30.05.2019 commercial use (NonCommercial, or CC-BY-
Published: 18.06.2019 NC) provided the original author and source
are credited.

Published By East African Scholars Publisher, Kenya 49

Ambuj chandna.T et al., EAS J Dent Oral Med; Vol-1, Iss-3 (May-Jun, 2019): 49-53
Bioactive Glass Ceramics1
Bioglass (US: Biomaterials) is composed of The major strength of HA is a chemical
calcium salts and phosphates in similar proportions composition, which fools living bone tissue behaving as
found in bone and teeth. This graft is amorphous if the HA implant were natural autogenous bone.
material, hence its developers believed that degradation
of the material by tissue fluids and subsequent loss of Hydroxyapatite-Tricalcium Phosphate bioceramics3
the crystal would cause the material to lose its integrity. The two calcium phosphate systems that have
been most investigated as bone implant material are HA
The Graft Has Two Properties: and tricalcium phosphate.TCP system became eclipsed
 Relative quick rate of reaction with host cells by a succession of commercially introduced HA
 Ability to bond with collagen found in connective containing implantable products. HA, commonly called
tissue. It has been reported that the high degree of tribasic calcium phosphates, is a geologic mineral that
bioactivity induces osteogenesis. Since the closely resembles the natural vertebrate bone tissue.
bioactivity index is high, reaction develops within These materials must not be confused with tricalcium
minutes of implantation. phosphate (TCP), which is chemically similar to HA
but it is not a natural bone material.
Zirconia Dental Implants2
The zirconium dioxide is a hot isostatic ADVANCES IN FORMS, SHAPE, AND SURFACE
pressed, high-strength ceramic material with a flexural TOPOGRAPHY
strength of 1,250 MPa which makes the implant Mini‑implants4
suitable for interdental spaces and for single tooth Mini‑dental implant (MDI) is in fact a trade
replacement. name for the most widely used small diameter implant,
the 3M ESPE MDI. Some small diameter implants are
New tooth-colored implants are made from used as anchors in orthodontic cases and are called
zirconium dioxide, for esthetic restorations. It does not temporary anchorage devices.
cause any allergic reactions and hence fulfills the wish
of particularly sensitized patients for full A single minimally invasive surgery is needed
biocompatibility. Moreover plaque accumulation is also for insertion of MDI. Immediate loading can be done
excluded; this way hygiene and durability of the due to their self‑tapping design.
implant restoration are ensured. Due to the absence of
the free electron, zirconium oxide ceramics are electric Fixed crowns or bridges can be cemented
insulators and hence entirely free from characteristics directly to the square or cubic head of the mini
found in metals. Consequently, it does not conduct heat implants. Anatomic locations, bone quality, esthetic
and can be ground in the mouth and the risk of considerations, and protective occlusal schemes are
osteonecrosis is avoided. Besides, the white color keys to ensure successful treatment outcomes
renders it the ideal material for aesthetic tooth and
implant reconstructions. Transitional implants5
Transitional implants are narrow diameter
Advantages: implants that were developed to support provisional
1. Utmost biocompatiblility fixed restorations during the phase of osseointegration
2. Very easy to clean of the definitive implants and are usually placed
3. Natural tooth shade simultaneously with definitive implants. They are
4. Ideal for allergy patients fabricated with pure titanium in a single body with
5. High strength treated surface. They are placed in a non-submerged
fashion in a single stage surgical procedure and are
Hydroxyapatite-Coated Metals3 designed to be immediately loaded. The primary
HA plasma coating process involves first function is to absorb masticatory stress during the
roughening the metal to be coated in order to increase healing phase, ensuring stress free maturation of bone
the surface area available for mechanical bonding with around the submerged implants and allowing them to
HA coating. Then a stream of HA powder is blown heal uneventfully.
through a very high temperature flame that partially
melts and ionizes the powder, which emerges from the The main rationale for use of transitional
flame, hits the metallic surface to be coated and implants is to provide retention, stability and support
condenses to form a ceramic coating that is partially for a fixed provisional prosthesis during the time
glossy and partially crystalline in nature. These coatings required for osseointegration of conventional implants.
are built up in thin layers using robotic techniques, until The other applications documented for transitional
the final thickness (usually 40-l00 μ) is achieved. implants are
 To provide a fixed provisional for protecting
The major shortcoming of HA ceramics is an osseous grafted site.
their lack of mechanical strength.

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 To provide a vertical stop for a fixed prosthetic Computed tomography8
reconstruction during the healing period. CT is a digital and mathematical imaging
technique that creates tomographic sections. With latest
 To provide stability to the surgical stent during CT scanners, images with sectional thickness of 0.25
implant placement. mm can be obtained. This is useful in determining the
implant site in terms of parameters like bone density,
 To eliminate need for a temporary tissue borne and location of adjacent anatomic structures.
restoration.
Recent Advances In Computed Tomography
 Act as an orthodontic anchor for quick and CBCT. Use of CBCT is becoming increasingly
effective movement of other teeth. popular and widespread among clinicians globally. It
provides details of anatomic landmarks and vital
 Transitional Implants Are Also Used To structures, such as neurovascular canals and bundles,
 Stabilize existent dentures. being at risk during implant placement.
 Replace congenitally missing maxillary
lateral incisors. It uses a cone beam and reconstructs the image
 Repair of broken bridges. in any direction using special software. It provides
advantage of CT diagnosing at one‑eighth of the
One‑piece implants6 radiation dose and at a much lower cost. The special
Abutment and implant body are in one piece software is used to display and visualize the anatomy in
and not separate; they are commercially available in 3 a clinically efficient manner.
mm diameter and 12, 15, and 18 mm length.
Microtomography9
They Have Unique Properties Such As: Micro‑CT allows a fully three‑dimensional
 Maximum strength – Minimum Profile. Since it is characterization of the bone structure around the
one‑piece, titanium alloy construction provides implant.and is non-destructive and fast modality, its
maximum strength. It allows placement in areas of high resolution enables visiualisation of individual
limited tooth‑to‑tooth spacing. trabeculae.

 Minimal surgery – Maximum Esthetics. Because Multi‑slice helical computed tomography10

one‑piece implants are placed using a single‑stage The rapid volumetric data acquisition offers
protocol, the soft tissue experiences less trauma higher accuracy of images as compared to CT.
than typical two‑stage protocols.
Dentascan10
ADVANCES IN DIAGNOSTIC IMAGING Dentascan imaging provides a programmed
Diagnostic imaging techniques are an essential reformation, organization and display of the imaging
tool in developing and implementing a comprehensive study. The cross‑sectional and panoramic images are
treatment plan. The exceptional imaging modalities that spaced 1 mm apart thus enabling accurate pre-prosthetic
exist today are employed to ascertain vital information treatment planning.
concerning both preoperative and postoperative phases.
Limitations Images require compensation for
The current trend in implant imaging is cone magnification as they may not be of true size.
beam computed tomography (CBCT), which provides
three‑dimensional images with axial, coronal, and Hard copy dentascan images includes only a
sagittal views and a stream of useful data with reduced limited range of the diagnostic gray scale of the study.
amounts of radiation to the patient.
Interactive computed tomography9
Advanced Imaging Techniques Includes:  This technique enables transfer of the images
Zonography 7 to a computer file. An important element of
A modification of the panoramic radiographic ICT is that the clinician and radiologist both
machine for making cross‑sectional images of the jaws. can perform ‘electronic surgery (ES).
The tomographic layer is ~5 mm. For better
appreciation of the spatial relationship between the  ICT enable the development of
critical structures and the implant site. three‑dimensional treatment plans.

Tomography8
It enables visualization of a section of patient’s
anatomy by blurring regions other than the site of
interest. For interest of dental implant a high‑quality
complex motion tomography is required.

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Computer-aided design and computer-aided greatly reduced by a flapless procedure no temporaries
manufacturing technology13 and no significant pain or swelling is seen. It allows
(CAD) and Computer-Aided Manufacturing replacing missing teeth with permanent dental implants
(CAM) have arrived in the form of commercial in an easy, quick, and comfortably manner.
software and hardware products for planning and
placing dental implants. Nanotechnology-based implants15
Nanotechnology approaches require novel
Three-dimensional imaging systems that can ways of manipulating matter in the atomic scale.
penetrate the body without damage are increasingly Currently, extensive research on techniques to produce
regarded as the modality of choice for detailed planning nanotechnology-based implants are being investigated.
in 3D prior to the surgical intervention itself. Nanotechnology-based trends for dental implants
consist on surface roughness modification at the
This newly emerging use of 3D data in nanoscale level to promote protein adsorption
planning and device manufacturing has provided the
profession-treatment modalities such as operative The possibilities introduced by
support devices (surgical templates) and subperiosteal nanotechnology now permit the tailoring of implant
implant manufacture. These new methods help chemistry and structure with an unprecedented degree
practitioners respond to an ever-increasing demand for of control. For the first time, tools are available that can
improved patient benefits. be used to manipulate the physicochemical environment
and monitor key cellular events at the molecular level.
Implants and abutment fabrication has and Thesenew tools and capabilities will result in faster
continues to undergo significant metamorphosis, and bone formation, reduced healing time, and rapid
since nowadays, complicated shape implants and recovery to function.
abutments are used, CAD/CAM techniques are being
implemented. CONCLUSION
With a long history of dental implantology and
The advantages of the technique are accuracy ever since modern dental implants were introduced
and less time required for manufacturing the parts. more than 40 years ago, the development of the ideal
implant has been a major research subject in the field,
ADVANCES IN IMPLANT DENTISTRY thereby changing the practice of implant dentistry.
All on four Through research, dental implant technology has been
The all on four system is used for edentulous constantly improving in the recent years, providing
jaws with minimum bone volume. It is developed to patients with unparalleled levels of effectiveness,
make the best use of available bone and to allow for convenience, and affordability.
immediate function using only four implants. The
system takes the benefits of tilting the posterior Several design parameters have been evaluated
implants to provide a secure and optimal prosthetic and many designs have also been tested. Although
support for a bridge that can be fabricated and can design and implantation requirements such as
function within just a few hours after surgery. biomaterials, biomechanical behavior, geometry of the
implant, medical condition of the patient, and bone
Zygoma implants14 quality have been defined, it is still necessary to further
Zygomatic implants are a good rehabilitation evaluate and understand the correlation of those
alternative for upper maxilla with severe bone variables in the long term success of the dental implant.
reabsorption. These implants reduce the need for onlay-
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