Macro And Micro Design of Threaded Root-Form

Dental Implants

Dr. Noha Taha Kamel Taha Alloush

Lecturer in
Removable Prosthodontics Division
MIU
 ‫كلية طب الفم واألسنان‬

‫رؤية الكلية‬

‫تتطلع الكلية أن تكون في مصاف المؤسسات التعليمية المعترف بها إقليمياً وعالمياً من خالل برامج تعليمية متطورة وأبحاث تطبيقية مبتكرة وتنمية مجتمعية‬
.‫مستدامة‬

The Faculty aspires to be a recognized educational institution, regionally and internationally, by providing advanced educational programs,
innovative applied research, and sustainable community development.
‫رسالة الكلية‬

‫ ذو كفاءة معرفية وتطبيقية من خالل برامج تعليمية متطورة تتوافق مع االحتياجات الفعلية لسوق العمل‬،‫إعداد طبيب أسنان ملتزم بالقيم االنسانية واألخالق المهنية‬
.‫ كما تلتزم الكلية بإعداد بحوث تطبيقية متوافقة مع االستراتيجيات القومية وكذلك تقديم خدمة مجتمعية مستدامة وفقاً لمعايير الجودة العالمية‬.‫المحلي والعالمي‬

The mission is to prepare knowledgeable and well-trained dentists committed to human values and professional ethics, by developing advanced
educational programs that correspond to the actual needs of the local and global labor market. The Faculty is also committed to preparing
applied research in line with national strategies, as well as providing sustainable community service following international quality standards.
Student learning outcomes (SLOS)

1.Identify Features of Macro and Micro design of oral implants.

2.List different Macroscopic and microscopic design features.
3.Clarify the different components of micro and macro design of dental implants.
4.Recognize the different material used in dental implant construction and their properties.
5.identify different implant surface treatments.
6.Explain different material properties for material used for dental implant construction.
7.Distinguish different methods of surface treatment and micro design of dental implant.
Evolution Of Dental Implants Designs And
Protocols
 Implant Design Features
The dental implant by Branemark had a relatively
smooth surface with average roughness of about 0.5
to 1 micrometer.
The disadvantage of the shape of machined implants is
that bone-forming cells tend to proliferate along surface
grooves. This requires a longer healing time of three to six
months before loading.
 Implant Design Features
Increase the surface area (SA) of dental
implant

Increase bone implant contact (BIC)

Establishment of reliable Osseointegration

 Implant Design Features
Macroscopic design features: Microscopic design features:

Body Design Thread Geometry

Implant Material Surface Morphology

Macro Design of Root Form Implants
Macroscopic design features:

Body Design Thread Geometry

Root form implant structure can be segmented into 3
main zones:
I. Implant neck (crest module)
II. Implant body
III. Implant Apex

Neck Body Apex

 I. Neck design
• It was proposed that bone-retention elements such as
microthreads and rough surface at the implant neck might help
stabilize the marginal bone (Hansson 1999). This would help
decrease early bone loss

Smooth Rough Micro thread

II. Implant body
a. Taper
• Straight (cylindrical implants) have the same
diameter from neck to apex) while tapered
(conical implants have narrower diameter at the
apex)
• There are many forms of tapers supplied by
manufacturers

Straight Tapered
The clinical benefits of using tapered rather than non- tapered implants under different
clinical circumstances focus on enhanced “primary stability.”

The tapered body design allows for gradual bone densification (and / or expansion)
which improve primary stability

Final drills
II. Implant body
b. Thread Design
• There are 4 common thread designs namely:

A. V-shaped,
B. Buttress,
C. Reverse buttress,
D. Squared.
V-shaped threads allows easier bone cutting during implant insertion, but it is 10
times than the square in shear stresses.
Squared threads theoretically would transfer the most favorable stress transfer
pattern at the bone thread interface, but cutting screw efficiency is less.

Reverse buttress design allows for combining both benefits of easy cutting
and favorable stress transfer
II. Implant body
c. Thread Depth

• Refers to the distance from the thread tip to

the solid implant body
 c. Thread Depth

• Deep threads are suitable for soft bone where

the thread cuts into the bone to improve
primary stability

•For dense bone, such cutting is not possible

and shallower threads are advised to avoid
over compression during implant insertion

•Progressive thread designs are optimum in

cases with dense coronal cortex and soft
medullary bone Shallow Deep Progressive
II. Implant body
d. Pitch distance

•It the distance between the peak of two successive threads

•Large pitch allow faster insertion

• Small pitch have larger surface area

BIC--osseointeg

Significance
????
III. Implant Apex
Tip design
• The apex may have cutting or no cutting end

• Cutting tips allow easier insertion but can easily

perforate through critical structure

• Blunt end are safer and can be used in cases of

closed sinus lift
III. Implant Apex
Grooves and vent

•Range from vertical grooves to apical

holes

• Apical features claimed to provide

better initial anchorage by locking
bone around the implants (Anti
rotational lock)
 Implant Design Features
Macroscopic design features: Microscopic design features:

Body Design Thread Geometry

Implant Material Surface Morphology

Dental Implant Materials
 Implant materials
Requirements of the biomaterial to be used:
• Biologically compatible.
• Mechanically compatible.
 1. Titanium
•Titanium was first
discovered by the
Reverend William
Gregor in 1790 who
was a clergyman and
amateur mineralogist
 Why titanium????
1. High strength to weight
ratio
2. Low density
3. High corrosion
resistance
4. Biocompatible (non-
toxic and it is not
rejected by the body)
 Drawbacks of titanium

• Titanium allergy: A possible association

between surface corrosion of titanium, on
one hand, and hypersensitivity reactions,
on the other hand.
 2. Zirconium
• Ceramics, particularly the yttrium-stabilized tetragonal
polycrystalline zirconia (Y-TZP), exhibit improved mechanical
properties that make them suitable substrates for the fabrication
of dental implants
 3. PEEK
• Polyether ether ketone. Initially
introduced as high performance polymer
for hip and knee replacement

•It is bioinert and exhibit elastic modulus

close to that of bone

•The major challenge is the poor

wettability
 Implant Design Features
Macroscopic design features: Microscopic design features:

Body Design Thread Geometry

Implant Material Surface Morphology

Implant Surface Treatment
 Machined (Turned) Implant surface

• The original osseointegrated implants had a

moderately smooth machined surface

•The disadvantage of the shape of machined

implants is that bone-forming cells tend to
proliferate along surface grooves. This requires
a longer healing time of three to six months
before loading.
 WHY surface treatment??

A. Increase the surface energy of the implant

Enhancing wettability with blood

B. Increase the surface area (SA) of dental implant
By Roughness

Increase bone implant contact (BIC)

Establishment of reliable Osseointegration

 Surface morphology
A. Subtractive surface treatment. B. Additive surface treatment.
1. Sand blasting. 1. TPS. roughness-SA

2. Acid etching. 2. Hydroxyapatite-coating.

chemical bond with bone/CaPO4 bardo
3. Sandblasted/acid etched 3. Electro-chemical treatment
surface (SLA)
4. Laser treatment
A. Subtractive surface treatment.
1.Sandblasting (RBM)

•It works on the concept of bombarding

the surface with high velocity hard
particles of various sizes, with help of
compressed air.

• Different ceramic particles have been

used, like glass, silica, alumina and
titanium oxide particles.
A. Subtractive surface treatment.

2. Acid etching
• Etching with strong acids like a mixture of
hydrochloric acid and sulfuric acid to
roughen implants made of titanium.
• Other acids as hydrofluoric and nitric acids
can be used
•The process of treatment with an acid
provides for equal roughness, an active
surface area and better adhesion.
A. Subtractive surface treatment.

3. Sandblasted/acid etched surface (SLA)

• One on the most popular implant surfaces
• The surface is sandblasted with light grit
blasting particles
• The surface is then treated with acids to
remove the blasting particles and improve
surface activity
A. Subtractive surface treatment.
4. Laser treatment (PDL)
• Precision dimension laser techniques aims to create even roughness
and activate the surface for wetting using excimer laser beam
• This method is thought to increase the speed of bone formation
around implants.
 Surface morphology
A. Subtractive surface treatment. B. Additive surface treatment.
1. Sand blasting. 1. TPS.
2. Acid etching. 2. Hydroxyapatite-coating.
3. Sandblasted/acid etched 3. Electro-chemical treatment
surface (SLA)
4. Laser treatment
B. Additive surface treatment.

1. Titanium Plasma spraying: activating the

surface by surface bombardment with ionized
titanium (hot plasma).
B. Additive surface treatment.

2. Hydoxy apatite coating: Bioactive materials “Calcium

Phosphate” Coatings on Dental Implants, The hydroxyapatite
(HA) ceramic particles are injected into a plasma torch at high
temperature
B. Additive surface treatment.

3. Electro-chemical treatment:
Electrodeposited of Calcium-Phosphates Coatings on implant
surface, The mechanical stability of the Ca–P coating requires a
rough titanium surface to ensure the mechanical stability of the
coating.
 WHY surface treatment??

A. Increase the surface energy of the implant

Enhancing wettability with blood

B. Increase the surface area (SA) of dental implant
By Roughness

Increase bone implant contact (BIC)

Establishment of reliable Osseointegration

Take home message
• Root form endosseous implant are the mainly used implant
types. still some other forms has limited use is special
clinical indications
• Implant design criteria as implant taper, thread design and
depth must be taken into consideration for the different
cases. No single design suits all patients
• Machined implants are obsolete. All available implants are
surface treated to improve BIC ratio and accelerate bone
healing