Oral Surgery | Implants | INBDE, ADAT

Ryan introduces the topic of dental implants, explaining their purpose to replace missing teeth. He discusses a schematic and a radiograph showing an implant in place. Contraindications for implant placement are listed, including uncontrolled diabetes, immunocompromised status, insufficient bone volume, bisphosphonate therapy, bruxism, smoking, history of head and neck radiation, cleft palate, and adolescent growth concerns. The video outlines three main categories of implants: subperiosteal, transosseous, and endosteal, with a focus on the root form endosteal implant.

The video breaks down the four primary components of endosteal implants: the implant body, abutment, abutment screw, and implant crown. The implant body is inserted into the bone, and its placement procedure is detailed, including the use of sequential drills to enlarge the osteotomy. Abutments are categorized into one-piece and two-piece, with the latter offering more flexibility and an anti-rotation component. The implant crown can be either screw-retained or cement-retained, each with its advantages and disadvantages.

The differences between one-piece and two-piece abutments are further explored, with emphasis on the benefits of the two-piece abutment, such as the ability to correct angulation post-implant surgery. The video also discusses the advantages and disadvantages of screw-retained and cement-retained crowns, including aesthetic considerations and the potential for peri-implantitis with cement-retained crowns.

The concept of osseointegration is introduced as a critical feature for titanium implants, providing a direct connection between the implant and bone. The importance of checking for osseointegration before placing the final abutment and crown is emphasized. Primary and secondary stability are defined, and a graph illustrates the transition from primary to secondary stability over time. The video also discusses the quality of bone and its impact on implant success, categorizing bone into four types based on density and location.

Guidelines for safe implant placement are provided, including minimum distances from various anatomical structures to avoid nerve damage and ensure proper healing. The importance of space between implants and adjacent teeth is highlighted, with specific measurements provided for different implant diameters. The video stresses the significance of these measurements for the board exam.

The video explains the difference between one-stage and two-stage implant surgeries, detailing the reasons for choosing a two-stage approach, such as poor primary stability, the need for a graft, or medically compromised patients. The impression process is described, including the use of impression copings to record the implant's position accurately. Open tray and closed tray impression techniques are discussed, each with its specific coping and process.

Socket preservation techniques are discussed to maintain the alveolar ridge's height and width after tooth extraction. The video outlines the steps for atraumatic extraction and the use of bone graft material and a resorbable collagen membrane. The concept of biologic width and the difference between a tooth and an implant in terms of periodontal ligament are explained. Surgical stents are introduced as a guided surgery tool. The video concludes with the characteristics of successful implants, including immobility, no radiopacity, minimal bone loss, and absence of symptoms, as well as factors that can lead to implant failure.

The video wraps up with a reminder of the importance of minimizing heat generation during implant surgery to avoid compromising osseointegration. The optimal temperature thresholds for drilling are provided, emphasizing the need for sharp drills, copious irrigation, and sequential drilling. The presenter thanks the viewers for their attention and interest in dental implants and encourages support for the channel.