Hands On

Tapered implant essentials

Background

Specific factors contribute to the success and durability of dental implants. The four main factors that create stability in implants are implant design, surface, surgical technique, and bone quality of the recipient site. The way these factors relate to one another defines the initial stability and influences the lifespan of these interventions. Parameters that can influence the success of tapered implants, which have been shown to be the most successful design, include drill protocol, thread

Drilling Protocol

Low levels of compressive stresses after the implant is placed and micromotion is reduced are facilitated by proper implant selection and surgical drilling technique. The relationship between implant shape and bone also must be considered. High insertion torque may reduce destructive micromotion but does not always lead to stability.

Surgical instrumentation and implant design may produce high levels of contact between implant and bone directly after placement, which will reduce micromovement.

Thread Design

The biomechanical design of implants can be optimized to improve implant osseointegration. This principle applies to all types of implant designs. Thread shape is determined by thread thickness and thread face angle and includes V-shaped, square shape, buttress, and reverse buttress types. Thread shape defines the angle between a thread face and a pleat threading perpendicular to the implant’s long axis.

Thread pitch refers to the distance between thread centers as measured parallel to the screw

Surface Modification

In the early stages of bone healing around endosseous implants, changes to the macrogeometry and/or surgical instrumental and/or surface modifications can alter the process whether tapered or other implant designs are used. Ideally, the surface should enhance bone healing, which explains the use of blasting and acid etching. Roughening procedures not only create an uneven surface but also result in surface chemistry alterations. This alters the rate of osseointegration of implants and

Implant Shape

With bone of poor quality, it is essential that the implant be carefully selected to optimize the chance for stability. A tapered-screw implant design provides stability by creating pressure on cortical bone where bone quality is reduced. The interaction of factors such as load magnitude, load direction, loading rates, loading frequency, bone quality, bone quantity, and ability of cells to respond determines unfavorable loading conditions and bone response. Tapered screw-type implants