Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
DENTISTRY
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Contents
Introduction
Implant Dentistry
Implant placement
Impressions
Implant prosthesis
Occlusion
Overdentures
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Implant Dentistry
• Implantology – A substance that is placed into the jaw to
support a crown or fixed or removable denture
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Implants
• Dental implant - An artificial titanium fixture which is
placed surgically into the jaw bone to substitute for a
missing tooth and its root(s).
Bone evaluation
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Diagnostic tools
• Periapical radiograph • Main goals of presurgical
• Occlusal radiograph imaging
• Orthopantomograph • Identify disease
• CBCT • Determine bone quality
• Cephalometric radiograph • Determine bone quantity
• Computed Tomography • Determine implant
(3D) position
• Magnetic resonance • Determine implant
imaging (3D) orientation
• Interactive computed
tomography (3D)
• Photographs/Study models
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Osseointegration
The phenomenon of
osseointegration of titanium
implants was discovered by the
Swedish surgeon, Branemark in
1952.
Two-stage Surgical
Protocol
Implant
placement
Single-stage Surgical
Protocol
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ACCURATE IMPRESSIONS
PROVIDE A FOUNDATION FOR
SUCCESSFUL IMPLANT
PROSTHODONTICS
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Impression materials
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Abutment
level
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3. Polyvinylsiloxane
1. Implant fixture 2.Copings attached to impression material is
the implant body injected around the
impression coping
4. Impression is made
5.Impression coping 6.Coping placed in
with a heavy body
removed from the the impression
impression material.
fixture
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Splint together
• Durelay
• Wire/Durelay
Advantages
• More accurate for multi units
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Restorative options
• Cement-retained Restorations
• Cement-retained implant restorations are very
similar to crown & bridge restorations. A
prepared implant abutment is screwed onto the
implant.
• The crown or restoration is cemented to the
prepared abutment, much like a prepared tooth.
• Indications
• Single or multiple-unit implant restorations
• Totally edentulous or partially edentulous arch
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Restorative options
• Limitations
• Ease of retrievability
• Advantages
• Conventional crown & bridge procedures
• Maximum control of occlusion
• More esthetic than screw-retained Implant-level
Cement-retained Restorations
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Occlusion
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Introduction - Occlusion
• Occlusion is not defined solely as the
nature of occlusal contact between
opposing teeth but more broadly refers to
the dynamic relation between the teeth, the
neuromuscular system, the TMJ and their
interactive relationship on the craniofacial
environment.
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Occlusion
• Achieving proper occlusion for a patient is
as fundamental to success as function or
esthetics and is of paramount importance
when providing implant supported
prosthesis to the patient.
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No contact on maximum
intercuspation
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No prematurities in retruded
contact position (RCP)
Additional Goals
Anterior guidance
whenever possible.
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AIMS IN DESIGNING
IMPLANT OCCLUSION
Protect the implant Maximize occlusal
host interface. function.
Minimize risk of
fracture of the Minimize wear of
implant occlusal surfaces
superstructure.
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Implant occlusion
• Consequences of biomechanical overload
• Early implant failure
• Early crestal bone loss
• Intermediate to Late implant failure
• Intermediate to Late implant bone loss
• Screw loosening
• Cement debonding
• Component fracture
• Porcelain fracture
• Prosthesis fracture
• Periimplantitis (secondary to bone loss )
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Implant occlusion
Disadvantages
• No shock absorption
• Stresses concentrated at
the crestal bone
• Crestal bone loss
• Prosthetic component
fracture
Implant overdenture
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Implant overdenture
• For those patients requiring more retention and
stability for an upper and lower denture, the all
implant-supported overdenture may be the
answer.
• A removable implant overdenture is a prosthesis
which is removable by the patient and is
supported or retained by dental implants.
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Implant overdenture
• The prosthesis has to be removed for the
purpose of cleaning around the abutments
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Implant overdenture
• Overdenture: Any
removable dental prosthesis
that covers and rests on
one or more remaining
natural teeth, the roots of
natural teeth, and/or dental
implants; a dental
prosthesis that covers and
is partially supported by
natural teeth, natural tooth
roots, and/or dental
implants.
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Implant overdenture
Advantages force(300%)
• Prevents bone loss • Increased occlusal efficiency
• Improved esthetics • Improved retention
• Improved stability (reduces or • Improved support
eliminates prosthesis • Improved speech
movement) • Reduced prosthesis size
• Improved occlusion (eliminates palate, flanges)
(reproducible centric relation • Improved maxillofacial
occlusion) prostheses
• Decrease in soft tissue
abrasions
• Improved chewing
efficiency(20%) and
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• Improved esthetics
• Labial flange
• Denture teeth
• Soft tissue drape
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• Lower cost
• Fewer implants
• Sites which require grafting can be avoided
• Easy repair
• Decreased laboratory costs
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Implant overdenture
Disadvantages
• Psychological (need for non-removable teeth)
• Greater abutment crown height space required
Implant overdenture
Disadvantages
• Long-term maintenance
• Attachment (susceptible to wear)
• Relines (RP-5)
• New prosthesis every 7 years(wear of denture
teeth)
• Continued posterior bone loss
• Food impaction
• Movement (RP-5)
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Meg Rhein
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References
• Rathee M, Bhoria M. Basics of clinical diagnosis in
implant dentistry. J Int Clin Dent Res Organ [serial online]
2015 [cited 2018 Jul 23];7, Suppl S1:13-8. Available
from: http://www.jicdro.org/text.asp?2015/7/3/13/172929