implants presentation
DESCRIPTION
Prosthodontic evidence-based treatment planning for dental implantsTRANSCRIPT
Under the Supervision of : Prof. Samahi
King Abdulaziz University
Faculty of Dentistry
Removable Prosthodontics Division
Based Dentistry (EBD), a brief definition:-Evidence
Empowers practitioners a strong scientific basis rather than common
or expert’s opinion.practice
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Finding
information
Critically
evaluating it
Wisely
applying it
in our
practice
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AAFP Report: Review of Selected Dental Wood MR, Vermilyea SG. .1Based Treatment Planning for Dental Implants.-Literature on Evidence
J Prosthet Dent 2004; 92:447-62.
Aim:
Provide dentists with evidence-based guidelines to apply when
planning treatment with osseointegrated implants
Method:
Peer-reviewed literature published in the English language
was reviewed2003and 1969between
Based Guidelines for Implant Treatment Planning:-Evidence
Factors
Systemic Host Factors"The Cluster Phenomenon”
HabitsSmoking, Bruxing
Local Host Factors
bone quality/quantity
Prosthesis Design Factors
AAFP Report: Review of Selected Wood MR, Vermilyea SG. .1Cont.
Based Treatment Planning for Dental -Dental Literature on Evidence
62-447:92; 2004J Prosthet Dent Implants.
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AAFP Report: Review of Selected Wood MR, Vermilyea SG. .1Based Treatment Planning for -Dental Literature on Evidence
Dental Implants.
J Prosthet Dent 2004; 92:447-62.
ProsthodonticStern R. -Taylor TD, Belser U, Mericske.2.107-101(Suppl.): 11 : 2000Clin Oral Impl Res Considerations.
Prosthodontic Considerations:
Aim:
Come up with a general agreement on issues related to the prosthodontic
phase of implant therapy.
Method:
to 1952Examined issues related to the prosthodontic phase of implant therapy from
.1997in a Consensus Conference held in Switzerland in 1997
Agreement on all points was reached by voting within the prosthodontic section.
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. Number, Size and Position of Implants:1
* Greater number and size stress distribution, retention [1]
* Length 7mm [2]
* Width 4mm [3]
* Ideal mesiodistal distance 3mm (implant-implant)
1.5mm (implant-tooth) [4]
* Narrow-body vs. wide-body implants [5]
[1],[2],[3] Wood et al (2004) [5],[8] Taylor et al (2000)
. Cantilever:2
* Anterior-posterior spread 11.1 mm [6]
* Maximum cantilever length 15 mm – mandible
10-12 mm – maxilla [7]
[4],[6] Carl Mish (2005) [7] Kim Y. et al (2005)
. Passivity to Fit:3
Accuracy in impression making [8]
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Cont. Prosthodontic Considerations:
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Retained Restorations:-. Cemented Vs. Screw4
Cemented Restorations:
] 1single unit restorations, short span restorations. [Indications:
] 2fit. [-loosening is not a complication, passive-screwAdvantages:
Retained Restorations:-Screw
Indications:
long span and full arch restorations
deep mucosal implant shoulder placement ( > 3mm )
extended cantilever
[3]
[1],[3] Taylor et al (2000)
[2] Wood et al (2004)
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Occlusal Ju Oh, Misch CE, Wang H. -Kim Y, Tae.3Considerations in Implant Therapy: clinical guidelines with
.35-26:16; 2005Clin. Oral Impl. Res biomechanical rationale.
Aim:
Method:
Discuss the importance of implant occlusion for implant longevity.
Provide clinical guidelines of optimal implant occlusion.
Possible solutions managing complications related to implant occlusion.
was reviewed2002and 1958Literature published between
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Occlusal Considerations in Implant Therapy
Occlusal considerations for implants do not differ from those for natural teeth
However
lack of the periodontal ligament causes osseointegrated implants to react
biomechanically in a different fashion to occlusal force.
Occlusal Overloading
Implant Failure
Kim Y. et al (2005)
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Occlusal Ju Oh, Misch CE, Wang H. -Kim Y, Tae.3Cont
Considerations in Implant Therapy: clinical guidelines with
.35-26:16; 2005Clin. Oral Impl. Res biomechanical rationale.
Overloading Factors of Implant Occlusion:
1. Overextended cactilever
> 15mm in the mandible
> 10-12mm in the maxilla
2. Parafunctional habits / Heavy bite force
3. Excessive premature contacts
4. Steep cuspal inclination
5. Large occlusal table
6. Poor bone density/quality
7. Inadequate number of implants
Kim Y. et al (2005)
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Principles of Implant Occlusion:
1. Bilateral stability in centric occlusion.
2. Evenly distributed occlusal contacts and force.
3. Wide freedom in centric occlusion.
4. Anterior or canine guidance whenever possible.
5. Smooth lateral excursive movements without working/non-working
interferences.
Kim Y. et al (2005)
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Clinical Applications:
Full-arch
Fixed
Prosthesis
Bilateral Balanced
occlusion with
opposing
complete denture
Group function
occlusion or
mutually protected
occlusion when
opposing natural
teeth
No working and
balancing
contact on
cantilever
Infraocclusion
in cantilever
segment
Freedom in
centric
(1-1.5mm)
Kim Y. et al (2005)
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Overdenture
Bilateral balanced
occlusion using
lingualized occlusion
Monoplane occlusion
on a severely resorbed
ridge
ContinuedClinical Applications…
Kim Y. et al (2005)
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Conclusion:
Review:st1
treatmentWith any prosthodontic restoration, meticulous attention must be given to
planning.
, it is no longer acceptable to apply the based” enviroment-“evidenceIn the current
principles and concepts for the treatment of natural teeth to the treatment of dental
implants.
-for evidencerandomized, controlled clinical trialsClinicians need the results of
based decision making.
Limitations:
with implants. esthetic restorationThe article has not discussed the issue of
There is lack of quantifiable evidence-supported guidelines regarding esthetics.
Future research is required to establish such guidlines.
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Cont. Conclusion:
Review:nd2
Limitation:
Many of the consensus statements were reached unanimously, while some were
reached with compromise and split vote.
Review:rd3
specific concept -, implantbased-no evidenceIt emphasized that currently there is
of occlusion. Future studies in this area are needed to clarify the relationship
between occlusion and implant success.
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AAFP Report: Review of Selected Wood MR, Vermilyea SG. .1
Based Treatment Planning for -Dental Literature on Evidence
.62-447:92; 2004. J Prosthet Dent Dental Implants
ProsthodonticStern R. -Taylor TD, Belser U, Mericske.2
.107-101(Suppl.): 11 : 2000Clin Oral Impl Res Considerations.
Occlusal Ju Oh, Misch CE, Wang H. -Kim Y, Tae.3
Considerations in Implant Therapy: clinical guidelines with
.35-26:16; 2005Clin. Oral Impl. Res biomechanical rationale.
, Elsevier 2005, Dental Implant ProstheticsCarl E. Misch: . 4
Mosby, chapter 14, 206-227.
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