Fixed Dental Prostehsis Implant's
Fixed Dental Prostehsis Implant's
Fixed Dental Prostehsis Implant's
Introduction to implants
Definition:
Implants are surgically fixed substitutes for roots of missing teeth and dental implantology is the study of arts and science concerned with surgical insertion and restoration of materials and devices restoring partially or totally edentulous patient to function.
Indications of implants
Particularly any edentulous space. Patient with history of trauma Congenitally missing teeth Periodontal disease Failure of fixed or removable prosthesis Oro and maxillofacial clefts and other defects Esthetics
Contraindications of implants
Debilitating or uncontrolled disease like uncontrolled diabetes ,cardiac valves, dialysis, liver failure Pregnancy. Lack of adequate training of practitioner. Immunocompression e.g.,HIV,radiation therapy. Poor patient motivation. Psychiatric disorders.
Inability of patient to manage oral hygiene. Patient hypersensitivity to specific components of the implant. Acute bone resorption Chronic inflammation History of smoking and alcoholism Unattainable prosthodontic reconstruction.
Crest module for retention of prosthetic component in two piece system. Body either screw type or cylindrical or combined
Other components
Cover screw prevents debris contamination Transepithelial portion known as the healing portion Abutments retains the prosthesis Superstructure provides attachment for fixed prosthesis in the framework Transfer coping is used to position die in an impression
Classification of implants
On the basis of implant tissue interface Direct bone implant interface (osseointegration) Indirect bone implant interface (blade and subperiosteal)
On the basis of location and stress response Submucous Supraperiosteal Subperiosteal Endosseous Transosseous endodontic
On the basis of function Retentive Supportive On the basis of implant material Metallic Polymer Ceramic Vitreous carbon
On the basis of implant design Branemark implantimplantthreaded screw Core vent implant-open implantbasket vents with threads IMZ-rough plasma IMZsprayed implant surface Stryker implant-fluted implantdesign
No peri-implantitis periNo peri-implant radiolucency periMarginal bone loss of about 1.0-1.5mm 1.0first year after placement; then < 0.1mm bone loss per year Tissue integration: bone/soft tissue ("osseointegration") Absence of mobility Stable clinical attachment level Absence of bleeding. Absence of discomfort Success rate varies with bone quality, loading dynamics etc
lower jaw, front lower jaw, back upper jaw, front upper jaw, back
PeriPeri-implantitis
Is an inflammatory reaction with loss of supporting bone in the tissues surrounding a functioning implant. Causes can be bacterial, systemic or overloading of an implant.
Initial evaluation
chief complaint medical/dental history review intra/extraoral exam evaluation of existing prosthesis diagnostic impressions/articulated casts radiographs photographs
treatment options/informed consent explanation of long-term longcommitment restorative - surgical joint consult
TwoTwo-stage surgery Restorative phase Regular recall Payment policy Form, function and esthetics
Number of remnant teeth Relationship to adjacent teeth Root angulations quality, quantity, width, support of the bone MD width of edentulous space (min of 6-7mm space 6b/w teeth,>than 1.5mm b/w tooth & implant) for edentulous 7mm from the center of implant
Crown/root ratio Mobility Oral hygiene Furcations Probing depths Systemic manifestations Destructive habits Mucogingival problems
Periapical pathology Radiopaque/radiolucent regions Adequate vertical bone height in edentulous area 10mm alveolar bone Implants should be placed at a minimum of 2mm from the inferior alveolar canal or below the maxillary sinus Adequate interradicular area - 8mm interradicular bone width
Immediate implant placed at time of tooth extraction Delayed immediate (8-10 week delay from (8extraction) Delayed (9-10 months (9or longer)
Surgical analysis
Surgical handling of the tissues with minimal heat generation is necessary. (< 47 . for one minute or less) provides the most predictable healing response.
Esthetic analysis
Smile line Lip shape full Vs. thin Existing ridge defect Implant emergence profile (360 degree) Occulosal analysis MaxMax-mand relations
2. Bone contouring
3. Osteotomy
7. Closure
14. Abutment transferred into the oral cavity & final contouring done
Teeth in an Hour.flv
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