Teeth in a DAY

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Teeth in a DAY

  1. 1. TEETH IN A DAY Immediately loaded implant supported fixed provisional denture Ting-Wey Yen, DDS, MS 4300 Long Beach Blvd Ste 320 Long Beach, CA 90807 www.drdreamsmile.com
  2. 2. TWYen Immediate Loading  Balshi TJ, Wolfinger GJ. Immediate loading of Branemark implants in edentulous mandibles: a preliminary report. Implant Dent. 1997 Summer;6(2):838.  Schnitman PA, Wohrle PS, Rubenstein JE, DaSilva JD, Wang NH. Ten-year results for Branemark implants immediately loaded with fixed prostheses at implant placement. Int J Oral Maxillofac Implants. 1997 Jul-Aug;12(4):495-503.  Tarnow DP, Emtiaz S, Classi A. Immediate loading of threaded implants at stage 1 surgery in edentulous arches: ten consecutive case reports with 1- to 5-year data. Int J Oral Maxillofac Implants. 1997 May- Jun;12(3):319-24.  Cooper LF, Rahman A, Moriarty J, Chaffee N, Sacco D. Immediate mandibular rehabilitation with endosseous implants: simultaneous extraction, implant placement, and loading. Int J Oral Maxillofac Implants. 2002 Jul-Aug;17(4):517-25.
  3. 3. TWYen Advantages  Time  Minimal overall discomfort  Eliminate removable provisionals  Cost  Use existing impression/denture repair techniques—minimal new instrumentation
  4. 4. TWYen Disadvantages  Learning curve  Lab support  Requires coordinated visits between two offices
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  6. 6. TWYen PROCEDURE (before surgery)  Develop Tx plan with surgeon— make sure bone adequate  Establish OVD  Duplicate lower prosthesis or  Fabricate new prosthesis  Fabricate surgical guide  Modify existing tx denture (24 hr prior)
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  8. 8. TWYen PROCEDURE (day of surgery)—Surgeon:  Extraction of hopeless teeth  Alveolectomy (to level the bone and create restorative space)  Place implants  Place abutments  Place closed tray impression copings  Close up soft tissue--place sutures  Call Dr. Yen 30 min prior to end
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  10. 10. TWYen PROCEDURE (day of surgery)—Restorative:  Verify tightness of closed tray impression copings  Try in modified tx denture—adjust as necessary for clearance  Full arch PVS impression—capture pear shaped pads  CJR using the tx denture or surgical guide
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  15. 15. TWYen LABWORK  Pour up impression  Mount using tx denture  Place metal temporary cylinders  Modify denture to fit  Check occlusion, connect  Reinforce with Ribbond  Fill in the remainder with resin  Check embrasure, polish
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  21. 21. TWYen DELIVERY (24-48 hr):  Remove closed tray impression copings—return to OS  Deliver fixed implant provisional  Adjust occlusion  Check embrasures  Seal with cotton/Fermit  POD instructions
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  24. 24. TWYen FOLLOW-UP  One week check  Adjust occlusion -- avoid breakage  Check embrasure  OHI: initially-- rinse only; after 3 weeks-start brushing, implant floss  Fabricate definitive restoration in 2- 3 months
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  26. 26. TWYen Precautions  Keep maximum interocclusal space  Alveolectomy to lower ridge height  Use shortest abutment heights  Fixture level impressions if necessary  Avoid high water design
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  31. 31. TWYen After 3 months— start fabrication of final prosthesis
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  41. 41. TWYen Immediately loaded implant supported fixed provisional denture  Time  Eliminate removable provisionals  Cost  Use existing impression/denture repair techniques—less inventory  Chee W, Jivraj S. Efficiency of immediately loaded mandibular full-arch implant restorations. Clin Implant Dent Relat Res. 2003;5(1):52-6.
  42. 42. Thank you Questions?
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