OCCLUSAL CONSIDERATIONSOCCLUSAL CONSIDERATIONS
FOR IMPLANT – SUPPORTEDFOR IMPLANT – SUPPORTED
PROSTHESESPROSTHESES
INDIAN ...
CONTENTSCONTENTS
INTRODUCTIONINTRODUCTION
OCCLUSAL CONSIDERATIONSOCCLUSAL CONSIDERATIONS
NATURAL TOOTH VS IMPLANT MOBILITY...
INTRODUCTIONINTRODUCTION
The clinical success and longevity of endosteal dentalThe clinical success and longevity of endos...
Implant Protective OcclusionImplant Protective Occlusion
Previously presented asPreviously presented as medial positionedm...
OCCLUSAL CONSIDERATIONSOCCLUSAL CONSIDERATIONS
Natural tooth vs implant mobilityNatural tooth vs implant mobility
The PDL ...
The greater the width of a tranosteal structureThe greater the width of a tranosteal structure
the lesser magnitude of str...
Under similar mechanical loading conditions,Under similar mechanical loading conditions,
implants generate greater stresse...
Teeth benefit from increased occlusalTeeth benefit from increased occlusal
awareness compared with implants.awareness comp...
A lateral force on a natural tooth is rapidlyA lateral force on a natural tooth is rapidly
dissipated away from the crest ...
Occlusion on Natural Teeth andOcclusion on Natural Teeth and
ImplantsImplants
In the implant tooth fixed prostheses, fourI...
Because of initial difference in verticalBecause of initial difference in vertical
movement of teeth and implants in the s...
To harmonize the occlusal forces b/w implantsTo harmonize the occlusal forces b/w implants
and teeth, a heavy bite force o...
If anterior implants must disocclude the posteriorIf anterior implants must disocclude the posterior
teeth in excursion, t...
Implant Orientation and Influence ofImplant Orientation and Influence of
Load DirectionLoad Direction
Implants are designe...
www.indiandentalacademy.comwww.indiandentalacademy.com
Bone Mechanics and OcclusionBone Mechanics and Occlusion
‘‘Anisotropy’ refers to the character of theAnisotropy’ refers to...
www.indiandentalacademy.comwww.indiandentalacademy.com
The IPO attempts to eliminate lateral loads toThe IPO attempts to eliminate lateral loads to
an implant supported prosthes...
Premature occlusal contacts result in localizedPremature occlusal contacts result in localized
lateral loading of the oppo...
Once the natural teeth are removed, the boneOnce the natural teeth are removed, the bone
remodels to the height at or belo...
IPO aims at reducing the force of occlusalIPO aims at reducing the force of occlusal
contacts, increasing implant number,c...
OCCLUSAL SCHEMESOCCLUSAL SCHEMES
The primary goal of an occlusal scheme isThe primary goal of an occlusal scheme is
to mai...
The forces generated by a patient areThe forces generated by a patient are
influenced by :influenced by :
ParafunctionPara...
IMPLANT PROTECTIVEIMPLANT PROTECTIVE
OCCLUSIONOCCLUSION
The concept of “Medial positionedThe concept of “Medial positioned...
www.indiandentalacademy.comwww.indiandentalacademy.com
OCCLUSAL TABLE WIDTHOCCLUSAL TABLE WIDTH
In IPO, “the width of the occlusal table isIn IPO, “the width of the occlusal tab...
The wider the occlusal table, the greater theThe wider the occlusal table, the greater the
force developed by the biologic...
The restorations mimicking the occlusalThe restorations mimicking the occlusal
anatomy of natural teeth often result in of...
CROWN CONTOURCROWN CONTOUR
DIVISION – A - BONEDIVISION – A - BONE
Implant can be placed in a more idealImplant can be plac...
Ideally, the implant is located directly underIdeally, the implant is located directly under
the primary occlusal contact ...
The Div A mandibular implant is placedThe Div A mandibular implant is placed
under the central fossa region of the natural...
The lingual contour of the mand. Implant crown isThe lingual contour of the mand. Implant crown is
similar to the original...
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
In the posterior esthetic regions of maxilla aIn the posterior esthetic regions of maxilla a
larger diameter implant may b...
CROWN CONTOURCROWN CONTOUR
DIVISION – B - BONEDIVISION – B - BONE
Div B bone has maxillary and mandibularDiv B bone has ma...
www.indiandentalacademy.comwww.indiandentalacademy.com
Bone augmentation for larger implant width isBone augmentation for larger implant width is
more indicated in the maxilla b...
Influence of Surface AreaInfluence of Surface Area
Mechanical stress = defined as the forceMechanical stress = defined as ...
The mechanical stress at the crest is reducedThe mechanical stress at the crest is reduced
with wider implants compared wi...
Design to the Weakest ArchDesign to the Weakest Arch
All treatment planning decsions for IPO should beAll treatment planni...
Stress relieving components reduce impact loads toStress relieving components reduce impact loads to
the implant support.t...
Full Arch Fixed ProsthesisFull Arch Fixed Prosthesis
Fixed prostheses on natural teeth opposingFixed prostheses on natural...
Occlusal MaterialsOcclusal Materials
The materials selected for the occlusalThe materials selected for the occlusal
surfac...
Occlusal materials are evaluated byOcclusal materials are evaluated by
following criterias:following criterias:
EstheticsE...
EstheticsEsthetics
Porcelain – Most estheticPorcelain – Most esthetic
Acrylic – AcceptableAcrylic – Acceptable
Metal – Is ...
ForcesForces
The hardness of a material is related to itsThe hardness of a material is related to its
ability to absorb st...
Chewing EfficiencyChewing Efficiency
Fixed prostheses exhibit an improvedFixed prostheses exhibit an improved
efficiency c...
WearWear
Definition – Wear is the deterioration,Definition – Wear is the deterioration,
change,or loss of a surface caused...
The factors affecting the amount of wearThe factors affecting the amount of wear
include:include:
MagnitudeMagnitude
Durat...
The wear rate of occlusal materials, especiallyThe wear rate of occlusal materials, especially
in the partially edentulous...
Material FractureMaterial Fracture
Acrylic or composite materials fracture moreAcrylic or composite materials fracture mor...
AccuracyAccuracy
Metal shrinkage is 10 times less than porcelainMetal shrinkage is 10 times less than porcelain
or acrylic...
Interarch SpaceInterarch Space
Acrylic restorations receive their strength fromAcrylic restorations receive their strength...
CONCLUSIONCONCLUSION
The local occlusal considerations in implant dentistryThe local occlusal considerations in implant de...
Thank you
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
Upcoming SlideShare
Loading in...5
×

Occlusal considerations for implant / orthodontic seminars

397

Published on


Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.

Published in: Education
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
397
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Transcript of "Occlusal considerations for implant / orthodontic seminars"

  1. 1. OCCLUSAL CONSIDERATIONSOCCLUSAL CONSIDERATIONS FOR IMPLANT – SUPPORTEDFOR IMPLANT – SUPPORTED PROSTHESESPROSTHESES INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. CONTENTSCONTENTS INTRODUCTIONINTRODUCTION OCCLUSAL CONSIDERATIONSOCCLUSAL CONSIDERATIONS NATURAL TOOTH VS IMPLANT MOBILITYNATURAL TOOTH VS IMPLANT MOBILITY OCCLUSION ON NATURAL TEETH AND IMPLANTSOCCLUSION ON NATURAL TEETH AND IMPLANTS IMPLANT ORIENTATION AND INFLUENCE OF LOAD DIRECTIONIMPLANT ORIENTATION AND INFLUENCE OF LOAD DIRECTION BONE MECHANICS AND OCCLUSIONBONE MECHANICS AND OCCLUSION OCCLUSAL SCHEMESOCCLUSAL SCHEMES IMPLANT PROTECTIVE OCCLUSIONIMPLANT PROTECTIVE OCCLUSION OCCLUSAL MATERIALSOCCLUSAL MATERIALS CONCLUSIONCONCLUSION www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. INTRODUCTIONINTRODUCTION The clinical success and longevity of endosteal dentalThe clinical success and longevity of endosteal dental implants as load bearing abutments are controlledimplants as load bearing abutments are controlled largely by the mechanical setting in which theylargely by the mechanical setting in which they function.function. Complications reported in follow up studies underlineComplications reported in follow up studies underline occlusion as a determining factor for success orocclusion as a determining factor for success or failure.failure. A passive prosthesis of adequate retention and formA passive prosthesis of adequate retention and form and a progressive loading to improve the amount andand a progressive loading to improve the amount and density of the adjacent bone and further reduce thedensity of the adjacent bone and further reduce the risk of stress beyond physiologic limits.risk of stress beyond physiologic limits. www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. Implant Protective OcclusionImplant Protective Occlusion Previously presented asPreviously presented as medial positionedmedial positioned – lingualized occlusion.– lingualized occlusion. This occlusal concept refers to an occlusalThis occlusal concept refers to an occlusal plan that is often unique and specificallyplan that is often unique and specifically designed for the restoration of endostealdesigned for the restoration of endosteal implants, providing an environment forimplants, providing an environment for improved clinical longevity of both implantimproved clinical longevity of both implant and prostheses.and prostheses. www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. OCCLUSAL CONSIDERATIONSOCCLUSAL CONSIDERATIONS Natural tooth vs implant mobilityNatural tooth vs implant mobility The PDL surrounding the natural teethThe PDL surrounding the natural teeth decreases the magnitude of stress to the bonedecreases the magnitude of stress to the bone at the crest, as well as extend the time in whichat the crest, as well as extend the time in which the load is dissipated.the load is dissipated. An implant is not as resilient as natural toothAn implant is not as resilient as natural tooth After occlusal trauma is eliminated, the toothAfter occlusal trauma is eliminated, the tooth returns to its original condition whereas implantreturns to its original condition whereas implant rarely returns.rarely returns. www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. The greater the width of a tranosteal structureThe greater the width of a tranosteal structure the lesser magnitude of stress transmitted tothe lesser magnitude of stress transmitted to the surrounding bone.the surrounding bone. The cross-sectional shape of tooth resistsThe cross-sectional shape of tooth resists lateral bending loads whereas implants are lesslateral bending loads whereas implants are less effective.effective. The elastic modulus of a tooth is closer to boneThe elastic modulus of a tooth is closer to bone than any of the currently available dentalthan any of the currently available dental implant biomaterials.implant biomaterials. www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. Under similar mechanical loading conditions,Under similar mechanical loading conditions, implants generate greater stresses and strainsimplants generate greater stresses and strains at the crest of the bone compared with a tooth.at the crest of the bone compared with a tooth. Natural teeth exhibit reversible signs andNatural teeth exhibit reversible signs and symptoms of occlusal trauma whereas implantssymptoms of occlusal trauma whereas implants do not.do not. The tooth show clinical signs of increasedThe tooth show clinical signs of increased stress.stress. www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. Teeth benefit from increased occlusalTeeth benefit from increased occlusal awareness compared with implants.awareness compared with implants. Teeth deliver a rapid, sharp pain sensationTeeth deliver a rapid, sharp pain sensation under high pressure that triggers a protectiveunder high pressure that triggers a protective mechanismmechanism Clinical evidence of occlusal trauma on teethClinical evidence of occlusal trauma on teeth include overall increase in PDL thicknessinclude overall increase in PDL thickness whereas implant signs are only around thewhereas implant signs are only around the crestal region.crestal region. www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. A lateral force on a natural tooth is rapidlyA lateral force on a natural tooth is rapidly dissipated away from the crest of the bonedissipated away from the crest of the bone toward the apex of the tooth and pivots 2/3rdstoward the apex of the tooth and pivots 2/3rds turn toward the tapered apex with a lateral load.turn toward the tapered apex with a lateral load. The natural tooth, with its modulus of elasticityThe natural tooth, with its modulus of elasticity similar to bone, periodontal ligament, andsimilar to bone, periodontal ligament, and unique cross sections and dimensionsunique cross sections and dimensions constitutes a near perfect optimization systemconstitutes a near perfect optimization system to handle stress.to handle stress. www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. Occlusion on Natural Teeth andOcclusion on Natural Teeth and ImplantsImplants In the implant tooth fixed prostheses, fourIn the implant tooth fixed prostheses, four important components contributeimportant components contribute movement to the systemmovement to the system 1. the implant1. the implant 2. bone2. bone 3. tooth and3. tooth and 4. prosthesis4. prosthesis www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. Because of initial difference in verticalBecause of initial difference in vertical movement of teeth and implants in the samemovement of teeth and implants in the same arch, the initial occlusal contacts shouldarch, the initial occlusal contacts should account for this difference,or the implant willaccount for this difference,or the implant will sustain greater loads than the adjacent teeth.sustain greater loads than the adjacent teeth. The implant should barely contact and theThe implant should barely contact and the adjacent teeth should exhibit greater initialadjacent teeth should exhibit greater initial contactscontacts Only axial occlusal contacts should be presentOnly axial occlusal contacts should be present on the implant crown.on the implant crown. www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. To harmonize the occlusal forces b/w implantsTo harmonize the occlusal forces b/w implants and teeth, a heavy bite force occlusaland teeth, a heavy bite force occlusal adjustments is used.adjustments is used. All lateral excursions of IPO opposing fixedAll lateral excursions of IPO opposing fixed prosthesis or natural teeth should disoccludeprosthesis or natural teeth should disocclude the posterior components. The resultant lateralthe posterior components. The resultant lateral forces are thus distributed only to the anteriorforces are thus distributed only to the anterior segments of the jaws, resulting in a decrease insegments of the jaws, resulting in a decrease in overall occlusal force.overall occlusal force. www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. If anterior implants must disocclude the posteriorIf anterior implants must disocclude the posterior teeth in excursion, two or more implants splintedteeth in excursion, two or more implants splinted together should help to dissipate the lateral forces.together should help to dissipate the lateral forces. Light force and thin articulating paper are first used toLight force and thin articulating paper are first used to ensure that no implant crown contact occurs duringensure that no implant crown contact occurs during the initial occlusal or lateral movement of the teeth.the initial occlusal or lateral movement of the teeth. A heavier force during centric occlusion andA heavier force during centric occlusion and excursions is then used to develop similar occlusalexcursions is then used to develop similar occlusal contacts on both anterior implants and natural teeth.contacts on both anterior implants and natural teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. Implant Orientation and Influence ofImplant Orientation and Influence of Load DirectionLoad Direction Implants are designed for a long axis load toImplants are designed for a long axis load to the implant body.the implant body. The greater the angle of the load to the implantThe greater the angle of the load to the implant long axis, the greater the compressive, tensilelong axis, the greater the compressive, tensile and shear stresses.and shear stresses. Not only is the ‘amount’ of stress increased withNot only is the ‘amount’ of stress increased with angled load, but the ‘type’ of stress converts toangled load, but the ‘type’ of stress converts to more dangerous shear component.more dangerous shear component.www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15. www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. Bone Mechanics and OcclusionBone Mechanics and Occlusion ‘‘Anisotropy’ refers to the character of theAnisotropy’ refers to the character of the bone, whereby its mechanical properties,bone, whereby its mechanical properties, including ultimate strength, depend on theincluding ultimate strength, depend on the direction in which the bone is loaded.direction in which the bone is loaded. Cortical bone of human long bones hasCortical bone of human long bones has been reported as strongest inbeen reported as strongest in compression, 30% weaker in tension, andcompression, 30% weaker in tension, and 65% weaker in shear.65% weaker in shear. www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. The IPO attempts to eliminate lateral loads toThe IPO attempts to eliminate lateral loads to an implant supported prostheses because thean implant supported prostheses because the magnitude of the force increases and strengthmagnitude of the force increases and strength of the bone decreases.of the bone decreases. When these loads cannot be eliminated, aWhen these loads cannot be eliminated, a reduction in the force magnitude or additionalreduction in the force magnitude or additional surface area of implant support is indicated tosurface area of implant support is indicated to reduce the risk of bone loss or implantreduce the risk of bone loss or implant component fracture.component fracture. www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. Premature occlusal contacts result in localizedPremature occlusal contacts result in localized lateral loading of the opposing contactinglateral loading of the opposing contacting crowns.crowns. Occlusal evaluation and adjustment in partiallyOcclusal evaluation and adjustment in partially edentulous implant patients are more importantedentulous implant patients are more important than in natural dentition.than in natural dentition. The premature occlusal contact on a toothThe premature occlusal contact on a tooth corresponds to less initial occlusal force andcorresponds to less initial occlusal force and often modifies the closure of the mandible,often modifies the closure of the mandible, resulting in a centric occlusion different fromresulting in a centric occlusion different from centric relation occlusion.centric relation occlusion.www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. Once the natural teeth are removed, the boneOnce the natural teeth are removed, the bone remodels to the height at or below the lowestremodels to the height at or below the lowest level of the lateral cortical plates.level of the lateral cortical plates. The greater the crown height, the greater theThe greater the crown height, the greater the resulting crestal moment with any lateralresulting crestal moment with any lateral component of force that develops as acomponent of force that develops as a consequence of an angled load.consequence of an angled load. www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. IPO aims at reducing the force of occlusalIPO aims at reducing the force of occlusal contacts, increasing implant number,contacts, increasing implant number, and/or increasing implant diameter forand/or increasing implant diameter for implants subjected to angled loads or withimplants subjected to angled loads or with an increased crown height or on thean increased crown height or on the cantilever portion of a prosthesis.cantilever portion of a prosthesis. www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. OCCLUSAL SCHEMESOCCLUSAL SCHEMES The primary goal of an occlusal scheme isThe primary goal of an occlusal scheme is to maintain the occlusal load that hasto maintain the occlusal load that has been transferred to the implant body withinbeen transferred to the implant body within physiologic limits of each patient .physiologic limits of each patient . www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. The forces generated by a patient areThe forces generated by a patient are influenced by :influenced by : ParafunctionParafunction Masticatory DynamicsMasticatory Dynamics Tongue SizeTongue Size Implant arch position and locationImplant arch position and location Implant arch form and crown heightImplant arch form and crown height www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. IMPLANT PROTECTIVEIMPLANT PROTECTIVE OCCLUSIONOCCLUSION The concept of “Medial positionedThe concept of “Medial positioned lingualized occlusion” apply to fixedlingualized occlusion” apply to fixed implant supported restorations.implant supported restorations. The maxillary permucosal implant siteThe maxillary permucosal implant site gradually shifts toward the midline as thegradually shifts toward the midline as the ridge resorbs.ridge resorbs. www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. OCCLUSAL TABLE WIDTHOCCLUSAL TABLE WIDTH In IPO, “the width of the occlusal table isIn IPO, “the width of the occlusal table is directly related to the width of the implantdirectly related to the width of the implant body.”body.” A wide occlusal table favors offsetA wide occlusal table favors offset contacts during mastication orcontacts during mastication or parafunctionparafunction During mastication , the amount of forceDuring mastication , the amount of force used to penetrate the food bolus is relatedused to penetrate the food bolus is related to the occlusal table width.to the occlusal table width. www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. The wider the occlusal table, the greater theThe wider the occlusal table, the greater the force developed by the biologic system toforce developed by the biologic system to penetrate the bolus of food.penetrate the bolus of food. The narrow occlusal table facilitates dailyThe narrow occlusal table facilitates daily homecare and improves axial loading.homecare and improves axial loading. The narrower occlusal contour also reduces theThe narrower occlusal contour also reduces the risk of porcelain fracture.risk of porcelain fracture. www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. The restorations mimicking the occlusalThe restorations mimicking the occlusal anatomy of natural teeth often result in offsetanatomy of natural teeth often result in offset loads (increased stress), complicated homeloads (increased stress), complicated home care, and increased risk of porcelain fracture.care, and increased risk of porcelain fracture. As a result , in nonesthetic regions of the mouth,As a result , in nonesthetic regions of the mouth, the occlusal table should be reduced in widththe occlusal table should be reduced in width compared with natural teeth.compared with natural teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. CROWN CONTOURCROWN CONTOUR DIVISION – A - BONEDIVISION – A - BONE Implant can be placed in a more idealImplant can be placed in a more ideal position for occlusion and esthetics.position for occlusion and esthetics. In the anterior region, a dicision is madeIn the anterior region, a dicision is made early in treatment whether an abutment forearly in treatment whether an abutment for screw retention or for cement retention willscrew retention or for cement retention will be used in the restoration because itbe used in the restoration because it affects the position of the implant body.affects the position of the implant body. www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. Ideally, the implant is located directly underIdeally, the implant is located directly under the primary occlusal contact and loaded inthe primary occlusal contact and loaded in an axial direction, thus minimizing thean axial direction, thus minimizing the effect of offset loads.effect of offset loads. To load the implant in an axial direction,To load the implant in an axial direction, the primary occlusal contact shouldthe primary occlusal contact should therefore be the central fossa region in Divtherefore be the central fossa region in Div A bone.A bone. www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. The Div A mandibular implant is placedThe Div A mandibular implant is placed under the central fossa region of the naturalunder the central fossa region of the natural tooth.tooth. When opposing a natural maxillary molar,When opposing a natural maxillary molar, the primary contacting cusp becomes thethe primary contacting cusp becomes the maxillary lingual cusp opposing the mand.maxillary lingual cusp opposing the mand. Implant crown, with the mand. Cusp ofImplant crown, with the mand. Cusp of decreased height and width over the implantdecreased height and width over the implant body.body. www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. The lingual contour of the mand. Implant crown isThe lingual contour of the mand. Implant crown is similar to the original natural dentition in position,similar to the original natural dentition in position, and no occlusal contact on the lingual cusp, soand no occlusal contact on the lingual cusp, so offset loads during parafunction are eliminated.offset loads during parafunction are eliminated. The posterior maxillry crown is reduced from theThe posterior maxillry crown is reduced from the lingual aspect, compared with a natural maxillarylingual aspect, compared with a natural maxillary molar, to reduce the occlusal table width.molar, to reduce the occlusal table width. When opposing max.implants, the buccal cusps ofWhen opposing max.implants, the buccal cusps of natural mand.teeth(or crowns on implants) shouldnatural mand.teeth(or crowns on implants) should be recontoured to minimize offset loads in centricbe recontoured to minimize offset loads in centric relation occlusion.relation occlusion. www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. www.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. In the posterior esthetic regions of maxilla aIn the posterior esthetic regions of maxilla a larger diameter implant may be placed thatlarger diameter implant may be placed that permits restoration of the buccal contours.permits restoration of the buccal contours. Posterior implants opposing eachother, thePosterior implants opposing eachother, the facial cusps of max. crowns is required forfacial cusps of max. crowns is required for esthetics.esthetics. The other contours of opposing crowns areThe other contours of opposing crowns are reduced in width to minimize the occlusal tablereduced in width to minimize the occlusal table width and axially load the implantswidth and axially load the implants www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. CROWN CONTOURCROWN CONTOUR DIVISION – B - BONEDIVISION – B - BONE Div B bone has maxillary and mandibularDiv B bone has maxillary and mandibular implants positioned under lingual cusp whenimplants positioned under lingual cusp when compared with the original natural tooth position.compared with the original natural tooth position. The medially positioned Div B mandibularThe medially positioned Div B mandibular implant crown central fossa is more lingual thanimplant crown central fossa is more lingual than the original position.the original position. A Div B max.implant is often placed under theA Div B max.implant is often placed under the palatal cusp region of the original natural tooth.palatal cusp region of the original natural tooth. www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37. www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. Bone augmentation for larger implant width isBone augmentation for larger implant width is more indicated in the maxilla because of themore indicated in the maxilla because of the less dense bone and the prosthetic needs toless dense bone and the prosthetic needs to replace an esthetic buccal crown contour.replace an esthetic buccal crown contour. The weakest implant in bone density, width orThe weakest implant in bone density, width or prostheses type determines the axial load.prostheses type determines the axial load. www.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. Influence of Surface AreaInfluence of Surface Area Mechanical stress = defined as the forceMechanical stress = defined as the force magnitude divided by the cross sectional areamagnitude divided by the cross sectional area over which that force is applied.over which that force is applied. When forces are increased in magnitude,When forces are increased in magnitude, direction, or duration, ridge augmentation maydirection, or duration, ridge augmentation may be required to improve implant placement,be required to improve implant placement, reduce crown height, and increase implant widthreduce crown height, and increase implant width and number to compensate for the increasedand number to compensate for the increased loads.loads. www.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. The mechanical stress at the crest is reducedThe mechanical stress at the crest is reduced with wider implants compared with narrowwith wider implants compared with narrow ones.ones. Unavoidable, less ideal implant orientationsUnavoidable, less ideal implant orientations should be accommodated through adjustmentsshould be accommodated through adjustments in occlusion.in occlusion. www.indiandentalacademy.comwww.indiandentalacademy.com
  41. 41. Design to the Weakest ArchDesign to the Weakest Arch All treatment planning decsions for IPO should beAll treatment planning decsions for IPO should be based on careful consideration ofbased on careful consideration of 1. Identifying the weakest link in the overall1. Identifying the weakest link in the overall restorationrestoration 2. Establishing occlusal and prosthetic2. Establishing occlusal and prosthetic schemes to protect that component ofschemes to protect that component of the structure.the structure. www.indiandentalacademy.comwww.indiandentalacademy.com
  42. 42. Stress relieving components reduce impact loads toStress relieving components reduce impact loads to the implant support.the implant support. The most common implant treatment, a traditional softThe most common implant treatment, a traditional soft tissue supported complete denture, is a maxillarytissue supported complete denture, is a maxillary denture opposing a mandibular implant supporteddenture opposing a mandibular implant supported restoration.restoration. Reduced occlusal forces with an absence of lateralReduced occlusal forces with an absence of lateral contacts in excursions are recommended on posteriorcontacts in excursions are recommended on posterior cantilevers or anterior offset pontics.cantilevers or anterior offset pontics.www.indiandentalacademy.comwww.indiandentalacademy.com
  43. 43. Full Arch Fixed ProsthesisFull Arch Fixed Prosthesis Fixed prostheses on natural teeth opposingFixed prostheses on natural teeth opposing FP -1 to RP -1 implant restorations shouldFP -1 to RP -1 implant restorations should follow mutually protected occlusal shemes.follow mutually protected occlusal shemes. In protrusion, there should be total absence ofIn protrusion, there should be total absence of posterior contacts.posterior contacts. Two or more implants should share any lateralTwo or more implants should share any lateral force, and lateral excursions should occur asforce, and lateral excursions should occur as far forward as is practical and include thefar forward as is practical and include thewww.indiandentalacademy.comwww.indiandentalacademy.com
  44. 44. Occlusal MaterialsOcclusal Materials The materials selected for the occlusalThe materials selected for the occlusal surface of the prostheses affect thesurface of the prostheses affect the transmission of forces and thetransmission of forces and the maintenance of occlusal contacts.maintenance of occlusal contacts. The three most common groups ofThe three most common groups of occlusal materials areocclusal materials are porcelain, acrylicporcelain, acrylic and metal.and metal. www.indiandentalacademy.comwww.indiandentalacademy.com
  45. 45. Occlusal materials are evaluated byOcclusal materials are evaluated by following criterias:following criterias: EstheticsEsthetics Impact ForceImpact Force A Static LoadA Static Load Chewing EfficiencyChewing Efficiency FractureFracture WearWear Inter arch Space RequirementsInter arch Space Requirements Accuracy of CastingAccuracy of Castingwww.indiandentalacademy.comwww.indiandentalacademy.com
  46. 46. EstheticsEsthetics Porcelain – Most estheticPorcelain – Most esthetic Acrylic – AcceptableAcrylic – Acceptable Metal – Is a poor ChoiceMetal – Is a poor Choice www.indiandentalacademy.comwww.indiandentalacademy.com
  47. 47. ForcesForces The hardness of a material is related to itsThe hardness of a material is related to its ability to absorb stress from impact loads.ability to absorb stress from impact loads. Enamel has a hardnes of 350 kg/mm2Enamel has a hardnes of 350 kg/mm2 Porcelain – 2.5 times greater than enamelPorcelain – 2.5 times greater than enamel Composit - 85% that of enamelComposit - 85% that of enamel Acrylic – 17kg/mm2Acrylic – 17kg/mm2 www.indiandentalacademy.comwww.indiandentalacademy.com
  48. 48. Chewing EfficiencyChewing Efficiency Fixed prostheses exhibit an improvedFixed prostheses exhibit an improved efficiency compared with removable softefficiency compared with removable soft tissue – borne prostheses, regardless oftissue – borne prostheses, regardless of the occlusal material.the occlusal material. Shultz – Acrylic was 30% less efficientShultz – Acrylic was 30% less efficient than porcelain/metal whereas there wasthan porcelain/metal whereas there was no difference b/w gold and porcelainno difference b/w gold and porcelain www.indiandentalacademy.comwww.indiandentalacademy.com
  49. 49. WearWear Definition – Wear is the deterioration,Definition – Wear is the deterioration, change,or loss of a surface caused bychange,or loss of a surface caused by use.use. Dramatic changes in occlusal contacts inDramatic changes in occlusal contacts in centric relation and excursions, occlusalcentric relation and excursions, occlusal vertical dimension, and esthetics mayvertical dimension, and esthetics may occur as a consequence of significantoccur as a consequence of significant occlusal wear.occlusal wear. www.indiandentalacademy.comwww.indiandentalacademy.com
  50. 50. The factors affecting the amount of wearThe factors affecting the amount of wear include:include: MagnitudeMagnitude DurationDuration AngleAngle SpeedSpeed HardnessHardness TemperatureTemperature Surface force of opposing forceSurface force of opposing force Chemical natureChemical nature www.indiandentalacademy.comwww.indiandentalacademy.com
  51. 51. The wear rate of occlusal materials, especiallyThe wear rate of occlusal materials, especially in the partially edentulous patients within the partially edentulous patients with unrestored teeth, should be simolar to enamel.unrestored teeth, should be simolar to enamel. Adhesive wear occurs when one hard surfaceAdhesive wear occurs when one hard surface slides over a surface of lesser hardness. (goldslides over a surface of lesser hardness. (gold occlusals)occlusals) Porcelain in esthetic regions opposing gold inPorcelain in esthetic regions opposing gold in the more nonesthetic areas or metal occlusalsthe more nonesthetic areas or metal occlusals in both arches when parafunction or marginalin both arches when parafunction or marginal interarch space is present are the materialsinterarch space is present are the materials most often selected as implant occlusalmost often selected as implant occlusal materials.materials. www.indiandentalacademy.comwww.indiandentalacademy.com
  52. 52. Material FractureMaterial Fracture Acrylic or composite materials fracture moreAcrylic or composite materials fracture more easily.easily. Compressive strength of enamel is 40,000psi.Compressive strength of enamel is 40,000psi. Metal occlusals donot easily fracture, provideMetal occlusals donot easily fracture, provide good wear resisatance, and have minimumgood wear resisatance, and have minimum impact load compared with porcelain.impact load compared with porcelain. www.indiandentalacademy.comwww.indiandentalacademy.com
  53. 53. AccuracyAccuracy Metal shrinkage is 10 times less than porcelainMetal shrinkage is 10 times less than porcelain or acrylic and therefore permits the fabrication ofor acrylic and therefore permits the fabrication of a more passive casting, as with screw retaineda more passive casting, as with screw retained restorations, the occlusal material may make arestorations, the occlusal material may make a significant difference.significant difference. This is most important in regions of long spansThis is most important in regions of long spans and/or with a large volume of material.and/or with a large volume of material. www.indiandentalacademy.comwww.indiandentalacademy.com
  54. 54. Interarch SpaceInterarch Space Acrylic restorations receive their strength fromAcrylic restorations receive their strength from bulk and therefore require greater interarchbulk and therefore require greater interarch space.space. Metal occlusals require the least amount ofMetal occlusals require the least amount of space.space. Esthetics is best satisfied with porcelain, whichEsthetics is best satisfied with porcelain, which has improved properties compared with acrylichas improved properties compared with acrylic concerning fractures and retention.concerning fractures and retention. www.indiandentalacademy.comwww.indiandentalacademy.com
  55. 55. CONCLUSIONCONCLUSION The local occlusal considerations in implant dentistryThe local occlusal considerations in implant dentistry include the transoteal forces, bone biomechanics,include the transoteal forces, bone biomechanics, basic biomechanics, differences in natural teeth andbasic biomechanics, differences in natural teeth and implants, muscles of mastication and occlusal force,implants, muscles of mastication and occlusal force, and bone resorption.and bone resorption. The incorporation of all these factors lead to anThe incorporation of all these factors lead to an occlusal scheme (IPO) and it is a consistent approachocclusal scheme (IPO) and it is a consistent approach for implant occlusal schemes.for implant occlusal schemes. www.indiandentalacademy.comwww.indiandentalacademy.com
  56. 56. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com

×