Treatment planning of dental implants /orthodontic courses by Indian dental academy

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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.

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Treatment planning of dental implants /orthodontic courses by Indian dental academy

  1. 1. TREATMENT PLANNING OF IMPLANTS IN THE AESTHETIC ZONE INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2. INTRODUCTION THE PREDICTABILITY OF AESTHETIC SUCCESS DEPENDS ON THE TISSUE LOSS PRESENT AT THE INITIATION OF THE TREATMENT THE GREATER THE BONE AND SOFT TISSUE LOSS, THE MORE DIFFICULT IT BECOMES TO PRODUCE AN IDEAL AESTHETIC RESULT SINGLE TOOTH IMPLANTS HAVE A HIGH DEGREE OF PREDICTABILITY AS THE ADJACENT TEETH PROVIDES THE MORPHOLOGICAL SUBSTRUCTURE THAT IS REQUIRED TO RESTORE THE NATURAL GINGIVAL AND PAPILLARY ARCHITECTURE. www.indiandentalacademy.com
  3. 3. DIAGNOSIS AND APPROPRIATE TREATMENT PLANNING ARE CRITICAL IN OBTAINING A SUCCESSFUL OUTCOME. www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. BONE RESORPTION FOLLOWING ANTERIOR TOOTH EXTRACTION OFTEN COMPROMISES GINGIVAL TISSUE LEVELS FOR THE IMPLANT SUPPORTED RESTORATIONS. www.indiandentalacademy.com
  6. 6. PRIMARY OBJECTIVE: COMPLETE RECONSTRUCTION OF TOOTH AND GINGIVAL RELATED AESTHETICS. PREDICTABILITY: DEPENDS ON THE TISSUE LOSS PRESENT AT THE INITIATION OF TREATMENT. www.indiandentalacademy.com
  7. 7. DIAGNOSIS AND TREATMENT PLANNING PLAY A VERY IMPORTANT ROLE FOR A SUCCESSFUL OUTCOME. TREATMENT PLANNIG MUST ADDRESS HARD AND SOFT TISSUE DEFICIENCIES AND COMBINE THIS WITH PRECISION IN IMPLANT PLACEMENT. www.indiandentalacademy.com
  8. 8. FACTORS AFFECTING AESTHETIC OUTCOME . PATIENT SELECTION AND SMILE LINE. TOOTH POSITION. ROOT POSITION OF THE ADJACENT TEETH. BIOTYPE OF THE PERIODONTIUM AND TOOTH SHAPE. THE BONY ANATOMY OF IMPLANT SITE. THE POSITION OF THE IMPLANT. www.indiandentalacademy.com
  9. 9. PATIENT SELECTION AND SMILE LINE. PATIENT DESIRES. BENEFITS OF IMPLANT RESTORATION. ADDITIONAL LENGTH OF TIME. ADDITIONAL COST. www.indiandentalacademy.com
  10. 10. PATIENTS AESTHETIC EXPECTATIONS MUST BE EVALUATED TOGETHER WITH THERE LIP ACTIVITY AND LIP LENGTH. www.indiandentalacademy.com
  11. 11. TOOTH POSITION TOOTH POSITION APICOCORONAL FACIOLINGUAL MESIODISTAL www.indiandentalacademy.com
  12. 12. APICO CORONAL POSITION: THE GINGIVAL MARGIN OF TOOTH TO BE EXTRACTED FOR IMMEDIATE PLACEMENT MUST BE EVALUATED. www.indiandentalacademy.com
  13. 13. MESIODISTAL POSITION: IDEALLY THE MESIODISTAL TOOTH WIDTH SHOULD BE EQUAL TO THE WIDTH OF THE CONTRALATERAL TOOTH FOR AN GOOD AESTHETIC OUTCOME. EXCESSIVE MESIO DISTAL SPACE IN THE REGION REQUIRING IMPLANT RESTORATION. RESTORATION RESULTING WITH ABSENCE OF INTERDENTAL PAPILLA www.indiandentalacademy.com
  14. 14. ROOT POSITION OF THE ADJACENT TEETH. TEETH WITH ROOT PROXIMITY OFTEN PRECLUDES PLACING OF IMPLANTS. THE THIN BONE PRESENT CREATES A GREATER RISK OF LATERAL RESORPTION LEADING TO DECREASE IN THE VERTICAL BONE HEIGHT AFTER EXTRACTION OR IMPLANT PLACEMENT. www.indiandentalacademy.com
  15. 15. BIOTYPE OF PERIODONTIUM AND TOOTH SHAPE. THIN SCALLOPED PERIODONTIUM THIN BIOTYPE REQUIRES THE IMPLANT BODY AND SHOULDER TO BE PLACED MORE PALATALLY TO MASK ANY TITANIUM SHOWTHROUGH. THICK,FLAT PERIODONTIUM. www.indiandentalacademy.com
  16. 16. Thin scalloped >15% DELICATE SOFT TISSUE CURTAIN DEHISCENCE AND FENESTRATION REDUCED QUALITY AND QUANTITY OF KERATINISED GINGIVA. REDUCED FACIALLY AND INTER PROXIMALLY WITH INSULT www.indiandentalacademy.com
  17. 17. THICK FLAT DENSER MORE FIBROTIC SOFT TISSUE CONTOUR INCREASED QUALITY AND QUANTITY OF THE KERATNISED MUCOSA POCKET FORMATION WITH INSULT CONTACT AREAS ARE LOCATED MORE TOWARDS THE MIDDLE THIRD OF THE TOOTH www.indiandentalacademy.com
  18. 18. IDEALLY THE FACIAL CONTOUR SHOULD BE SLIGHTLY FLATTER THAN THE CONTRALATERAL NATURAL TOOTH TO MINIMISE APICAL DISPLACEMENT OF THE FREE GINGIVAL MARGIN AFTER INSERTION. OVER CONTOURING OF IMPLANT PROVISIONAL RESTORATION AS IT EMERGES FROM THE FREE GINGIVAL MARGIN RESULTING IN APICAL MIGRATION OF THE SOFT TISSUES. www.indiandentalacademy.com
  19. 19. BONY ANATOMY OF IMPLANT SITE. BONY ANATOMY OF THE SITE MUST HAVE A THREE DIMENSIONAL CONFIGURATION THAT PERMITS PLACEMENT OF THE IMPLANT IN RESTORATIVELY IDEAL POSITION. BONE GRAFTING IS ADVISED IN CASE OF ANY INADEQUACIES. INADEQUATE BUCCOLINGUAL WIDTH FOR IMPLANT PLACEMENT. www.indiandentalacademy.com
  20. 20. IMPLANT POSITION IMPLANT SHOULD BE PLACED SUCH THAT IT ALLOWS THE MAINTENANCE OF BOTH HARD AND SOFT TISSUE ARCHITECTURE. Implant position Apicocoronal placement Mesiodistal placement Faciolingual Placement. www.indiandentalacademy.com
  21. 21. •APICOCORONAL PLACEMENT IMPLANT SHOULD BE PLACED 3- 4mm APICAL TO THE EXISTING FREE GINGIVAL MARGIN. ADEQUATE ROOM IS REQUIRED FOR THE TRANSITION FROM THE HEAD OF THE IMPLANT TO THE POINT WHERE THE RESTORATION EXITS THE FREEGINGIVAL MARGIN. IDEAL PLACEMENT SHALLOW PLACEMENT OF AN IMPLANT RESULTING IN INADEQUATE SPACE FOR TRANSITION AND A SHORT RESTORATION IN LENGTH. www.indiandentalacademy.com
  22. 22. MESIODISTAL PLACEMENT IMPROPER MESIODISTAL POSITIONING OF IMPLANTS CAN HAVE A SUBSTANTIAL EFFECT ON THE GENERATION OF INTERPROXIMAL PAPILLARY SUPPORT AS WELL AS ON THE OSSEOUS CREST OF THE ADJACENT TEETH. IT SHOULD BE PLACED 1.5-2mm FROM AN ADJACENT TOOTH. www.indiandentalacademy.com
  23. 23. FACIO LINGUAL POSITION THE AMOUNT OF AVAILABLE BONE SHOULD BE ATLEAST 1mm GREATER THAN THE IMPLANT DIAMETER ON EACH SIDE. IDEAL IMPLANT PLACEMENT SHOULD BE PALATAL TO AN IMAGINARY LINE THAT OUTLINES THE CURVATURE OF THE TEETH www.indiandentalacademy.com
  24. 24. TWO ANATOMIC STRUCTURES ARE IMPORTANT IN DETERMINING THE PREDICTABILITY OF THE SOFT TISSUES AFTER IMPLANT PLACEMENT 1. HEIGHT AND THE THICKNESS OF THE FACIAL BONE WALL AND 2. BONE HEIGHT OF THE ALVEOLEAR CREST IN THE INTER PROXIMAL AREA. www.indiandentalacademy.com
  25. 25. . HEIGHT AND THE THICKNESS OF THE FACIAL BONE WALL THIS WAS BASED ON THE VERTICAL DISTANCE OF THE OSSEOUS CREST TO THE FREE GINGIVAL MARGIN. THE GREATER THE DISTANCE THE GREATER WILL BE THE RISK AFTER AN INVASIVE PROCEDURE MEASURING THIS HEIGHT BEFORE AN EXTRACTION WILL HELP US ANTICIPATE THE FINAL POSITION OF THE FREE GINGIVAL MARGIN www.indiandentalacademy.com
  26. 26. BONE HEIGHT OF THE ALVEOLEAR CREST IN THE INTER PROXIMAL AREA. THIS PLAYS AN IMPORTANT ROLE IN THE PRESENCE OR ABSENCE OF PERI-IMPLANT PAPILLAE. www.indiandentalacademy.com
  27. 27. IMPLANT POSITION www.indiandentalacademy.com
  28. 28. RESTORATION DRIVEN IMPLANT PLACEMENT CONCEPT. OPTIMAL ESTHETIC IMPLANT RESTORATION DEPENDS ON PROPER THREE DIMENSIONAL IMPLANT POSITIONING. FOUR POSITIONAL PARAMETERS CONTRIBUTE TO THE SUCCESS OF THE RESTORATION AND MUST BE CAREFULLY CONSIDERED DURING IMPLANT PLACEMENT. www.indiandentalacademy.com
  29. 29. BUCCOLINGUAL POSITION: BUCCAL DEHISCENCE RESTORATION PALATAL RIDGE LAP UNHYGIENIC, UNAESTHETIC BUCCAL WALL THICKNESS 1MM TO PREVENT RECESSION. www.indiandentalacademy.com
  30. 30. MESIO-DISTAL DECREASED PAPILLARY HEIGHT RESTORATIVE PROBLEMS POOR EMBRASSURE FORM AND EMERGENCE PROFILE LONG CONTACT ZONE www.indiandentalacademy.com
  31. 31. APICO CORONAL ERRORS IN APICO CORNAL IMPLANT PLACEMENT CAN HAVE SERIOUS AESTHETIC AND BIOMECHANICAL IMPLICATIONS. AN IMPLANT PLACED TOO CORONALLY WILL ALLOW ADEQUATE TRANSITION FROM THE HEAD OF THE IMPLANT TO THE POINT WHERE THE RESTORATION EXITS FROM THE FREE GINGIVAL MARGIN www.indiandentalacademy.com
  32. 32. TOO DEEP IMPLANT PLACEMENT DIFFICULTY IN IMPRESSION MAKING DIFFICULTY IN INSTRUMENTATION TISSUE IMPENGINGMENT www.indiandentalacademy.com
  33. 33. www.indiandentalacademy.com
  34. 34. CONSIDERATIONS FOR MULTIPLE IMPLANTS www.indiandentalacademy.com
  35. 35. www.indiandentalacademy.com
  36. 36. CONCLUSION WHEN A PATIENT HAS A MISSING ANTERIOR TEETH AND DESIRES REPLACEMENT, ADECISSION SHOULD BE MADE WHETHER HE HAS TO GO FOR A BRIDGE OR AND IMPLANT OR A RESIN BONDED PROSTHESIS AFTER A THROUGH EXAMINATION AND DIAGNOSIS FOR A PREDICTABLE AESTHETICS www.indiandentalacademy.com
  37. 37. REFERENCES 1.TREATMENT PLANNONG OF IMPLANTS IN AESTHETIC ZONE, BRITISH DENTAL JOURNAL, VOL 201, NO-2, JUL 22 2006. 2. DEVELOPMENT OF SOFT TISSUE EMERGENCE PROFILE: A TECHNIQUE, J PROSTHET DENT, 1994, 71, 364-368. www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com

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