Treatment planing in dental implants/ orthodontic continuing education

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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 planing in dental implants/ orthodontic continuing education

  1. 1. Treatment planning INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Loss of teeth • Loss of function • Disuse atrophy of ridge • Migration of teeth • TMJ www.indiandentalacademy.com
  3. 3. Sequelae Of Loss Of Teeth www.indiandentalacademy.com
  4. 4. Occlusal Plane Derangement www.indiandentalacademy.com
  5. 5. Occlusal Plane Derangement www.indiandentalacademy.com
  6. 6. Shift Of Masticatory Apparatus www.indiandentalacademy.com
  7. 7. Treatment plan • Fixed dentures • Implant supported fixed denture • Removable partials • Make a dental cripple www.indiandentalacademy.com
  8. 8. Fixed dentures are the most preferred! www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10. www.indiandentalacademy.com
  11. 11. www.indiandentalacademy.com
  12. 12. www.indiandentalacademy.com
  13. 13. www.indiandentalacademy.com
  14. 14. Removable partial dentures may be the IDEAL treatment choice www.indiandentalacademy.com
  15. 15. Solution or the problem? www.indiandentalacademy.com
  16. 16. Problem continues…. www.indiandentalacademy.com
  17. 17. Indications for a RPD • Length of edentulous span • No abutment tooth posterior to the edentulous area • Need for cross arch stabilization • Excessive bone loss of the residual ridgewww.indiandentalacademy.com
  18. 18. • Reduced Periodontal support of the remaining teeth • Patient desires • Youth • Physically or emotionally handicapped www.indiandentalacademy.com
  19. 19. • Abutments with guarded prognosis • Economic considerations www.indiandentalacademy.com
  20. 20. Contraindications • Epileptic patient having frequent and severe attacks, without premonition • Poor patient attitude www.indiandentalacademy.com
  21. 21. Treatment plan • Examination • Diagnosis & prognosis • Comprehensive rehabilitation • Pre prosthetic treatment • Revaluation • Prosthetic treatment plan • Treatment phase • Maintenance phasewww.indiandentalacademy.com
  22. 22. Principle of RPD is the DE VAN’s principle. Broad distribution of forces Least damage to the abutments Effective utilization ofwww.indiandentalacademy.com
  23. 23. THE SOLUTION IS Keep the end in mind Plan treatment for a favorable and predictable prognosis www.indiandentalacademy.com
  24. 24. Treatment planning • Identification of patients needs • Correction of existing disease • Prevention of future disease • Restoration of function • Improvement of appearance www.indiandentalacademy.com
  25. 25. Evaluation of existing prosthesis www.indiandentalacademy.com
  26. 26. Treatment of abused tissues • Inflammed and irritated mucosa www.indiandentalacademy.com
  27. 27. Steps for successful treatment • Step 1  ascertaining what the patient desires or wants • Step 2  finding what he actually needs • Step 3  developing a treatment plan relevant to the patient’s wants and needs • Step 4  executing the treatment plan after explaining the plan to the patient McCracken's Removable Partial Prosthodontics www.indiandentalacademy.com
  28. 28. Evaluation of occlusion • Collapsed occlusion • Traumatic occlusion • Deranged occlusal plane Herbert T. Shillingburgwww.indiandentalacademy.com
  29. 29. • Signs of traumatic occlusion – Excessive wear of teeth – Chipping or fracture – Tooth mobility, migration or discomfort during occlusal contact – Pain in the T.M.J , muscle spasm or joint dysfunction • Radiographic – Widening of periodontal ligament space – Thickening of lamina dura – Root resorption or alveolar resorption www.indiandentalacademy.com
  30. 30. Signs of collapse of occlusion • Collapse of vertical dimension of occlusion – Requires extensive treatment www.indiandentalacademy.com
  31. 31. www.indiandentalacademy.com
  32. 32. Treatment Objectives • Restore lost tooth structure • Restore lost VD • Establish new horizontal relation • Develop new engram • Transfer data to articulator • Develop new occlusal relationship for the established VD&HR www.indiandentalacademy.com
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  35. 35. www.indiandentalacademy.com
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  37. 37. Diagnostic wax up www.indiandentalacademy.com
  38. 38. Modified dentures www.indiandentalacademy.com
  39. 39. Diagnostic casts www.indiandentalacademy.com
  40. 40. •Analysis of the existing occlusion »Angulation »inclination » supraeruption » elongation » jaw relation » occlusal plane » occlusal contacts » interference » interocclusal space » proximal tooth contacts » guide planeswww.indiandentalacademy.com
  41. 41. Analysis of existing occlusion » Angulation » Inclination » Supraeruption » Elongation www.indiandentalacademy.com
  42. 42. Analysis of existing occlusion » Interocclusal space » Proximal tooth contacts Type of restoration Anterior Posterior Removable 12 mm. 12 mm www.indiandentalacademy.com
  43. 43. Management of less Interarch space. 1. Surgical reduction of tuberosities. 2. Osteoplasty and /or soft tissue reduction of implant region 3. Selective grinding 4. Prosthodontic restorations 5. Endodontic therapy. www.indiandentalacademy.com
  44. 44. Management of increased Interarch space. •MMay be decreased by addition of onlay grafts . •AAutogenous and /or membrane grafts. –AAlloplastic grafts www.indiandentalacademy.com
  45. 45. Analysis of existing occlusion » Jaw relation » Occlusal plane www.indiandentalacademy.com
  46. 46. Analysis of existing occlusion » Occlusal contacts » Interference www.indiandentalacademy.com
  47. 47. Occlusion • Occlusal plane • Occlusal relation • CO CR discrepancy www.indiandentalacademy.com
  48. 48. Correction of occlusal plane • Enameloplasty • Onlay restoration • Intentional RCT & crown • Orthodontics • Extraction • Sinus lift • Increase VD www.indiandentalacademy.com
  49. 49. Intentional RCT www.indiandentalacademy.com
  50. 50. Tilted abutment www.indiandentalacademy.com
  51. 51. • Angulation of abutment • Tooth contact www.indiandentalacademy.com
  52. 52. Orthodontic up righting www.indiandentalacademy.com
  53. 53. Analysis of abutment • Root length • Size • Form • Crown root ratio www.indiandentalacademy.com
  54. 54. Abutment evaluation • Dentition and abutment • Caries susceptibility www.indiandentalacademy.com
  55. 55. Restorations www.indiandentalacademy.com
  56. 56. Caries susceptibility restorative status www.indiandentalacademy.com
  57. 57. Post-Endodontic Restorations Presented by Dr.T.V.Padmanabhan www.indiandentalacademy.com
  58. 58. Salvage or Sacrifice www.indiandentalacademy.com
  59. 59. www.indiandentalacademy.com
  60. 60. www.indiandentalacademy.com
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  62. 62. www.indiandentalacademy.com
  63. 63. Periodontal conditions www.indiandentalacademy.com
  64. 64. Fixed Splinting • Incase of compromised periodontal support of remaining teeth • Short tapered roots • To improve support for the partial denture www.indiandentalacademy.com
  65. 65. www.indiandentalacademy.com
  66. 66. Convert modification areas to FPDs, making design simple www.indiandentalacademy.com
  67. 67. Missing teeth www.indiandentalacademy.com
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  70. 70. www.indiandentalacademy.com
  71. 71. Removable splinting • When abutment teeth exhibit a alveolar bone loss of greater than 50% splinting them by means of fixed splints to adjacent healthy teeth, the adjacent teeth is also subsequently weakened • Splinting may also be accomplished using properly designed removable partial dentures www.indiandentalacademy.com
  72. 72. • This is done by means of lingual plating in conjunction with multiple facially positioned clasp arms • Thus remaining teeth and removable prosthesis functions as a single functional unit • Forces are distributed over increased number of teeth, increasing the longevity of the remaining teeth www.indiandentalacademy.com
  73. 73. Existing prosthesis • Response of teeth and residual ridge to previous stress • Arch form www.indiandentalacademy.com
  74. 74. Plan the prosthesis www.indiandentalacademy.com
  75. 75. 1 Knowledge of design 2 Incorporation in to present clinical situation www.indiandentalacademy.com
  76. 76. Design 1 • Cingulam rest • I-bar clasp • A-P palatal bar • Proximal plate www.indiandentalacademy.com
  77. 77. Design 2 Only possible modificatio n is to incorporate embrasure clasp towww.indiandentalacademy.com
  78. 78. www.indiandentalacademy.com
  79. 79. Alternative treatment modalities www.indiandentalacademy.com
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  85. 85. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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