Tooth to Implant Supported Fixed Partial Dentures. OBJECTIVE: Tooth-to-implant–connected prostheses have been described as a possible treatment option for patients with long-span edentulous situations that were not conducive for placement of an adequate number of supporting implants. In this comprehensive overview of systematic reviews, the incidence of complications and the long-term survival rates of tooth-to-implant–supported fixed partial dentures (FPDs) were evaluated to determine whether it is a viable treatment.

1. Tooth-to-Implant Supported Fixed Partial
Dentures- A Comprehensive Overview of
Systematic Reviews
AUTHORS:TING, MIRIAM ; FAULKNER, ROBERT J.;
DONATELLI, DAVID P.; SUZUKI, JON B.
2019
Faryal Afzal

2. Objectives:
Tooth-to-implant–connected prostheses have been described as a possible treatment option
for patients with long-span edentulous situations that were not conducive for placement of an
adequate number of supporting implants. In this comprehensive overview of systematic
reviews, the incidence of complications and the long-term survival rates of tooth-to-implant–
supported fixed partial dentures (FPDs) were evaluated to determine whether it is a viable
treatment.

3. Introduction
What are implant-supported dentures?
An implant-supported denture is an oral appliance that replaces several teeth at once.
It’s similar to a traditional denture. But instead of resting on top of your gums, an implant-
supported denture attaches directly to your jawbone using dental implants.
DENTAL IMPLANT? Dental implants are tiny threaded posts that replace missing teeth
roots. Implant-supported dentures offer improved stability for chewing, eating and
speaking.
Indications: For Implant-Supported Restorations
o In partially edentulous pts. are the free-end distal extension when no posterior abutment is
available.
o Long edentulous span.
*In both situations, conventional dental treatment plan would include a partial removal
prosthesis. However with advent of dental implant, pt. can benefit from fixed restorations.

4. Dental Implant (Cont.)
ContraIndications: (To Implant Placement)
o Acute illness.
o Terminal illness.
o Pregnancy.
o Uncontrolled metabolic disease.
o Tumoricidal irradiation of implant site.
o Unrealistic pt. expectation.
o Improper pt. motivation.
o Lack of operator experience.

5. Advantages (Tooth-to-Implant Supported
Prosthesis)
o Increased mechanoreception. Mechanoreceptors – have ability to detect
stimuli such as touch, pressure, vibration & sound from external and internal
environment.
o Additional support for the total load on the dentition.
o Increased treatment possibilities for the restorative dentist.
o Reduced cost of teeth replacement.
o And the elimination of cantilevering. *FDP in which only one side of pontic
is attached to a retainer referred as cantilevered. * The bone surrounding the
cantilever fpd is subjected to Increased Torquing forces which maybe associated
with failure of bone-implant interface or bone loss around fpd.

6. Disadvantages (Tooth-to-Implant Supported
Prosthesis)
o Increased need for repair and maintenance.
o Increased periodontal and prosthetic complications.
o Difference in mobility between the teeth and osseointegrated implants may
result in excessive stresses on the implant and subsequent marginal bone loss or
osseointegration failure.

7. Complications
Biological & Technical complications were reported.
Biological Complications:
o Peri-Apical Lesions
o Caries
o Tooth fracture
o Periapical pathology
o Loss of Osseointegration
o Fistulas

8. Complications (Cont.)
Technical Complications:
o Porcelain occlusal fracture
o Screw loosening
o Prosthesis remake
o Facing fracture and replacement of composite plug
o Cement failure and screw fractures
o Occlusal interferences requiring adjustment and material replacement
o Loss of retention.

9. Complications
Tooth Intrusion – was reported in abutment teeth.
One review conducted a meta-analysis on the intrusion between the rigid
connection group and the nonrigid connection group of the tooth-to‐implant–
supported FPDs.
*In the nonrigid tooth-to-implant FPDs, there were conflicting reports of intrusion
in abutment teeth.
*no intrusion was detected in the abutment teeth of rigidly connected tooth-to-
implant FPDs.

10. Conclusions
Within the limitations of this overview, it was concluded that (1) the 10-year survival rates
for tooth-to-implant FPDs were lower than the 5-year survival rates, (2) the tooth-to-
implant FPDs' survival was lower than the individual abutment tooth or implant
supporting it, (3) the biological and technical complications were more at 10 years
compared with 5 years, and (4) the intrusion of the abutment teeth was more in the
nonrigid connection FPDs than the rigid connection FPDs. Therefore, tooth-to-implant
FPDs are a viable option but should be considered secondary to other available options
with higher long-term survival rates and lower complications.

11. Reference
https://journals.lww.com/implantdent/Fulltext/2019/10000/Tooth_to_Implant_Supported_Fixe
d_Partial_Denture_.12.aspx

12. THANKYOU 