This document discusses the indications and contraindications of implant supported prostheses. It provides indications for different types of dental implants based on factors like the amount and location of available bone. Contraindications include uncontrolled medical conditions like diabetes or thyroid disorders that could impact healing. For patients with controlled conditions, careful planning is needed to minimize risks during dental procedures.
The document discusses immediate dentures, which are dentures fabricated and inserted immediately following tooth extraction. It describes the different types of immediate dentures, including conventional/classic immediate dentures, interim immediate dentures, labial flange dentures, partial flange dentures, and flangeless/socketed dentures. The advantages of immediate dentures include maintaining a patient's appearance without teeth, providing a bandage effect to extraction sites, and allowing easier adaptation to dentures during healing. However, immediate dentures also present challenges like reduced retention from undercuts caused by remaining posterior teeth.
This document provides an overview of implant supported overdentures, including definitions, history, indications, contraindications, advantages, disadvantages, treatment options, and procedures. Key points discussed include:
- Overdentures are removable prostheses that cover natural tooth roots, implants, or both for support.
- Implant supported overdentures have better outcomes than conventional dentures or overdentures supported only by natural tooth roots.
- Treatment options depend on factors like jaw, bone quality, number of implants, and can involve bar-retained or independent attachments.
- Procedures involve medical evaluation, treatment planning, transitional dentures, surgical placement, attachment connection, and definitive prosthesis fabrication
This document discusses attachments used in prosthodontics. It begins with an introduction to attachments, defining them as mechanical devices used to retain and stabilize prostheses. The document then covers the history, classification, indications, disadvantages, and selection of attachments. It discusses both intracoronal and extracoronal attachments. In summary, the document provides an overview of attachments, their uses in prosthodontics, and factors to consider in selecting the appropriate attachment.
The document discusses implant dentistry and implant prosthetics. It covers topics such as reasons for dental implants, implant placement techniques, impressions, fixed and removable implant prostheses, and occlusion considerations. Implant placement can be done using two-stage or single-stage surgical protocols. Impressions can be taken at the fixture or abutment level using closed or open tray techniques. Restorations can be cement-retained or screw-retained. Proper occlusion is important to minimize risks and maximize function.
This document discusses prosthetic options for implant dentistry. It outlines 5 prosthetic options (FP-1 to FP-3 and RP-4 to RP-5) and describes the amount of support and number of implants required for each. The key steps are to first plan the desired prosthesis, then determine the ideal abutment positions and amount of support needed before placing implants and designing the final restoration. Removable prostheses offer advantages like fewer implants and reduced costs but have higher risks of bone resorption over time.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
This document discusses the components and design of an I-bar removable partial denture (RPD). It begins by defining RPI, which stands for rest, plate, and I-bar clasp. It then describes the key components of an I-bar RPD including mesial rests, proximal plates, and a modified I-bar retainer called the RPI system developed by Krol. The RPI system aims to reduce tooth coverage and stress compared to a standard I-bar by modifying the rest, plate, and I-bar clasp design.
The document discusses immediate dentures, which are dentures fabricated and inserted immediately following tooth extraction. It describes the different types of immediate dentures, including conventional/classic immediate dentures, interim immediate dentures, labial flange dentures, partial flange dentures, and flangeless/socketed dentures. The advantages of immediate dentures include maintaining a patient's appearance without teeth, providing a bandage effect to extraction sites, and allowing easier adaptation to dentures during healing. However, immediate dentures also present challenges like reduced retention from undercuts caused by remaining posterior teeth.
This document provides an overview of implant supported overdentures, including definitions, history, indications, contraindications, advantages, disadvantages, treatment options, and procedures. Key points discussed include:
- Overdentures are removable prostheses that cover natural tooth roots, implants, or both for support.
- Implant supported overdentures have better outcomes than conventional dentures or overdentures supported only by natural tooth roots.
- Treatment options depend on factors like jaw, bone quality, number of implants, and can involve bar-retained or independent attachments.
- Procedures involve medical evaluation, treatment planning, transitional dentures, surgical placement, attachment connection, and definitive prosthesis fabrication
This document discusses attachments used in prosthodontics. It begins with an introduction to attachments, defining them as mechanical devices used to retain and stabilize prostheses. The document then covers the history, classification, indications, disadvantages, and selection of attachments. It discusses both intracoronal and extracoronal attachments. In summary, the document provides an overview of attachments, their uses in prosthodontics, and factors to consider in selecting the appropriate attachment.
The document discusses implant dentistry and implant prosthetics. It covers topics such as reasons for dental implants, implant placement techniques, impressions, fixed and removable implant prostheses, and occlusion considerations. Implant placement can be done using two-stage or single-stage surgical protocols. Impressions can be taken at the fixture or abutment level using closed or open tray techniques. Restorations can be cement-retained or screw-retained. Proper occlusion is important to minimize risks and maximize function.
This document discusses prosthetic options for implant dentistry. It outlines 5 prosthetic options (FP-1 to FP-3 and RP-4 to RP-5) and describes the amount of support and number of implants required for each. The key steps are to first plan the desired prosthesis, then determine the ideal abutment positions and amount of support needed before placing implants and designing the final restoration. Removable prostheses offer advantages like fewer implants and reduced costs but have higher risks of bone resorption over time.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
This document discusses the components and design of an I-bar removable partial denture (RPD). It begins by defining RPI, which stands for rest, plate, and I-bar clasp. It then describes the key components of an I-bar RPD including mesial rests, proximal plates, and a modified I-bar retainer called the RPI system developed by Krol. The RPI system aims to reduce tooth coverage and stress compared to a standard I-bar by modifying the rest, plate, and I-bar clasp design.
This document discusses occlusal equilibration and selective grinding. It begins by defining the key characteristics of a stable occlusion and the signs of an unstable occlusion. It then outlines the principles, indications, goals and procedures for occlusal equilibration and selective grinding. Specific techniques are covered such as how to eliminate interferences in centric relation, achieve the centric contact position, and adjust for lateral and protrusive interferences. The document emphasizes developing simultaneous contacts between cusp tips and flat surfaces to achieve occlusal stability.
This document provides information about indirect retainers used in removable partial dentures (RPDs). It defines indirect retainers as parts of RPDs that function through lever action to help prevent displacement of distal extension bases. The main functions of indirect retainers are to shift the fulcrum line away from lifting forces and stabilize the denture. Factors like the effectiveness of direct retainers, distance from the fulcrum line, and rigidity of connectors impact the effectiveness of indirect retention. Common types of indirect retainers discussed include auxiliary occlusal rests, canine extensions, and continuous bar retainers.
Principles of tooth preparation in Fixed Partial DenturesVinay Kadavakolanu
The document discusses principles of tooth preparation for dental restorations. It summarizes that the all-ceramic crown preparation design requires the highest percentage of tooth structure reduction at 65.26%, while ceramic veneers require the lowest at 30.28%. Proper tooth preparation aims to preserve tooth structure, provide retention and resistance, maintain structural durability and marginal integrity, and preserve the periodontium. The amount and location of tooth reduction impacts these factors.
The document discusses overdentures, which are removable partial or complete dentures that cover and rest on one or more remaining natural teeth, tooth roots, or dental implants. Key points include:
- Retaining natural teeth can preserve alveolar bone and periodontal receptors important for function.
- Abutment teeth are prepared with short copings or left uncovered, and attachments may be added to improve retention.
- Overdentures can improve retention, stability, support and proprioception compared to conventional dentures.
- Proper case selection and maintenance are important for long term success.
Occlusion refers to the relationship between opposing teeth when the jaws are closed. There are several types of complete denture occlusion including balanced, monoplane, and lingualized occlusion. Balanced occlusion involves simultaneous anterior and posterior tooth contacts on both sides during chewing and is unique to dentures but enhances stability. It requires a minimum of three contact points. Monoplane occlusion uses non-anatomic teeth without cuspal height for a simpler arrangement, while lingualized occlusion positions the maxillary lingual cusps against the mandibular teeth. Both have advantages and disadvantages related to function, forces, and appearance. Proper planning of occlusion is important for complete dentures.
Surveyor and technique of Surveying in Removable partial dentureFarah Fahad
The document discusses surveying in removable partial dentures. It provides information on the history and development of dental surveyors. Key aspects covered include:
- The purpose of surveying is to determine the path of insertion, guiding planes, and contours for the design of removable partial dentures.
- Early instruments included paralleling devices and the first dental surveyors developed in the 1910s-1920s.
- Modern surveyors consist of a level platform, vertical arm, and interchangeable surveying tools to assess contours, undercuts, and plan the path of insertion.
- Surveying involves an initial assessment, analysis of retention and interference, and final survey to determine the survey lines and design of clasps
The document discusses different types of anchorage used in orthodontics. It defines anchorage as the resistance used to overcome the reaction to an applied force. There are different factors that affect a tooth's resistance to force, as well as different types of anchorage including extra-oral anchorage like headgear and intra-oral anchorage that can be intra-maxillary or inter-maxillary. Examples of each type are provided. Temporary orthodontic micro anchorage systems are also discussed as a modern method to reinforce anchorage.
Implants can provide support and retention for fixed or removable prostheses. There are various types of implants classified based on location and surgical exposure. Osseointegration is the key mechanism for implant integration with bone. Implants are indicated for fully and partially edentulous patients to improve function, aesthetics and quality of life over conventional dentures. Treatment options include implant overdentures, fixed bridges and single tooth implants. Masticatory performance is improved with implant supported or retained dentures compared to conventional dentures.
The document discusses the benefits of meditation for reducing stress and anxiety. Regular meditation practice can help calm the mind and body by lowering heart rate and blood pressure. Studies have shown that meditating for just 10-20 minutes per day can have significant positive impacts on both mental and physical health over time.
This document discusses balanced occlusion for complete dentures. It begins with an introduction that defines occlusion and the goal of reducing trauma to supporting tissues. It then defines various occlusion terms like centric occlusion, eccentric occlusion, functional occlusion, and balanced occlusion. The document discusses theories of complete denture occlusion and various concepts like balanced, monoplane, and lingualized occlusion. It outlines the objectives, characteristics, types, advantages, and factors influencing balanced occlusion. The factors discussed are condylar guidance, incisal guidance, plane of occlusion, cuspal angulation, and compensating curve. The document provides details on each of these factors and their significance in achieving balanced occlusion.
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
The document discusses various concepts of occlusion for fixed partial dentures, including bilaterally balanced occlusion, unilaterally balanced occlusion, and mutually protected occlusion. Bilaterally balanced occlusion aims for simultaneous contact on both sides but is difficult to achieve, while unilaterally balanced occlusion distributes forces to multiple teeth on the working side only. Mutually protected occlusion relies on anterior guidance to prevent posterior contact during excursive movements. The concepts vary in their distribution of forces and indications depending on a patient's needs.
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.
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.
The All-on-4 treatment involves placing only four dental implants - two in the front of each jaw and two tilted posteriorly at a 45 degree angle. This technique allows for fixed teeth to be placed even in patients with minimal bone volume, as the tilted posterior implants make use of available bone. Studies show a 98% success rate for All-on-4, and it provides patients with a permanent set of teeth similar to natural teeth, avoiding the need for removable dentures. The procedure is typically completed in one or two appointments, with temporary teeth placed immediately and permanent teeth in a follow up visit 6-8 months later.
This document discusses dental implants, including osseointegration, indications, contraindications, instruments, surgical procedures, complications, types of implants, and classifications of root form implants. The key points are:
- Osseointegration refers to the direct structural and functional connection between implants and bone without soft tissue interference.
- Dental implants can replace dentition to restore function and appearance or preserve alveolar bone.
- Surgical procedures for implant placement involve flap creation, drilling a recipient site, implant installation, and cover screw placement.
- Success requires avoiding contamination, preventing thermal or surgical bone damage, and achieving initial stability. Complications include nerve damage, soft tissue perforation,
Altered Cast Impression Technique for Fabrication of Maxillary Obturator- Jou...Dr. Prathamesh Fulsundar
An obturator is a maxillofacial prosthesis that is used to close an acquired tissue opening, primarily of the hard palate, and/or a contiguous alveolar or soft tissue structure that has been removed by surgery. (GPT-8)
This clinical report describes the prosthodontic rehabilitation andfabrication of an obturator used for a partially edentulous patient with anacquired unilateral maxillary defect.
The impression was made in 2 steps in a similar manner as the altered castimpression technique.
Precise impression of the resection defect despite trismus was possible, thus providing this patient an accurately fitting obturator prosthesis.
This document discusses the history and classification of precision dental attachments. It begins by outlining some of the early developments in attachment designs from the 19th century. It then classifies attachments based on their fabrication method, relationship to abutment teeth, stiffness, and geometric configuration. The advantages and disadvantages of attachments are provided. Key factors in selecting abutment teeth are identified. Requirements for ideal abutment teeth are outlined. Contraindications and the role of attachments in different types of prosthodontic treatments are summarized.
The document discusses risk assessment for dental implant treatment. It finds that poor oral hygiene, a history of periodontitis, and cigarette smoking are strong risk indicators for peri-implant disease based on evidence from experimental and clinical studies. Future prospective studies are still needed to confirm these factors as true risk factors. The review also identifies that probing depth, bleeding on probing, and suppuration should be regularly assessed to diagnose peri-implant diseases, and radiographs are required to evaluate bone levels around implants.
Everything About Dental Implantology- How to Put Dental Implants.Dr. Aman Singh
This document provides an overview of a mini residency training course on oral implantology held in India. It discusses the academy providing the training, Odontos Academy, which is ISO certified and has trained over 1500 students across India. The course will cover topics related to dental implants including neurovascular considerations, implant surfaces, deciding implant length and diameter, osseointegration, implant stability, immediate loading, and the biological reactions and longevity of dental implants. It also provides details on the surgical procedure for placing dental implants and managing risks if an implant is too close to the inferior alveolar nerve, which can be addressed by performing nerve lateralization to reposition the nerve away from the implant site.
This document discusses occlusal equilibration and selective grinding. It begins by defining the key characteristics of a stable occlusion and the signs of an unstable occlusion. It then outlines the principles, indications, goals and procedures for occlusal equilibration and selective grinding. Specific techniques are covered such as how to eliminate interferences in centric relation, achieve the centric contact position, and adjust for lateral and protrusive interferences. The document emphasizes developing simultaneous contacts between cusp tips and flat surfaces to achieve occlusal stability.
This document provides information about indirect retainers used in removable partial dentures (RPDs). It defines indirect retainers as parts of RPDs that function through lever action to help prevent displacement of distal extension bases. The main functions of indirect retainers are to shift the fulcrum line away from lifting forces and stabilize the denture. Factors like the effectiveness of direct retainers, distance from the fulcrum line, and rigidity of connectors impact the effectiveness of indirect retention. Common types of indirect retainers discussed include auxiliary occlusal rests, canine extensions, and continuous bar retainers.
Principles of tooth preparation in Fixed Partial DenturesVinay Kadavakolanu
The document discusses principles of tooth preparation for dental restorations. It summarizes that the all-ceramic crown preparation design requires the highest percentage of tooth structure reduction at 65.26%, while ceramic veneers require the lowest at 30.28%. Proper tooth preparation aims to preserve tooth structure, provide retention and resistance, maintain structural durability and marginal integrity, and preserve the periodontium. The amount and location of tooth reduction impacts these factors.
The document discusses overdentures, which are removable partial or complete dentures that cover and rest on one or more remaining natural teeth, tooth roots, or dental implants. Key points include:
- Retaining natural teeth can preserve alveolar bone and periodontal receptors important for function.
- Abutment teeth are prepared with short copings or left uncovered, and attachments may be added to improve retention.
- Overdentures can improve retention, stability, support and proprioception compared to conventional dentures.
- Proper case selection and maintenance are important for long term success.
Occlusion refers to the relationship between opposing teeth when the jaws are closed. There are several types of complete denture occlusion including balanced, monoplane, and lingualized occlusion. Balanced occlusion involves simultaneous anterior and posterior tooth contacts on both sides during chewing and is unique to dentures but enhances stability. It requires a minimum of three contact points. Monoplane occlusion uses non-anatomic teeth without cuspal height for a simpler arrangement, while lingualized occlusion positions the maxillary lingual cusps against the mandibular teeth. Both have advantages and disadvantages related to function, forces, and appearance. Proper planning of occlusion is important for complete dentures.
Surveyor and technique of Surveying in Removable partial dentureFarah Fahad
The document discusses surveying in removable partial dentures. It provides information on the history and development of dental surveyors. Key aspects covered include:
- The purpose of surveying is to determine the path of insertion, guiding planes, and contours for the design of removable partial dentures.
- Early instruments included paralleling devices and the first dental surveyors developed in the 1910s-1920s.
- Modern surveyors consist of a level platform, vertical arm, and interchangeable surveying tools to assess contours, undercuts, and plan the path of insertion.
- Surveying involves an initial assessment, analysis of retention and interference, and final survey to determine the survey lines and design of clasps
The document discusses different types of anchorage used in orthodontics. It defines anchorage as the resistance used to overcome the reaction to an applied force. There are different factors that affect a tooth's resistance to force, as well as different types of anchorage including extra-oral anchorage like headgear and intra-oral anchorage that can be intra-maxillary or inter-maxillary. Examples of each type are provided. Temporary orthodontic micro anchorage systems are also discussed as a modern method to reinforce anchorage.
Implants can provide support and retention for fixed or removable prostheses. There are various types of implants classified based on location and surgical exposure. Osseointegration is the key mechanism for implant integration with bone. Implants are indicated for fully and partially edentulous patients to improve function, aesthetics and quality of life over conventional dentures. Treatment options include implant overdentures, fixed bridges and single tooth implants. Masticatory performance is improved with implant supported or retained dentures compared to conventional dentures.
The document discusses the benefits of meditation for reducing stress and anxiety. Regular meditation practice can help calm the mind and body by lowering heart rate and blood pressure. Studies have shown that meditating for just 10-20 minutes per day can have significant positive impacts on both mental and physical health over time.
This document discusses balanced occlusion for complete dentures. It begins with an introduction that defines occlusion and the goal of reducing trauma to supporting tissues. It then defines various occlusion terms like centric occlusion, eccentric occlusion, functional occlusion, and balanced occlusion. The document discusses theories of complete denture occlusion and various concepts like balanced, monoplane, and lingualized occlusion. It outlines the objectives, characteristics, types, advantages, and factors influencing balanced occlusion. The factors discussed are condylar guidance, incisal guidance, plane of occlusion, cuspal angulation, and compensating curve. The document provides details on each of these factors and their significance in achieving balanced occlusion.
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
The document discusses various concepts of occlusion for fixed partial dentures, including bilaterally balanced occlusion, unilaterally balanced occlusion, and mutually protected occlusion. Bilaterally balanced occlusion aims for simultaneous contact on both sides but is difficult to achieve, while unilaterally balanced occlusion distributes forces to multiple teeth on the working side only. Mutually protected occlusion relies on anterior guidance to prevent posterior contact during excursive movements. The concepts vary in their distribution of forces and indications depending on a patient's needs.
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.
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.
The All-on-4 treatment involves placing only four dental implants - two in the front of each jaw and two tilted posteriorly at a 45 degree angle. This technique allows for fixed teeth to be placed even in patients with minimal bone volume, as the tilted posterior implants make use of available bone. Studies show a 98% success rate for All-on-4, and it provides patients with a permanent set of teeth similar to natural teeth, avoiding the need for removable dentures. The procedure is typically completed in one or two appointments, with temporary teeth placed immediately and permanent teeth in a follow up visit 6-8 months later.
This document discusses dental implants, including osseointegration, indications, contraindications, instruments, surgical procedures, complications, types of implants, and classifications of root form implants. The key points are:
- Osseointegration refers to the direct structural and functional connection between implants and bone without soft tissue interference.
- Dental implants can replace dentition to restore function and appearance or preserve alveolar bone.
- Surgical procedures for implant placement involve flap creation, drilling a recipient site, implant installation, and cover screw placement.
- Success requires avoiding contamination, preventing thermal or surgical bone damage, and achieving initial stability. Complications include nerve damage, soft tissue perforation,
Altered Cast Impression Technique for Fabrication of Maxillary Obturator- Jou...Dr. Prathamesh Fulsundar
An obturator is a maxillofacial prosthesis that is used to close an acquired tissue opening, primarily of the hard palate, and/or a contiguous alveolar or soft tissue structure that has been removed by surgery. (GPT-8)
This clinical report describes the prosthodontic rehabilitation andfabrication of an obturator used for a partially edentulous patient with anacquired unilateral maxillary defect.
The impression was made in 2 steps in a similar manner as the altered castimpression technique.
Precise impression of the resection defect despite trismus was possible, thus providing this patient an accurately fitting obturator prosthesis.
This document discusses the history and classification of precision dental attachments. It begins by outlining some of the early developments in attachment designs from the 19th century. It then classifies attachments based on their fabrication method, relationship to abutment teeth, stiffness, and geometric configuration. The advantages and disadvantages of attachments are provided. Key factors in selecting abutment teeth are identified. Requirements for ideal abutment teeth are outlined. Contraindications and the role of attachments in different types of prosthodontic treatments are summarized.
The document discusses risk assessment for dental implant treatment. It finds that poor oral hygiene, a history of periodontitis, and cigarette smoking are strong risk indicators for peri-implant disease based on evidence from experimental and clinical studies. Future prospective studies are still needed to confirm these factors as true risk factors. The review also identifies that probing depth, bleeding on probing, and suppuration should be regularly assessed to diagnose peri-implant diseases, and radiographs are required to evaluate bone levels around implants.
Everything About Dental Implantology- How to Put Dental Implants.Dr. Aman Singh
This document provides an overview of a mini residency training course on oral implantology held in India. It discusses the academy providing the training, Odontos Academy, which is ISO certified and has trained over 1500 students across India. The course will cover topics related to dental implants including neurovascular considerations, implant surfaces, deciding implant length and diameter, osseointegration, implant stability, immediate loading, and the biological reactions and longevity of dental implants. It also provides details on the surgical procedure for placing dental implants and managing risks if an implant is too close to the inferior alveolar nerve, which can be addressed by performing nerve lateralization to reposition the nerve away from the implant site.
Implant : Challenging Drug Delivery Systembiniyapatel
This document discusses implantable drug delivery systems. Implants provide controlled delivery of drugs over long periods of time at the site of implantation. There are biodegradable and non-biodegradable implants. Implants can be classified based on their release mechanism, such as membrane permeation controlled, matrix diffusion controlled, or activation modulated systems. Implants offer benefits like continuous drug delivery and avoidance of peak concentrations but have disadvantages like requiring surgery and host reactions. Common applications of implants include cancer treatment, contraception, and ocular diseases.
This document discusses various complications that can occur with dental implants. It begins by classifying complications as accidents during surgery, early or late complications after surgery, and failures when desirable results are not achieved. Specific early complications discussed include bleeding/hematoma, swelling, ecchymosis, neurosensory disturbances, emphysema, and flap dehiscence. Late complications include failed osseointegration, peri-implantitis, and mechanical issues like screw loosening. The document provides details on causes and treatments for several common early complications.
This document discusses the clinical evaluation of dental implant patients. It covers topics such as definitions of dental implants, classifications of implants, components of implants, and pretreatment evaluation of potential implant patients. The pretreatment evaluation includes assessing medical history, dental history, local examination of bone and tissue quality, and determining if a patient's expectations are reasonable. Various classifications of available bone quality are provided, from abundant bone (Division A) to compromised bone (Division C), along with treatment options for each. The goal of the evaluation is to accurately diagnose a patient's current condition and determine if they are a suitable candidate for dental implants.
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.
Dental implants can be used to support crowns, bridges, or dentures for patients who are missing one or more teeth. There are several types of implants based on placement location and material. Implant surgery involves placing the implant fixture into the jawbone, with some procedures allowing the implant to heal below gum tissue or protruding above gum tissue. Regular dental visits are needed after implant placement to monitor bone and soft tissue health around the implants.
Dental implants are artificial roots, usually made of titanium, that are surgically placed into the jawbone to support replacement teeth. Implants can replace one or more missing teeth and provide support for dentures or bridges. The implant surgery involves drilling into the jawbone, placing the implant, and allowing time for osseointegration where the implant fuses with surrounding bone.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Indications & contra indications of implant supported prosthesis /certified f...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Selection of patient for intraoral implants / orthodontics training coursesIndian dental academy
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.
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.
Selection of dental implant patients /certified fixed orthodontic courses by ...Indian dental academy
The document discusses patient selection criteria for different types of intraoral implants. It provides an overview of various implant types including endosseous, subperiosteal, and transosteal implants. Indications and contraindications are described for each implant type based on factors like available bone structure and degree of edentulism. A thorough patient evaluation process is recommended involving medical/dental history, clinical exams, imaging, and prosthodontic planning to determine the most appropriate implant solution. Biomechanical considerations for implant placement and prosthesis design are also reviewed to minimize risks of overload.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document discusses patient selection criteria for different types of dental implants. It provides an overview of various implant types including endosseous, subperiosteal, and transosteal implants. Key factors for implant success like biomaterials, biomechanics, dental/medical evaluation, surgical requirements, healing processes and maintenance are reviewed. Indications and contraindications for different implant types are outlined based on bone quality and quantity, degree of edentulism, and practitioner training. Biomechanical principles for implant placement and prosthetic support are also covered.
The document discusses selection of patients for intraoral implants. It describes various types of implants including endosseous, subperiosteal, and transosteal implants. Key factors for successful long-term implant performance are discussed such as biomaterials, biomechanics, dental evaluation, medical evaluation, surgical requirements, healing processes, prosthodontics and post-insertion maintenance. Indications and contraindications for different implant types are provided based on bone availability and degree of edentulism.
Endodontic treatment and tooth extraction with dental implant placement are two main treatment options for a diseased tooth. There are numerous factors to consider when deciding between the options, including prognosis, risks and benefits, costs, and the patient's medical history and preferences. While implant survival rates are high in the short term, endodontic treatment has shown positive survival rates in both the short and long term. Additionally, endodontic treatment preserves the natural tooth and soft tissue, which is important for aesthetics. The optimal treatment must consider all relevant factors and the patient's best interests.
The document discusses the clinical evaluation of implant patients, including case types and indications, risk factors and contraindications, and the pre-treatment evaluation process. A comprehensive evaluation is needed to determine if implant therapy is possible, practical, and indicated for the patient. The evaluation should assess the patient's medical history, medications, habits, motivations, and oral examination to analyze the dentoalveolar condition and feasibility of implant placement. The patient's goals and expectations must also be evaluated to ensure realistic outcomes.
The document discusses the diagnostic process for removable partial dentures. It involves a thorough oral examination including medical and dental history, visual examination, radiographs, vitality testing, and analysis of diagnostic casts on an articulator and surveyor. This allows the dentist to evaluate tooth and tissue health, occlusion, interridge space, retention needs, and determine the ideal path of insertion for the partial denture. Inadequate diagnosis can lead to deficiencies in design or support, resulting in treatment failure.
Root canal treatment and dental implants are both viable treatment options for replacing missing or compromised teeth. Success rates of each treatment are generally high, ranging from 92-97% for root canals and 95-99% for implants. Other factors beyond success rates must be considered, including patient characteristics, habits, concerns, and costs. Overall, both treatments can successfully restore oral function but root canals may involve fewer complications and costs compared to implants. The decision requires weighing risks and benefits based on the individual clinical situation.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Long term effects of orthodontic treatment /certified fixed orthodontic cou...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
This document discusses the clinical evaluation of patients for dental implants. It outlines the key steps in evaluating implant patients, including:
1. Conducting a thorough medical and dental history to assess overall health and risk factors.
2. Performing an intraoral examination to evaluate the oral tissues and potential implant sites. This includes assessing bone quantity and quality using diagnostic models and radiographs.
3. Ensuring adequate space for implant placement and restoration by measuring interdental, interocclusal, and alveolar bone dimensions.
4. Identifying any habits, conditions, or anatomical limitations that could affect treatment outcomes.
Immediate dental implants provide several advantages over delayed implants. An immediate implant is placed directly into the extraction socket at the time of tooth removal. This summary outlines guidelines for immediate implant placement including patient selection criteria, surgical technique, and post-operative follow up. A case report details the successful placement of an immediate implant to replace an infected tooth. Results at one year found excellent osseointegration and minimal changes to the soft and hard tissues with no signs of infection or peri-implantitis. Immediate implants can reduce treatment time and discomfort for the patient while achieving functional and aesthetic restoration in a single visit.
This document discusses adult orthodontics, including:
- The history of adult orthodontics dating back to 1880.
- Reasons for the increased interest in adult orthodontics, such as improved appliance techniques and patient awareness.
- Differences between treating adult vs. adolescent patients, including that adults have no growth potential and require more collaboration with other specialists.
- Types of adult orthodontic patients and treatments, including adjunctive treatment to facilitate restorations by positioning teeth.
- Goals and procedures for adjunctive treatment focus on improving periodontal health and crown-root ratios by uprighting teeth.
This document discusses adult orthodontics and compares treatment of adult patients to adolescent patients. It notes that interest in orthodontic treatment for adults has increased due to factors like improved aesthetics from direct bonding and lingual appliances. Adult patients are generally divided into younger adults seeking comprehensive treatment and older adults prioritizing dental health. Treatment objectives, diagnosis, and planning require more customization for adults. Key differences from adolescents include no growth potential, more emphasis on symptoms over signs, and less adaptability.
Dental implant failure / /certified fixed orthodontic courses by Indian dent...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Dental implant failure /certified fixed orthodontic courses by Indian dental...Indian dental academy
This document discusses various factors that can contribute to dental implant failures. It covers preoperative factors like patient selection and medical conditions, as well as intraoperative errors like improper surgical technique, implant contamination, positioning errors, and errors in maintaining sterility. Postoperative factors discussed include errors in implant exposure timing, as well as prosthetic and soft tissue factors. The document provides details on strategies to avoid common errors and optimize outcomes for dental implant procedures.
Similar to Indications & contra indications of implant supported prosthesis / implant dentistry course/ implant dentistry course (20)
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
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.
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.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
This document discusses dental occlusion concepts and philosophies for complete dentures. It introduces key terms like physiologic occlusion and defines different occlusion schemes like balanced articulation and monoplane articulation. The document discusses advantages and disadvantages of using anatomic versus non-anatomic teeth for complete dentures. It also outlines requirements for maintaining denture stability, such as balanced occlusal contacts and control of horizontal forces. The goal of occlusion for complete dentures is to re-establish the homeostasis of the masticatory system disrupted by edentulism.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses dental casting investment materials. It describes the three main types of investments - gypsum bonded, phosphate bonded, and ethyl silicate bonded investments. For gypsum bonded investments specifically, it details their classification, composition including the roles of gypsum, silica, and modifiers, setting time, normal and hygroscopic setting expansion, and thermal expansion. It provides information on how the properties of gypsum bonded investments are affected by their composition. The document serves as a comprehensive overview of dental casting investment materials.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Find out more about ISO training and certification services
Training: ISO/IEC 27001 Information Security Management System - EN | PECB
ISO/IEC 42001 Artificial Intelligence Management System - EN | PECB
General Data Protection Regulation (GDPR) - Training Courses - EN | PECB
Webinars: https://pecb.com/webinars
Article: https://pecb.com/article
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Slideshare: http://www.slideshare.net/PECBCERTIFICATION
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
Reimagining Your Library Space: How to Increase the Vibes in Your Library No ...Diana Rendina
Librarians are leading the way in creating future-ready citizens – now we need to update our spaces to match. In this session, attendees will get inspiration for transforming their library spaces. You’ll learn how to survey students and patrons, create a focus group, and use design thinking to brainstorm ideas for your space. We’ll discuss budget friendly ways to change your space as well as how to find funding. No matter where you’re at, you’ll find ideas for reimagining your space in this session.
Reimagining Your Library Space: How to Increase the Vibes in Your Library No ...
Indications & contra indications of implant supported prosthesis / implant dentistry course/ implant dentistry course
1. INDICATIONS AND
CONTRAINDICATIONS OF IMPLANT
SUPPORTED PROSTHESIS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
2. INTRODUCTION
The goal of modern dentistry is to restore
the patients to normal contour, function,
comfort, esthetics speech and health,
regardless of the atrophy, disease or injury of
the stomatognathic system. However the more
teeth a patient is missing, the more arduous
this goal becomes with traditional dentistry. As
a result of continued research in treatment
planning, implant designs, materials and
techniques, predictable success of implants is
now a reality for the rehabilitation for many
challenging clinical situations.www.indiandentalacademy.com
3. The increased need and use of implant related
treatments results from the combined effect of
a number of factors including,
• aging population
• tooth loss related to age
• anatomic consequences of edentulism
• poor performance of removable prostheses
• psycholoicgal aspects of tooth loss
• predictable long term results of implant
supported prostheses
• advantages of implant supported prostheses
www.indiandentalacademy.com
4. Research advances in dental implantology
have led to the development of several different
types of implants, and it is anticipated that
continued research will lead to improved
devices. At present, continued evaluation is
necessary to determine that appropriate
implant devices are available to meet the
therapeutic demands of the different portions of
the jawbones and the unique needs of patients.
The medical evaluation remains of paramount
importance in implant dentistry, perhaps more
so than in other disciplines of dentistry. Implant
treatment is primarily a surgical, prosthetic and
maintenance discipline for a selected particular
segment of the population.www.indiandentalacademy.com
5. Many patients who are partially or fully
edentulous are better served with tissue
integrated prostheses, rather than other
classical forms of therapy. However not all
patients can or should be considered for this
procedure. The first step in the clinical protocol
is a thorough medical and dental evaluation to
screen out those patients who can be better
served by an alternative treatment modality.
Therefore a thorough understanding of the
indications and contraindications of implant
supported prostheses (intra oral implant) is
mandatory for the success of the treatment.www.indiandentalacademy.com
6. INDICATIONS
Generally any edentulous area can be an
indication for dental implants. A decision has to
be made whether it is a good idea based on the
patients requirements and expectations, the
amount of additional procedures required (bone
grafting etc.), the doctor’s skill level and the
long term prognosis.
It is generally a good idea to assume that a
toothless area can be considered a future
implant site; however a thorough evaluation will
help give better insight as to whether
alternative, more conventional treatment
options would be a better choice in each
individual situation.
www.indiandentalacademy.com
7. Some general indications for treatment
are:
• Severe morphologic compromise of denture
supporting areas that significantly undermine
denture retention.
• Poor oral muscular coordination.
• Low tolerance of mucosal tissues.
• Parafunctional habits leading to recurrent
soreness and instability of prostheses.
• Active or hyper active gag reflexes, elicited by a
removable prosthesis.
www.indiandentalacademy.com
8. • Psychological inability to wear a removable
prosthesis even if adequate denture retention
and stability is there.
• Unfavorable number and location of potential
abutments in a residual dentition. (Adjunctive
location of optimally placed osseointegrated
root analogues would allow for provision of a
fixed prosthesis.)
• Single tooth loss to avoid involving neighboring
teeth as abutments.
www.indiandentalacademy.com
13. Indications for each implant type are specified
below:
• ENDOSSEOUS: root form, blade (plate) form:
– Adequate bone to support the implant with width
and height being the primary dimensions of
concern.
– Maxillary and mandibular arch locations.
– Completely or partially edentulous patients.
• ENDOSSEOUS: ramus frame:
– Adequate anterior bone to support the implant with
width and height being the primary dimensions of
concern.
– Mandibular arch location.
– Completely edentulous patients.www.indiandentalacademy.com
14. • SUBPERIOSTEAL: complete, unilateral,
circumferential:
– Atrophy of bone but with adequate bone to support
the implant.
– Maxillary and mandibular arch locations.
– Completely and partially edentulous patients.
– Stable bone for support.
• TRANSOSSEOUS: staple, single pin, multiple
pin:
– Adequate anterior bone to support the implant with
width and height being the primary dimensions of
concern.
– Anterior mandibular arch location.
– Completely and partially edentulous patients.
www.indiandentalacademy.com
15. For long-term successful performance of all
dental implant types the following general
factors should be considered:
• Biomaterials.
• Biomechanics.
• Dental evaluation.
• Medical evaluation.
• Surgical requirements.
• Healing processes.
• Prosthodontics.
• Post insertion maintenance.
www.indiandentalacademy.com
16. With regard to indications for a specific
implant type, the bone available to support the
implant is the primary factor after prosthodontic
diagnosis and treatment plan. This bone is
measured in width, height, length, anatomical
contour, and density. These physiological and
anatomical factors may be altered by either
osteoplasty or augmentation of the bone. In
addition, other factors affecting indications for
implant type are the degree and location of the
edentulism of the patient.
www.indiandentalacademy.com
17. The AMERICAN SOCIETY OF ANESTHESIOLOGY has
given a classification in which patients have been
categorized according to presurgical risk.
• CLASS 1: patient is physiologically normal, no medical
diseases, lives a normal lifestyle.
• CLASS 2: patient has some type of medical disorder
but the disorder is controlled with various medications.
Patient can thus engage in normal activity.
• CLASS 3: patient who has multiple medical problems
with impaired normal activity.
• CLASS 4: advanced stage of disease, serious medical
condition requiring immediate attention.
• CLASS 5: patient usually is suffering from a fatal
disease, is in the terminal end of the disease and will
not survive the next 24 hours.
www.indiandentalacademy.com
18. CONTRAINDICATIONS AND THEIR MANAGEMENT
Systemic screening of a patient prior to implant
or/biomaterial insertion is critical to a patient’s well
being and success of the surgical procedure. It is no
longer appropriate to limit the general
contraindications to the malfunction of major organs
and systems and not consider the devastating long
term effects of an unhealthy lifestyle (smoking,
inadequate diet etc.). However, modern standards of
care should not systemically exclude patients with
relative or marginal health conditions without exploring
the possibilities of improving and stabilizing those
conditions. Based on the classification of American
Society of Anesthesiology, a number of absolute and
relative contraindications have been ascertained.
(Chanavaz M, 1999)
www.indiandentalacademy.com
19. These conditions relate to health conditions that
have the potential to jeopardize the patient’s overall
health. Elective dental procedures are rarely indicated
for these patients. However, some of the problems are
self limiting or treatable, so elective surgery may be a
realistic possibility in future. Thus even an absolute
contraindication may become relative over a period of
time.
Treatments are proposed for optimizing some
marginal health conditions and stabilizing unbalanced
physiological function prior to surgery. Knowledge of
the fundamentals of internal medicine is an important
prerequisite for predictable implant and preprosthetic
surgery.
www.indiandentalacademy.com
20. Standards of dental practice would suggest the
following general contraindications for the above three
categories of dental implants:
• Debilitating or uncontrolled disease.
• Pregnancy.
• Lack of adequate training of practitioner.
• Conditions, diseases, or treatment that severely
compromise healing, e.g., including radiation therapy.
• Poor patient motivation.
• Psychiatric disorders that interfere with patient
understanding and compliance with necessary
procedures.
• Unrealistic patient expectations.
• Unattainable prosthodontic reconstruction.
• Inability of patient to manage oral hygiene.
• Patient hypersensitivity to specific components of the
implant.
www.indiandentalacademy.com
21. DENTAL TREATMENTS CAN BE CLASSIFIED AS:
• TYPE 1: Examinations, radiographs, model
impressions, oral hygiene, instruction, supragingival
prophylaxis, simple restorative dentistry.
• TYPE 2: Scaling, root planning, endodontics, simple
extractions, curettage, simple gingivectomy, advanced
restorative procedures, simple implants.
• TYPE 3: Multiple extractions, gingivectomy, quadrant
periosteal reflections, impacted extractions,
apicectomy, plate form implants, multiple root forms,
ridge augmentation, unilateral sius grafts, and
unilateral subperiosteal implants.
• TYPE 4: Full arch implant (complete Subperiosteal
implants, ramus frame implants, full arch endosteal
implants), orthognathic surgery, autogenous bone
augmentation, bilateral sinus graft.www.indiandentalacademy.com
22. ENDOCRINE DISORDERS
• UNCONTROLLED DIABETES MELLITUS:
This refers to confirmed severe diabetes which does
not respond to treatment. The major symptoms are
polyuria, polyphagia, polydypsia and weight loss.
Diabetes patients are prone to develop infections and
vascular complications. The healing process is
affected by impaired vascular function, chemotaxis,
impaired neutrophil function and an anaerobic milieu.
Protein metabolism is decreased and healing of soft
and hard tissue is delayed. Nerve regeneration is also
altered and angiogenesis impaired. Such patients are
pre-disposed to tissue degeneration and compromised
healing with increased risk of infection.
www.indiandentalacademy.com
23. The implant dentist will confirm or discover diabetes
by the presence of glucose levels above 120 mg/dl. of
these patients 90%have adult onset diabetes mellitus,
which develops after age 40 and is common in adults
over 55. About 80%of non-insulin dependent diabetes
mellitus are overweight. All diabetic patients are
subject to a greater incidence and severity of
periodontal disease, dental caries due to xerostomia,
candidiasis, burning mouth syndrome and lichenoid
reactions. Approximately 75%of these patients suffer
from periodontal disease and exhibit increased
alveolar bone loss and inflammatory gingival changes.
Tissue abrasions are more likely in denture wearers
because the depletion in oxygen tension decreases
the rate of epithelial growth and decreases tissue
thickness.
www.indiandentalacademy.com
24. DENTAL IMPLANT MANAGEMENT
• The most serious complication for diabetic patients
during dental procedure sis hypoglycemia, which
usually occurs as a result of excessive insulin level,
hypoglycemic drugs or inadequate food intake.
Weakness, nervousness, tremor, palpitations and/or
sweating are all signs of hypoglycemia. If the
symptoms are not addressed, they may evolve from
confusion and agitation to seizure, coma and even
death.
• The stress of surgery may provoke the release of
counter regulatory hormones that will impair insulin
regulation and may result in hyperglycemia and a
catabolic state. A careful planning for post operative
food and medication intake is needed to ensure the
patient’s welfare.
www.indiandentalacademy.com
25. Patients at low risk of complications related to
diabetes are those who are asymptomatic and have
good metabolic control. Their blood glucose levels are
less than 150 mg/dl (average 100mg/dl).these patients
may be treated with a normal protocol for all non-
surgical appointments(type1). For surgical procedures
these patients need a little more care and attention.
Need for a stress reduction protocol, diet evaluation
before and after surgery and control of the risk of
infection are all addressed. Sedative procedures and
antibiotics are often used for implant or advanced
surgical procedures (type 3 or 4). Insulin therapy is
adjusted to half the dose in the morning of the surgery
if oral intake is expected to be compromised. Oral
medications can be discontinued for the day if the
patient has taken morning dose on the day of the
surgery. www.indiandentalacademy.com
26. Patients at moderate risk show periodic
manifestations of the disease but are in metabolic
balance because few complications of diabetes are
present. Their blood glucose levels are below
200mg/dl. Diet control, stress reduction protocol,
aseptic techniques and antibiotics are more important
for these individuals than for those in the low risk
group. Most non-surgical procedures can follow a
normal protocol (type 1). Oral or intravenous sedation
should be considered for many surgical or restorative
types 2 procedures. Corticosteroids, often used to
decrease edema, swelling and pain may not be used
in the diabetic patient because they adversely affect
blood glucose levels. Medical consultation should
precede moderate or advanced surgical procedures
(type 3 or 4). Insulin dosage is often altered. Sedative
techniques and hospitalization should be considered
for advanced surgical procedures (type 4).
www.indiandentalacademy.com
27. Patients at high risk report a history of
frequent hypoglycemia and show multiple
complications of diabetes. Their fasting blood
sugar fluctuates widely, often exceeding 250
mg/dl. These patients can follow type 1
procedures only when a conscious effort is
made to decrease stress. All other procedures
whether non-surgical or surgical require
medical consultation. Any treatment should be
deferred until the medical condition is
stabilized.
www.indiandentalacademy.com
28. THYROID DISORDERS:
• Second most common endocrine problem
affecting approximately 1% of the population,
particularly women.
• Excessive production of Thyroxine ( hormone
of the thyroid gland) results in hyperthyroidism.
Symptoms of this disorder include increased
pulse rate, nervousness, intolerance to heat,
excessive sweating, weakness of muscles,
diarrhea, increased appetite, increased
metabolism and weight loss. excessive
thyroxine may also cause atrial fibrillation,
angina and congestive heart failure.www.indiandentalacademy.com
29. An insufficient production of thyroxine produces
hypothyroidism. The related symptoms are a result of
decreased metabolic rate. The patient complains of
cold intolerance, weight gain and fatigue. Eventually
hoarseness of voice and decreased mental activity
occurs which may even lead to coma if left untreated.
Thyroid function tests are used to confirm the
diagnosis of hypothyroidism.
DENTAL IMPLANT MANAGEMENT
• Patients with hyperthyroidism are especially sensitive
to epinephrine used in local anesthetics and gingival
retraction cords. When exposed to such
catecholamines is coupled with stress (often related to
dental procedure) and tissue damage (dental implant
surgery), an exacerbation of the symptoms of
hyperthyroidism may occur. The result is termed
thyrotoxicosis or thyroid storm and this is a life
threatening condition.www.indiandentalacademy.com
30. • The hypothyroid patient is particularly sensitive
to CNS depressant drugs, especially narcotics
and sedatives drugs like diazepam and
barbiturates. The risk of respiratory depression
and/or cardiovascular depression must be
considered.
• Any patient with a thyroid disorder and a
medical examination in the preceding 6 months
who reports normal thyroid function and has no
symptoms of the disease is at low risk and a
normal protocol can be followed for all dental
implant surgery and restorative appointments
(type 1 – 4). www.indiandentalacademy.com
31. • The thyroid disorder patient who has no
symptoms related to thyroid disorders, but has
not had a physical or thyroid function test
recently, is placed in the moderate risk
category. The patient may follow a normal
protocol for type 1 procedures. For any further
treatment the physician needs to be consulted.
• A symptomatic patient is at high risk regardless
of when the last medical evaluation was
performed. All treatment is deferred until a
medical and laboratory evaluation confirms
control of the disorder.
www.indiandentalacademy.com
32. ADRENAL GLAND DISORDERS:
• Epinephrine, nor epinephrine (adrenal
medulla), glucocorticoids, mineralocorticoids
and sex steroids (adrenal cortex) are the major
hormones of the adrenal gland.
• Addison’s disease corresponds to a decrease
in adrenal function.
• Cushing’syndrome results from hyper
functioning of the gland.
www.indiandentalacademy.com
33. DENTAL IMPLANT MANAGENENT
• Patients with a history of adrenal gland disease,
whether hyperfunctioning or hypofunctioning, face
similar problems related to dentistry and stress. The
body is unable to produce increased levels of steroids
during stressful situations and cardiovascular collapse
may occur. Therefore for patients with known adrenal
disorders the physician should be consulted before
any implant related treatment. The nature of the
disorder and the recommended treatment should then
be evaluated.
• Steroids act in three different ways that affect implant
surgery. They decrease inflammation and are useful in
decreasing swelling related pain. However, steroids
also decrease protein synthesis, delay healing, also
decrease leucocytes and thereby reduce the patient’s
ability to fight infection.
www.indiandentalacademy.com
34. SEVERE HORMONE DEFICIENCY:
• This refers to patients with disorders affecting
more than two different hormone families. The
endocrine organs most often affected are the
thyroid, parathyroid, pancreas, suprarenals
prostrate and hypophysis.
www.indiandentalacademy.com
35. CARDIOVASCULAR DISEASES
RECENT MYOCARDIAL INFARCTION(MI):
MI is a prolonged ischemia or lack of oxygen
that causes injury to the heart. The patient
usually has severe chest pain in the sub sternal
or left precordial area during an MI episode. It
may radiate to the left arm or mandible.
Cyanosis, cold sweat, weakness, nausea,
vomiting and irregular and increased pulse
rates are all signs of MI. The complications of
MI include arrhythmias and congestive heart
failure. Any history of MI indicates significant
problems in the coronary vessels. Recent
infarctions correspond to higher morbidity and
death rates with even simple elective surgery.
www.indiandentalacademy.com
36. • Approximately 18 – 20% of patients with a
recent history of MI will have complications of
recurrent MI, with a high mortality rate of 40 –
70%.
• If surgery is done within 3 months of MI, the
risk of another MI is 30%.
• If within 3 – 6 months, it is 15%.
• After 12 months the incidence of recurrent MI
stabilizes at about 5%.
www.indiandentalacademy.com
37. DENTAL IMPLANT MANAGEMENT:
• Contemporary cardiology, including non-surgical
intervention procedures has greatly improved the care
and treatment of patients suffering from MI. this has
led to a much reduced use of patent anti-coagulants
on a permanent basis, while the cardio-vaso
protectors, beta-blockers, hypotensive drugs and mild
anti-coagulants are used extensively. A stable
condition for these patients is usually reached 6 – 12
months after initial care and treatment. However, it is
important to avoid any surgical stress which could
trigger uncontrolled vasoconstriction with tachycardia
and arrhythmia, until the patient is stabilized for at
least 6 – 12 months. Further more, if anti-coagulants
are prescribed, their interruption in the early stages of
the disease may also prove extremely risky.
www.indiandentalacademy.com
38. • The dental evaluation should include the dates of all
episodes of MI, especially the latest, and any
complications. Medical consultation should preclude any
extensive restorative or surgical procedure.
• Patients with a MI in the preceding 6 months may have
dental examinations (type 1) without any special protocol.
Any treatment should be postponed for 6 months.
• Patients who experienced MI 6 – 12 months preceding
consultation may have examination, non-surgical
procedures and simple emergency surgical procedures
performed after medical consultation. Longer procedures
should be segmented into several shorter appointments
whenever possible. Stress reduction protocol is always
indicated. Elective implant procedures should be
postponed for at least 12 months following MI.
• Elective hospitalization is an accepted modality for all
advanced surgical procedures, regardless of the time
elapsed after a MI; (it is mandatory if general anesthesia iswww.indiandentalacademy.com
39. CONGESTIVE HEART FAILURE(CHF):
• CHF is a chronic heart condition in which the
heart is failing as a pump. Symptoms include,
abnormal tiredness, shortness of breath,
wheezing, edema of legs and ankle, frequent
urination, nocturnal dyspnea, weight gain,
orthopnea, pulmonary edema etc.
www.indiandentalacademy.com
40. SUB ACUTE BACTERIAL ENDOCARDITIS/VALVULAR
HEART DISEASE
Bacterial endocarditis is an infection of the heart
valves or endothelial surfaces of the heart. It is the
result of growth of bacteria on damaged/altered
cardiac surfaces. The microorganisms most often
associated with endocarditis following dental treatment
are ά-hemolytic streptococcus viridans and less
frequently staphylococci and anaerobes. The disorder
is serious with a mortality rate of 10%. Dental
procedures causing transient bacteremia are a major
cause of bacterial endocarditis. As a result the implant
dentist should identify the patient at risk and
implement prophylactic procedures.
www.indiandentalacademy.com
41. • The risk of bacterial endocarditis increases with
the amount of intra oral soft tissue trauma.
• A correlation exists between the incidence of
endocarditis and the number of teeth extracted
or the degree of a pre existing inflammatory
disease in the mouth. A 6 times higher
incidence of bacteremia is found in patients
with severe periodontal disease.
• Endocarditis has also been reported to occur in
an edentulous patient with denture sores.
www.indiandentalacademy.com
42. VALVULAR PROSTHESES:
• The onset of bacteremia in patients fitted with valvular
prostheses constitutes a major threat to the longevity
of the cardiac valve. The oral cavity has been
traditionally recognized as the principal gateway to
such infections. It is therefore important to avoid
dental surgery or invasive periodontal procedures in
until a stable condition is achieved, usually 15 – 18
months after cardiac surgery. According to the type of
valve the patient may be on potent anti-coagulants (for
metallic valves) and mild plasma volume elevators (for
porcine valves). Any planned procedure must take into
consideration the occurrence of the surgical stress,
anti-coagulant imbalance and infection risk.
www.indiandentalacademy.com
43. DENTAL IMPLANT MANAGEMENT:
• The implant dentist must be familiar with the antibiotic
regimens for heart conditions requiring prophylaxis. A
similar regimen is required for any person requiring
antibiotic coverage.
• In some patients implant therapy is contraindicated
because of high risk for endocarditis like, patients with
previous history of endocarditis, prosthetic heart valve,
surgical systemic pulmonary shunt, rheumatic valvular
defect, congenital heart disease, acquired valvular
disease, intravascular prostheses and coarctation of
aorta. Edentulous patients restored with implants must
contend with transient bacteremia from chewing,
brushing or peri-implant disease.
www.indiandentalacademy.com
44. As a result implant may be contraindicated in
patients with limited oral hygiene potential and
those with a history of stroke. In addition intra-
mucosal inserts may be contraindicated for
many of these patients because a slight
bleeding can occur on a routine basis for
several weeks during the initial healing
process. Endosseous implants with an
adequate width of attached gingival are the
implants of choice for patients in this group who
need implant supported prostheses.
www.indiandentalacademy.com
45. HYPERTENSION:
A patient is classified as hypertensive when
the mean value after three or more blood
pressure readings taken at three or more
medical visits reveals a resting arterial systolic
blood pressure at or above 140mm Hg and/or
mean diastolic blood pressure at or above
90mm Hg. Hypertension is usually
asymptomatic and is the major risk factor for
coronary heart disease and cerebro-vascular
accidents leading to cardiovascular morbidity
and mortality for people more than 50 years of
age. www.indiandentalacademy.com
46. In hypertensive patients 90% have
essential or idiopathic hypertension. The
medical history should focus on predisposing
factors such as excessive alcohol intake,
history of renal disease, stroke, other cardio-
vascular diseases, diabetes, obesity and
smoking. Essential hypertension is treated with
medications, many of which have an impact on
implant therapy because of their numerous side
effects. These include orthostatic hypotension,
dehydration, sedation, and xerostomia, gingival
hyperplasia around teeth and implants and
depression. The side effects may alter
treatment or require special precautions.
www.indiandentalacademy.com
47. DENTAL IMPLANT MANAGEMENT:
• Anxiety greatly affects the blood pressure. Therefore a
stress reducing protocol is indicated for the
hypertensive patient. Premedication may be indicated
before the procedure. Monitoring of the blood pressure
is recommended for all patients, especially if the
patient is diagnosed with hypertension. Patients in the
normal and high normal (140-159/90-99 mmHg) range
with no other systemic disease may follow regular
treatment and can tolerate all non-surgical and single
implant surgical type 1 and type 2 procedures.
• However, patients in the range of 180-209/110-
119mm Hg (stage 3) or 210/120mm Hg or greater
(stage 4) can follow only emergent non-stressful
procedures therapy (type 1) and should be
immediately referred to a physician.
www.indiandentalacademy.com
48. ANGINA PECTORIS:
Angina pectoris or chest pain or cramp of
the cardiac muscle is a form of coronary heart
disease. The classical symptom of retrosternal
pain often develops during stress or physical
exertion, radiates to the shoulder, left arm or
mandible, or right arm, neck, palate, tongue,
these symptoms are relieved by rest.
www.indiandentalacademy.com
49. DENTAL IMPLANT MANAGEMENT
The major concern of the dentist is the
precipitation and/or management of the actual
attack. Precipitating factors can be exertion,
cold, heat, large meals, humidity, psychological
stress and dental related stress. All these
factors cause catecholamines release which in
turn increases heart rate, blood pressure and
myocardial oxygen demand. However, the
physician must be consulted before any
surgical procedures in a patient with history of
angina.
www.indiandentalacademy.com
50. BONE DISEASES
OSTEOPOROSIS
The most common disease of bone metabolism the
implant dentist will encounter is osteoporosis, an age
related disorder characterized by a decrease in bone
mass, increased microarchitectural deterioration and
susceptibility to fractures. This condition is common in
post menopausal women. The osteoporotic changes
in the jaws are similar to other bones in the body. The
structure of the bone is normal, however, due to the
uncoupling of the bone resorption/formation process
with emphasis on resorption, the cortical plates
become thinner, the trabecular bone pattern more
discrete and advanced demineralization occurs. Oral
bone loss related to osteoporosis may be expressed in
both dentate and edentulous patients. Recent
advances in radiology such as DXA can measure as
little as 1 mg of bone mass change and can therefore
predict high risk cases.www.indiandentalacademy.com
51. DENTAL IMPLANT MANAGENENT
• The bone density affects the treatment plan,
surgical approach, length of healing and the
nature of progressive loading. Implant designs
should be greater in width and coated with
hydroxyapatite to increase bone contact and
density.
www.indiandentalacademy.com
52. • VITAMIN D DISORDERS:
• Vitamin D is synthesized by the body in several steps
involving the skin, liver, kidney and intestine. Its
deficiency leads to osteomalacia in adults. Oral
symptoms include a decrease in trabecular bone,
indistinct lamina dura and an increase in chronic
periodontal disease.
• HYPERPARATHYROIDISM:
• Oral changes occur with the advanced state of this
disease. Loss of lamina dura, loosening of teeth,
altered trabecular bony pattern are some of the
features of this disorder. It has been noted that when
skeletal depletion occurs as a result of stimulation by
the parathyroid gland, alveolar bone may be affected
before that of the rib.www.indiandentalacademy.com
53. • FIBROUS DYSPLASIA:
• A disorder in which fibrous connective tissue replaces
areas of normal bone. It is found twice more
commonly in women than men and may affect a single
bone or multiple bones, twice more commonly in the
maxilla than mandible. Implant dentistry is
contraindicated in the regions of this disorder.
• PAGET’S DISEASE:
• A slowly progressive chronic bone disorder where
both osteoblasts and osteoclasts are involved, but
osteoblastic activity is more predominant. The maxilla
is more often involved than the mandible. Oral
implants are contraindicated in the regions affected by
this disorder.
www.indiandentalacademy.com
54. • MULTIPLE MYELOMA:
• Plasma cell neoplasm originating in the bone
marrow. Usually seen in patients between 40 –
70 years of age. Pathologic fractures may
occur. Paresthesia, swelling, tooth mobility and
gingival enlargements are also seen. Implants
are contraindicated in these patients.
www.indiandentalacademy.com
56. • SEVERE RENAL DISORDER:
• Etiology may be repetitive kidney infections
(nephritis), malignant or voluminous benign
tumors (or multiple cystic kidneys), uncontrolled
diabetes, and/or complications arising from
kidney stones. Damage to the nephrons may
lead to bone destruction via calciuria and loss
of production of 1,25-DHCC. In fact the lack of
reabsorption of calcium together with the
malfunction of PTH could rapidly lead to
metabolic osteopenia and retention of plasma
endotoxins with major infection risks. Excessive
use of common analgesics may also contribute
to kidney failure.
www.indiandentalacademy.com
57. • HEAVY SMOKING HABITS:
• Smoking more than 20 cigarettes a day is an
absolute contraindication. The deleterious
effects of tobacco use (smoking or chewing)
have been well documented over the last
decade. A definite correlation has been
established between smoking and poorer levels
of periodontal conditions. Tobacco smoke
decreases PMNs activity leading to reduced
phagocytic activity. Smoking is also associated
with decreased calcium absorption. A reduced
mineral content in the bone of aging smokers
and to a greater degree in post menopausal
women.
www.indiandentalacademy.com
58. • DENTAL IMPLANT MANAGEMENT
• When incision line opening after surgery
occurs, smokers will delay the secondary
healing, contaminate a bone graft and
contribute to early bone loss during initial
healing. Therefore a cautious approach is
recommended. Doctors must inform their
patients that smoking will have a detrimental
effect on their treatment and therefore should
advise them to start a cessation program for
successful prognosis of the treatment.
Excessive smoking remains an absolute
contraindication for the long term success of
dental implant systems.
www.indiandentalacademy.com
59. • CHRONIC OR SEVERE ALCOHOLISM:
• This problem frequently leads to liver disorder,
cirrhosis and medullary aplasia with a cascade of
possible complications like platelet disorder, distress
infarction, aneurysm and risk of insidious hemorrhage.
Such patients often present retarded healing
aggravated by malnutrition, psychological disorder,
inadequate hygiene and major infection risk.
Alcoholics frequently suffer from osteopenia.
• DRUG ADDICTION:
• Most patients with drug addictions have a low
resistance to disease, predisposition to infection,
malnutrition, psychological disorders and inadequate
hygiene.
www.indiandentalacademy.com
60. • COPD.
• CIRRHOSIS.
• PREGNANCY:
• Implant surgery procedures are contraindicated
for the pregnant patient. The radiographs or
medications that may be needed for implant
therapy and the increased stress are all
reasons the elective implant surgical procedure
should be postponed till after childbirth.
Periodontal disease is often exacerbated during
pregnancy. All elective dental care with the
exception of dental prophylaxis should be
deferred until after childbirth.
www.indiandentalacademy.com
61. • HEMATOLOGIC DISEASES:
• Polycythemia.
• Anemia.
• Leucocytic disorders.
• RADIATION THERAPY IN PROGRESS:
• Disruption of defense mechanisms, compromised
Endosseous vascular system, inhibition of
osteoinduction and localized loss of osseous vitality
are the main insults to the body while the patient
undergoes radiation therapy. With regard to bone, the
osteogenic potential of the periosteum is most
severely affected. All these conditions can severely
limit the prognosis for reconstructive dental
procedures. Such patients may be subject to
osteoradionecrosis and should be treated with caution
only after the dentist consults the radiotherapist.www.indiandentalacademy.com
62. • Aids and seropositive patients
• Prolonged use of corticosteroids
• Disorders of phosphocalcic metabolism
• Bucco-pharyngeal tumors
• Chemotherapy in progress
• Hepato-pancreatic disorder
• Multiple endocrine disorder
• Psychological disorders, psychoses
• Unhealthy lifestyle
• Lack of understanding and motivation
• Unrealistic treatment plan
• Blood dyscrasias
• Regular intake of corticosteroids or
immunosuppressive drugswww.indiandentalacademy.com
63. • PATIENT’S CURRENT CONDITION:
• Before beginning any implant restorations in the
partially edentulous case, the dentist must thoroughly
evaluate the patient’s current dental condition.
Frequently the patients present with overerupted
and/or tipped teeth and inadequate vertical
dimensions, all of which lead to an unacceptable
occlusal plane. Treatment can be complicated by the
degree of malocclusion, severe caries, periapical
lesions (any infection, abscess, cysts) or periodontal
disease. These conditions require treatment before or
in conjunction with implant therapy to maximize long
term success by eliminating inflammatory disease and
unfavorable excessive occlusal forces.
• Existing residual bone, proximity of the adjacent teeth
and the opposing dentition must be evaluated. (The
optimal dimensions of the available bone for root form
implant placement are: 5mm in width, 13-15mm in
height and 5mm in length.)www.indiandentalacademy.com
64. SUMMARY
Systemic diseases have a broad effect.
They may be categorized as mild, moderate
and severe. Implant therapy also offers a broad
range of treatments. Patients with mild
diseases may follow any type of treatment. A
stress reduction protocol is suggested for
advanced treatment. Patients with moderate
disease usually require more monitoring.
Hospital assistance is usually required for the
more advanced procedures. Several diseases
generally contraindicate implant therapy.
www.indiandentalacademy.com
65. REVIEW OF LITERATURE
• In 1984, Mc Elroy TH, did a study on oral considerations of
infection in patients undergoing chemotherapy for cancer. He
concluded that because of the various factors associated with
the disease process and its treatment, the patient receiving
chemotherapy for cancer was highly susceptible to infection,
and infection accounts for approximately 70% of patient
fatalities. When potential sources of infection were considered
in the patient receiving chemotherapy for cancer, the mouth
provided ideal conditions for microbial growth, particularly in the
debilitated patient, and was a portal of entry for contamination
of the lungs, the digestive tract, and the circulatory system.
These patients were more susceptible to oral infection because
of alteration of oral flora towards greater pathogenicity and
impairment of host-defense mechanisms. Oral/dental
management of the patient receiving chemotherapy for cancer
will enhance the general health and comfort of the patient and
will prevent or reduce oral complications including mucositis
and local and systemic infection.
www.indiandentalacademy.com
66. In 1992, Karr RA, Kramer DC, Toth BB, did a study
on implants and chemotherapy complications. He
concluded that the cancer patient receiving
chemotherapy often suffers severe oral complications
related to the administration of antineoplastic drugs.
Cancer patients who also have transmucosal or
endosseous dental implants pose special problems for
medical oncologists and dentists, both when planning
for chemotherapy and when providing supportive care
during the course of treatment. The relationship
between dental implants and cancer chemotherapy
was described and complications experienced by
implant patients treated with chemotherapy at The
University of Texas M.D. Anderson Cancer Center
were reviewed. Recommendations on various aspects
of management involving implant evaluation and the
removal or retention of dental implants were
evaluated.
www.indiandentalacademy.com
67. • In 1994, Wicks RA, did a study on a systematic
approach to definitive planning for osseointegrated
implants. He said that thoughtful design selection is
crucial for the perpetual success of any dental implant
restoration. He reviewed treatment considerations
specific to the postsurgical presentation of the implant
patient and said that deviations from the originally
planned design may be necessary at that stage.
• In 1995, Steiner M, Windchy A, Gould AR, Kushner
GM, Weber R, conducted a study on the effects of
chemotherapy on patients with dental implants.
Endosseous implant placement is generally
considered to be contra-indicated in patients
undergoing chemotherapy for the treatment of cancer.
He presented a case where a patient was diagnosed
with cancer and began chemotherapy four weeks after
endosseous implants were placed. The impact of
chemotherapeutic agents on endosseous implant
acceptance as well as upon oral tissue was examined.www.indiandentalacademy.com
68. In 1998, Blanchaert RH, conducted a study on
implants in the medically challenged people. He said,
proper patient selection and careful technique will
always be the marks of quality implant dentistry
providers and described the implications for therapy,
of existing systemic disease or systemic therapies. All
health care delivery provided by dental practitioners
must take into account, always and foremost, the
patient. Careful patient evaluation is critical. Patients'
physicians may not fully appreciate the physiologic
ramifications of the complex and sometimes lengthy
appointments required in performing implant
procedures. The final decisions regarding the
prescription of therapy rests with the dentist. Through
increased knowledge of the pathophysiology of
diabetes mellitus, disorders of bone metabolism,
radiotherapy, and chemotherapy, improved patient
selection and perioperative management can benefit
the dental implant team.www.indiandentalacademy.com
69. In 1999, Crews KM, Cobb GW, Seago D,
Williams N, conducted a study on tobacco and
dental implants. Dental implants are the ideal
standard of care for many oral health care
providers. They concluded, tobacco use is an
impediment to the success of this sophisticated
procedure. Dentists who are trained to help
their patients stop using tobacco are in position
to improve their success rates with dental
implants. A suggested protocol for tobacco
cessation in the implant practice, if utilized,
could raise the standard of health care in the
dental office. www.indiandentalacademy.com
70. In 2000, Lambert PM, Morris HF, Ochi S, did a study on the
influence of smoking on a 3-year clinical success of
osseointegrated implants. Health risks associated with smoking
have been exhaustively documented and include increased
incidence of periodontal disease, greater risk of osteitis
following oral surgery, and compromised wound healing due to
hypoxia. Information related directly to dental implants,
although limited, points to higher rates of implant failures
among smokers than non-smokers. They studied long-term
clinical outcomes of osseointegrated dental implants placed in
smokers and non-smokers in a longitudinal clinical study of
endosseous dental implants smokers than non-smokers. They
suggested that increased implant failures in smokers were not
only the result of poor healing or osseointegration, but also of
exposure of peri-implant tissues to tobacco smoke. Data also
suggest that detrimental effects may be reduced by: 1)
cessation of smoking; 2) the use of preoperative antibiotics; and
3) the use of HA-coated implants.
www.indiandentalacademy.com
71. In 2002, Abdulwassie H, Dhanrajani PJ
conducted a clinical study on diabetes mellitus
and dental implants. They concluded, Diabetes
mellitus is no longer considered to be a
contraindication for implant-supported
prostheses, provided that the patient's blood
sugar was under control, and that there was
motivation for oral hygiene procedures. They
presented the experiences of treating diabetic
patients using implants with good success
rates.
www.indiandentalacademy.com
72. In 2002, Sugerman PB, Barber MT, did a study on oral
and systemic considerations in patients selection for
endosseous dental implants.
He reviewed and discusses patient selection for endosseous
dental implants and the effect of systemic and local pathology
on the success rate of dental implants. Endosseous dental
implants may be preferable to conventional dentures in patients
with compromised supporting bone or mucosa, xerostomia,
allergy to denture materials, severe gag reflex, susceptibility to
candidiasis, diseases affecting orofacial motor function or in
patients who demand optimal bite force, esthetics, and
phonetics. Conventional dentures or fixed partial prostheses
may be preferable to endosseous dental implants in growing
and epileptic patients and patients at risk of oral carcinoma,
anaphylaxis, severe hemorrhage, steroid crisis, endocarditis,
osteoradionecrosis, myocardial infarction, or peri-implantitis. He
outlined a systematic approach to dental implant patient
selection and recommended a centralized reporting of dental
implant outcome.
www.indiandentalacademy.com
73. In 2002, Farzad P, Andersson L, Nyberg J, did a
study on dental implant treatment in diabetic patients.
The purpose of their study was to investigate how
many diabetic patients and types of cases that were
treated with dental implants in their clinic and to
assess the outcome of such treatment. Medical
records from 782 patients were examined in patients
treated by the Branemark method for partial or total
edentulism with implant supported bridges. From
these records, 25 patients (3.2%) with diabetes before
implant treatment (136 implants) were identified and
further studied with respect to age, gender, type of
diabetes, treated jaw, degree of edentulism, bone
graft, implant survival, periimplant inflammation,
bleeding on probing, and radiographic bone loss.
Furthermore, the patients' opinion about the outcome
of the treatment was registered. The implant success
rate was 96.3% during the healing period and 94.1% 1
year after surgery.www.indiandentalacademy.com
74. Of all 38 bridges, one was lost. Few
complications occurred and all patients, except
for one, were satisfied with the treatment.
Today, diabetic patients are being treated
successfully for all types of edentulism,
including bone-grafting treatment. Diabetics
that undergo dental implant treatment do not
encounter a higher failure rate than the normal
population, if the diabetics' plasma glucose
level is normal or close to normal as assessed
by personal interviews.
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75. In 2002, Attard NJ, Zarb GA, conducted a study on
medically treated hypothyroid patients. Their purpose
was to investigate the success outcomes of implants
and prosthodontic treatment placed in patients with a
previous history of hypothyroidism that was being
controlled with medications. Twenty-seven female
patients with a medically confirmed history of primary
hypothyroid disease who were on replacement
medications at the time of implant surgery were
selected as the study group. Additional factors studied
were medical history, medications, smoking habits,
and bone quality and quantity. They suggested that
medically controlled hypothyroid female patients
treated with dental implants are not at higher risk of
implant failure when compared with matched controls,
and that a history of controlled hypothyroidism does
not appear to be a contraindication for implant therapy
with endosseous implants.
www.indiandentalacademy.com
76. In 2003, Beikler T, Flemmig TF, conducted a study on
implants in the medically compromised patients. Dental
clinicians are confronted with an increasing number of
medically compromised patients who require implant surgery
for their oral rehabilitation. However, there are only few
guidelines on dental implant therapy in this patient category and
thus numerous issues regarding pre- and post-operative
management remain unclear to the dental clinician. They
presented the current knowledge regarding the influence of the
most common systemic and local diseases on the outcome of
dental implant therapy, e.g., abnormalities in bone metabolism,
diabetes mellitus, xerostomia, and ectodermal dysplasias.
Specific pathophysiologic aspects of the above-mentioned
diseases as well as their potential implications for implant
success were critically appraised. In line with these
implications, guidelines for pre- and post-operative
management that may assist in the successful implant-
supported rehabilitation of this patient category were proposed.
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77. In 2004, Penarrocha M, Palomar M,
Sanchis JM, Guarinos J, Balaguer J, conducted
a radiologic study of marginal bone loss
around 108 dental implants and its relationship
to smoking, implant location, and morphology.
The concluded, conventional periapical films
and digital radiographs were more accurate
than orthopantomography in the assessment of
peri-implant bone loss. Smoking and implant
location in the maxilla were associated with
increased peri-implant marginal bone
resorption.
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78. REFERENCES
• Contemporary implant dentistry-Carl E. Misch
• Dental implants, the art and science-Charles A. Babbush
• Practical implant dentistry- Arun K. Garg
• The branemark system of oral reconstruction- Richard A.
Rasmussen
• Sugerman PB, Barber MT, Patient selection for endosseous
dental implants: oral and systemic considerations, Int J Oral
Maxillofac Implants. 2002 Mar-Apr;17(2):191-201.
• Chanavaz M, Patient screening and medical evaluation for
implant and preprosthetic surgery, J Oral Implantol.
1998;24(4):222-9.
• Beikler T, Flemmig TF, Implants in the medically compromised
patient, Crit Rev Oral Biol Med. 2003;14(4):305-16.
• Chanavaz M, Screening and medical evaluation of adults:
contraindications for invasive dental procedures, J Indiana Dent
Assoc. 1999 Fall;78(3):10-7.
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79. • Blanchaert RH, Implants in the medically challenged patient,
Dent Clin North Am. 1998 Jan;42(1):35-45.
• Karr RA, Kramer DC, Toth BB, Dental implants and
chemotherapy complications, J Prosthet Dent. 1992
May;67(5):683-7.
• Wicks RA, A systematic approach to definitive planning for
osseointegrated implant prostheses, J Prosthodont. 1994
Dec;3(4):237-42.
• McElroy TH, Infection in the patient receiving chemotherapy for
cancer: oral considerations, J Am Dent Assoc. 1984
Sep;109(3):454-6.
• Farzad P, Andersson L, Nyberg J, Dental implant treatment in
diabetic patients, Implant Dent. 2002;11(3):262-7.
• Crews KM, Cobb GW, Seago D, Williams N, Tobacco and
dental implants, Gen Dent. 1999 Sep-Oct;47(5):484-8.
• Lambert PM, Morris HF, Ochi S, The influence of smoking on
3-year clinical success of osseointegrated dental implants, Ann
Periodontol. 2000 Dec;5(1):79-89.www.indiandentalacademy.com
80. • Steiner M, Windchy A, Gould AR, Kushner GM, Weber
R, Effects of chemotherapy in patients with dental
implants, J Oral Implantol. 1995;21(2):142-7.
• Abdulwassie H, Dhanrajani PJ, Diabetes mellitus and
dental implants: a clinical study, Implant Dent.
2002;11(1):83-6.
• Attard NJ, Zarb GA, A study of dental implants in
medically treated hypothyroid patients, Clin Implant
Dent Relat Res. 2002;4(4):220-31.
• Penarrocha M, Palomar M, Sanchis JM, Guarinos J,
Balaguer J, Radiologic study of marginal bone loss
around 108 dental implants and its relationship to
smoking, implant location, and morphology, Int J Oral
Maxillofac Implants. 2004 Nov-Dec;19(6):861-7.
www.indiandentalacademy.com
81. For more details please visit
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