Description :
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
Implant and occlusion failures goli / dental implant courses by Indian 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
Implant occlusion and failures /certified fixed orthodontic courses by Indian...Indian dental academy
Description :
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
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 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
loading of dental implants/certified fixed orthodontic courses by Indian dent...Indian dental academy
Description :
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
Description :
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
Implant and occlusion failures goli / dental implant courses by Indian 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
Implant occlusion and failures /certified fixed orthodontic courses by Indian...Indian dental academy
Description :
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
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 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
loading of dental implants/certified fixed orthodontic courses by Indian dent...Indian dental academy
Description :
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
Description :
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
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.
Short Implants and their role in prosthetic replacement of missing toothSivaRaman Sms
This is an seminar on short implants related to implant dentistry .
This gives the insight on what has happened since the evolution of short implants and its role in implantology .Their role as replacement of missing tooth in the atrophied maxillary and mandibular posterior regions
Stress & force factors/cosmetic dentistry course by Indian dental academyIndian 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.
Stress & force factors in implants /certified fixed orthodontic courses by I...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
Biomechanics of dental implants/dental implant courses by Indian dental academyIndian 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.
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
Stress & force factors /certified fixed orthodontic courses by Indian 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.
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
A major connector joins the components on one side of the arch with those on the opposite side. Therefore, all components are attached to the associated major connector either directly or indirectly.
Description :
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
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.
Short Implants and their role in prosthetic replacement of missing toothSivaRaman Sms
This is an seminar on short implants related to implant dentistry .
This gives the insight on what has happened since the evolution of short implants and its role in implantology .Their role as replacement of missing tooth in the atrophied maxillary and mandibular posterior regions
Stress & force factors/cosmetic dentistry course by Indian dental academyIndian 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.
Stress & force factors in implants /certified fixed orthodontic courses by I...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
Biomechanics of dental implants/dental implant courses by Indian dental academyIndian 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.
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
Stress & force factors /certified fixed orthodontic courses by Indian 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.
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
A major connector joins the components on one side of the arch with those on the opposite side. Therefore, all components are attached to the associated major connector either directly or indirectly.
A Clinical Review of Spacer Design for Conventional_124155.pptxDrIbadatJamil
One of the key factors affecting the outcome of the treatment is the impression procedure involved in the fabrication of complete denture prosthesis. Selective-pressure impression technique is most accepted. In this technique, by using custom trays with spacers of different materials and designs, vulnerable tissues are relieved and stresses are distributed selectively to biomechanically sound tissues. But the uses stock tray for making primary impression as well as final impression due to the lack of knowledge of the following: optimum material for making custom impression tray, adequate extension, required thickness and designs of spacer, tissue stops, escape holes, tray handles, and polymerization time regarding custom impression trays in prosthodontics. This seminar will give a clear view to use accurate spacer design, material and thickness, tissue stops, and escape holes, based on various clinical situations.
The soft tissues along the junction of hard and soft palate on which pressure within the physiological limits of tissues can be applied by the denture to aid in retention of the denture.
Articulators is a mechanical device which represents the temporo-mandibular joints and jaw members to which maxillary and mandibular casts may be attached.’’
It occurs when a hard, rough surface slides along a softer surface and cuts a series of grooves.
The wearing away of a substance or structure through a mechanical process, such as grinding, rubbing or scraping .
Polishing is production of smooth mirror like surface without use of any external form.
A prosthetic device or alloplastic material
implanted into oral tissues beneath the mucosal
or periosteal tissues and/or within the bone to provide retention and support for fixed or removal prosthesis.
Denture Duplication aims the transfer of contours from old to new dentures to maintain neuromuscular control. New dentures will have successful features of old ones. Any modifications done to the basic shape of old denture should be : those needed to correct loss of fit and those considered essential by the dentist i.e replacement of worn acrylic teeth.
Fracturing and chipping of denture is common problem which need repair . Possible causes for fracture of denture is fall of the prosthesis on a hard surface , careless retrieval after processing of the prosthesis , manufacturing defect of the denture.
An immediate complete denture is a dental prosthesis constructed to replace the lost dentition and associate structure of the maxillae and/or mandible and inserted immediately following removal of remaining teeth.
Direct Filling Gold is the oldest filling material that is still being used in restorative dentistry. The vision to utilize this noble metal for the replacement of lost tooth structure stemmed from the perfect harmony of its biological and mechanical properties, excluding esthetics. Direct gold restorations exhibit excellent marginal integrity and biocompatibility in the oral environment.
A biomaterial can be defined as any substance other than a drug that can be used for any period of time as part of a system that treats, augments, or replaces any tissue, organ or function of the body.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
1. Occlusion in implants and implants failure
Dr. Ibadat Jamil
Assistant professor
Dep. Of Prothodontics
2. Contents
•Introduction
•Definition of implant failure
•Signs and Symptoms
•Criteria for successful Implants
•Failing and Failed Implants
•Peri implantitis
•Classification of implant failures
•Factors affecting Implant Failures
a. surgical factors
b. host factors
c. implant factors
d. prosthetic factors
3. • Force Delivery and Failure Mechanism
- Moment arm
- Fatigue Failure
• Basic Considerations for Occlusion for Implants
• Review of Occlusal Schemes
• Factors Affecting Selection of Occlusal Scheme
• Prescribed Occlusion
a)Edentulous Situations
b)Partially Edentulous situations
• Important Guidelines to Follow
• Conclusion
• References
5. Implant failure
Definition:An implant failure may be defined as the
first instance at which the performance of the implant,
measured in some quantitative way falls below a
specified acceptable level.
Or can be defined as an implant that has a hopeless
prognosis.
6. Signs and symptoms of implant failure
1) Horizontal mobility beyond 0.5mm or any clinically observed vertical movement under
<500g force
2) rapid progressive bone loss regardless of the stress reduction and peri implant therapy
3) Pain during function or on percussion
4) Dull sound on percussion
5) Continued exudation inspite of surgical attempts at correction
6) Generalized radiolucency around an implant
7) >1/2 of the surrounding bone is lost
8) SLEEPERS -Implants inserted in poor position making them useless for prosthetic support
9) Pocket depth of 5mm and increasing
10) Bleeding on probing(BOP) Index of 2 or above
7.
8. Failing and failed implants
Definition- Failure
process is in early
stages and is reversible
Clinical features-
• Progessive Marginal
Bone
loss(Saucerization)
• absence of mobility
• peri implant infection
(peri implantitis
Failure process has
reached the
irreversible state
Marginal bone loss
reaching the
apical 1/3 of implant
mobility
Thin peri fixtural
radiolucency
Failing Implant Failed Implant
9.
10. Peri Implantitis
Def-American Academy of Periodontology
Defines Peri implantitis as “progressive Peri
implant bone loss in conjunction with a soft
tissue inflammatory lesion.”
Causes
Bacterial Accumulation
Overloading or
Combination
12. Classification of Implant Failures
1.According to Branemark et al
• Loss of bone anchorage
- Mucoperiosteal perforation
- Surgical trauma
• Gingival problems
- Proliferative gingivitis
- Fistula formation
• Mechanical complications
- Fixture fractures
- Fracture of prostheses, gold screws, abutment screws
13. 2. According to Misch
Surgical failure inability to place the abutment at the time
of surgery
Osseous healing failure period from implant placement to
abutment connection,is related to
healing ability of bone
Early loading failure the first year the implant serves as a
prosthetic abutment
Intermediate implant failure time period after the 1st yr of loading upto
following 5yrs of function
Late implant failure after the implant and prosthesis have been
loaded for >5yrs but <10yrs.
Long term failure failures after 10 yrs.
14. Complications/factors leading to implant
failures
. Surgical factors (early failures)
Stage I surgery
1) Overheating of bone - necrosis,osteomyelitis
2) Lack of primary stability - bone loss
3) Infection
4) Lack of osseointegration
5) Poor placement or angulation, slips, eccentric drills
6) Damage to vital structures
7) Implant fracture
8) Inadequate no. of implants
15. Stage II surgery
• Loose abutment
• poor fixtures
• early loading by
prosthesis
• poor abutments
17. Implant related factors
1.Screw design:
conical screws - loosen
flat head screws - better
2.Implant body design:
smooth cylinder implant - shear force at implant-bone interface
threaded implant - can transform and change the direction of
force through thread geometry
18. a) Shape of thread Standard v
Thread
Square
Buttress thread
19. b) Thread pitch:
smaller the pitch more
will be the surface
c) Thread depth:
increases surface area
3. Implant length : increases surface area
4. Implant width : increases surface area
20. Host factors
• Patient dissatisfaction with the result.
• Inadequate patient follow-up
• Failure to maintain hygiene leading to periodontal breakdown
• Parafunctional habits
• Systemic health( medical complications)
• Medications- alter tissue metabolism and repair
• Social habits like smoking, stress,alcohol abuse affect wound healing
• Poor bone quality and quantity - avascular bone,bone density,
type of bone,etc.
21. Force delivery and failure mechanisms
Moment loads (torque or torsional loads):
is defined as a vector,the magnitude of which equals the product
of force magnitude and the perpendicular distance from the
implant
to the line of action of force.
24. Fatigue failure
Four factors influence fatigue:
1. Biomaterial
2. Geometry of the structure -Twice thicker material have sixteen times
more fatigue resistance .
3. Force magnitude
4. Number of loading cycles.
25. BASIC CONSIDERATION
– OCCLUSION CONCEPTS AND PHILOSOPHIES ARE NOT
BASED UPON SCINTIFIC RESEARCH AND EVIDENCE.
– THE CONCEPT THAT HAVE BEEN POPULAR FOR THE
RESTORATION OF NATURAL TEETH HAVE BEEN JUSTIFIED
BY PURELY EMPIRICAL METHODS AND HAVE HELD UP WELL
TO THE TEST OF TIME. FOR IMPLANTS THE SAME CONCEPTS
HAVE BEEN USED WHICH SERVE AS A GUIDE LINES TO
ACHIEVE OPTIMUM OCCLUSION .
IMPLANT OCCLUSION
26. -TRULSSON AND GUNNE IN 1998 : CONCLUDED THAT THE RANGE
OF “FOOD- HOLDING” FORCES FOR THE PATIENTS WITH IMPLANTS
IS SIGNIFICANTLY HIGHER THAN THOSE FOR PATIENTS WITH
NATURAL TEETH.
THE KEY FEATURES OF AN OCCLUSION FOR IMPLANTS SHOULD
DEPEND UPON THE TYPE OF PROSTHESIS GIVEN- SINGLE TOOTH
IMPLANTS/FPD/CD/OVERDENTURE ,AS THE REQUIREMENT AND
BIOMECHANICS OF EACH ARE DIFFERENT.
27. Flocken (1984) stated that to help alleviate the potential impact forces , the teeth should
contact
simultaneously when the mandible closes into maximum intercuspation.Natural teeth can
function
effectively from this position.
Lundgren , Laurell (1984) suggested the need to minimize horizontal forces created by
premature
contacts or steep cusps.
Albrektsson,et al., (1986) emphasized the need to distribute the load mainly over the areas
supported directly by fixtures.
Jemt (1986) described that when Osseo integrated implants are used in short span FPDs
and single
tooth replacements , the occlusion should be distributed in maximum intercuspation and
all cusp
interferences should be eliminated in eccentric positions.
Lucia (1987) advocated the application of gnathological principles in development of
occlusion
in implants.
Review of occlusal scheme
28. Misch (1991) developed IPO ‘Implant protective occlusion’ for implant supported
restorations.
IPO - Medial positioned lingualized occlusion
is based on :
- Narrow occlusal table.
- occlusal table width similar to width of implant body.
- Increasing surface area.
- Design of occlusion in favour of weakest arch.
- Decreasing force of occlusal contacts.
- Eliminating or reducing all shear loads to implant to bone interface.
- Posterior disocclusion by anterior components.
- Initial contacts on only natural teeth and later on multiple contacts on both
teeth and implants.
Norton (1995) recommended an ideal occlusal scheme for fixed implant supported
prostheses :
- A centric occlusion ‘cusp to central fossa’ contact which is light.
- An ideal anterior guidance : that is canine-guidance or group function; no posterior
interferences.
- Axial loading of the implants.
29. Factors affecting choice of occlusal scheme
1.Arch form:
- Curve arch is favorable for less stresses
- Influences no. of implants to be placed
- Opposing arch form affects occlusion
2.Interarch distance and jaw relations :
- May prevent development of particular
occlusal scheme
- May force to adapt a particular scheme
- Affects biomechanical aspects
3. Orientation of the occlusal plane :
- Arch in which is implant is placed becomes the dominant
arch and opposing edentulous arch becomes weaker arch.
- plane should favor weaker arch.
30. 4. Abnormal mandibular movements
5. Bone support and bone mechanics :
Sullivan (1990) stated that the final form of
restoration should be development
maintaining progressive loading.
Good bone support - occlusal contacts can be increased.
6. Occlusal material :
- affects the transmission of forces.
- affects the maintenance of occlusal contacts.
Acrylic has higher wear rate, so if acrylic is to be used then heavy occlusal
contacts can’t be given.
31. 6. Zarb (1985): stated that acrylic teeth have shock absorbing effect and can be
modified for use very easily.
They should be used to decrease overloading of implants.
However selection of occlusal material depends upon :
- Opposing occlusion.
- Remaining dentition.
- Arch to be restored.
32. 7. Attachment to natural teeth
•Hobo in 1986 recommended a non rigid attachment and a
Key and Key way type of attachment between teeth and
implant.
•Lundgren in 1986 recommended the use of Semi –
precision attachment which detaches the teeth from the
implant prosthesis allowing a tooth to move downward.
33. • The IMZ implant system uses a Intra mobile element [IME] to
act as a shock absorber during function.
It can act as a PDL analogue.
However, Gracia in 1998 reported intrusion of the natural
supporting teeth.
•Misch: stated that biomechanical concern and difference in
Support should be understood and applied before attaching
natural teeth to implants.
He advocates initial occlusal contacts on the natural teeth.(Thin
articulating paper of 25 m should be used for this.
Once the equilibrium with a light bite force is completed, a
heavier CR occlusal force is applied to have contacts on teeth as
well as implant also, thus harmonizing the occlusal forces.
34. Heavy bite force is used because it depresses the natural teeth positioning
them close to infra occluded or depressed implant position and equally
sharing the load.
Only possible advantage is additional support to convert
cantilever design to fixed one.
8. Quality of Osseo integration
Its is the ability of implant to bear occlusal load .
It depends upon:
1. Implant length , width, design, surface coatings.
2. Number of implants, position of implants, orientation of implants.
35. 1.Implants opposing implants with cantilevers
Onlight closure
ØMultiple even , simultaneous contact between all opposing
restorations except the distal cantilever unit , where 100 microns
clearance is required .
On firm closure
ØDistal cantilever will remain out of contact .
Prescribed occlusion
Edentulous situations
38. FIXTURES SUPPORTED OVERDENTURES
OPPOSING NATURAL TEETH WITH BRIDGE
MUTUALLY PROTECTED OCCLUSION
CANINE GUIDED
OR
ANTERIOR GROUP FUNCTION.
BALANCED OCCLUSION.
39.
40. PARTIAL EDENTULOUS CASES
SINGLE TOOTH IMPLANT
LIGHT LOAD ( INFRA- OCCLUSION BY 30 MICRONS ) UNDER
HEAVY CLENCHING .
AXIAL LOADING
LIGHT OR NO ECCENTRIC CONTACTS
NO GUIDANCE ON SINGLE IMPLANT
41. FIXTURES SUPPORTED BIDGE AGAINST
NATURAL DENTITION.
• CANINE PROTECTED / GROUP FUNCTION – LATERAL
GUIDANCE.
42. •M P O ( MUTUALLY PROTECTED OCCLUSION )
•ORGANIC OCCLUSION
43. FIXTURES SUPPORTED BRIDGE HAVING CANTILEVER
EXTENSIONS OPPOSING COMPLETE DENTURES
• BALANCED OCCLUSION
• NO CONTACT ON CANTILEVER UNITS.
44. KENNEDY CLASS I
• ANTERIOR GUIDANCE BY NATURAL TEETH AND
POSTERIOR DISCLUSION.
Canine guidance / anterior group function .
• MPO
45. KENNEDY CLASS II
• CONFIRM TO EXISTING OCCLUSION WITH 30
MICRONS CLEARANCE AT FREE END SADDLE
• MPO
46. KENNEDY CLASS III
• CONFIRM TO EXISTING OCCLUSION WITH
INFRA OCCLUSION AT IMPLANT SITE.
• MPO/ GROUP FUNCTION
47. KENNEDY CLASS IV
• CONFIRM TO EXISTING OCCLUSION WITH
INFRA OCCLUSION OF IMPLANT.
• ANTERIOR GUIDANCE WHICH ACHEIVES
POSTERIOR DISCLUSION.
• GROUP FUNCTION
48. IMPORTANT GUIDELINES TO FOLLOW
• INFRAOCCLUSION UPTO 30 MICRONS OF IMPLANT
SUPPORTED RESTORATION
• NO BALANCING CONTACTS ON CANTILEVERS.
• NO GUIDANCE ON SINGLE IMPLANTS.
• FREEDOM IN CENTRIC.
• OCCLUSAL TABLE DIRECTLY PROPORTIONAL TO IMPLANT
DIAMETER.
• NARROW OCCLUSAL WIDTH.
49. •IMPLANT LENGTH – CROWN RATIO
ideal – 1:2
acceptable – 1:1 for removable denture.
•AVOIDANCE OF CANTILEVER LENGTH.
maximum 10 and 20 mm is advised.
7 mm is optimum .
•SHALLOW CENTRAL FOSSAE WITH TRIPODAL CUSPAL
CONTACTS.
•NO CONTACT IN LATERAL EXCURSION.
•SLIGHT CONTACT IN CENTRIC OCCLUSION.
51. The surgeon’s tale
‘The implants were successfully integrated , but failed because
of excess loads.’
or
The Restorative Dentist’s tale
‘The implants were poorly integrated and so failed under normal
masticatory loads.’
either way
The Patient’s tale
‘My implants have failed!’
52. References
1.Carl.E.Misch : Implant Dentistry, 2nd ed.,pp 609-629,1999
2.Cury P.R.,Sendyk W.R.,Sallum A.W. Factors associated with early and late failure of
osseointegrated implant.Braz J Oral Sci.2003;2
3. Davies S.J.,Gray R.J.M.,Young M.P.J.:Good occlusal practice in the provision of implant
borne prosthes8es.BDJ 2002;192:79-88
4. Esposito M.,Hirsch J.M.,Lekholm U.,Thomsen P. Biological factors contributing to
failures of osseointegrated oral implants.Euro.J.of Oral Sc.1998;106:527-551
5. Hobo, Ichida, Garcia: Osseointegration and Occlusal Rehabilitation,1st ed. pp.239-47,1988
6. Michael D.Wise : Failure in the Restored Dentition:Management and Treatment,1st ed.
pp.489-564,1995
7. Palmer R,Palmer P,Howe L Dental implants: Part 10.Complications and maintenance.
BDJ 1999 ; 187:653-658
8.Vincent Jimenez-Lopez : Implant-supported prostheses:Occlusion,Clinical Cases,and
laboratory procedures, 1st ed.pp. 23-44,1995
9. Weinberg L A Reduction of implant loading using a modified centric occlusal anatomy.
Int J Prosthodont 1998 ; 11:55-69