This document discusses various types of implant prostheses and concepts related to implant dentistry. It describes fixed prostheses options like FP1, FP2, FP3 that replace different portions of the natural tooth structure. Removable prosthesis options like RP4 and RP5 that are supported by implants to different degrees are also described. Impression techniques like closed tray, open tray, digital impressions and abutment level impressions are summarized. Factors to consider for abutment selection including prefabricated versus custom abutments are provided. Surgical and prosthetic phases of implant treatment are briefly outlined.
Anterior Single Tooth implants in the Esthetic ZoneDoreen Bello
This document discusses considerations for placing single-tooth implants in the anterior esthetic zone. It outlines 7 levels of difficulty for implant success based on factors like bone quality and quantity, papilla health, and smile line visibility. Guidelines are provided for pre-treatment evaluation of soft tissue, bone dimensions, and root morphology. Surgical techniques like conservative flap design and use of osteotomes are recommended. Prosthetic factors like implant positioning and emergence profile are also discussed. The document describes traditional and immediate loading approaches for restoration.
This document provides an overview of immediate implant placement. It defines key terminology, discusses the advantages of immediate placement which include preserving bone and soft tissue and reducing treatment time. Guidelines for extractions that allow for immediate placement are described, such as atraumatic extractions and osteotomy preparation techniques. Factors such as implant selection, the use of grafts, and loading protocols are summarized. Potential disadvantages including lack of control of implant position and difficulty obtaining primary stability are also mentioned. The document concludes with a review of literature on case reports evaluating immediate placement.
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,
Dental implants are prosthetic devices implanted into the jawbone to support dental prostheses like dentures or bridges. This document discusses dental implant terminology, the science of osseointegration where bone directly attaches to the implant, rationales for implants over other options, classification of implants, components, surgical procedures, and success criteria. Implants have advantages over traditional bridges and dentures by avoiding abutment tooth preparation, reducing bone loss, and improving function. Careful patient evaluation and treatment planning is required for optimal implant placement and long term success.
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.
The document discusses classifications and designs of mini-implant anchorage devices used in orthodontics. Mini-implants can be classified based on their origin as either osseointegrated dental implants or surgical mini-implants. Their design involves factors such as material (typically titanium alloy), diameter, length, head shape, and thread cut. Selection of mini-implant size and location depends on the patient's anatomy and desired orthodontic tooth movement.
Treatment Planning of Implants in Posterior QuadrantsDr.Abid P Patel
The document outlines criteria for treatment planning dental implants in posterior quadrants. Sufficient space must be evaluated in three dimensions - mesiodistal, buccolingual, and occlusogingival. Factors like implant number, position, occlusion, prosthesis type, and overall treatment plan must be considered. When adequately planned according to guidelines, implants can provide advantages over removable dentures by improving support and stability and preserving bone.
Osseointegration is defined as a direct connection between living bone and a load-bearing implant. Four main factors are required for successful osseointegration: a biocompatible material, a precisely adapted implant, atraumatic surgery, and an undisturbed healing phase. Implant survival depends on proper home care including maintaining good oral hygiene and regular recall visits. Clinical components of an implant system include the implant, abutment, and prosthesis-retaining screw. Implant placement involves careful treatment planning, atraumatic surgery using guides, and a healing period before uncovering and prosthetic construction.
Anterior Single Tooth implants in the Esthetic ZoneDoreen Bello
This document discusses considerations for placing single-tooth implants in the anterior esthetic zone. It outlines 7 levels of difficulty for implant success based on factors like bone quality and quantity, papilla health, and smile line visibility. Guidelines are provided for pre-treatment evaluation of soft tissue, bone dimensions, and root morphology. Surgical techniques like conservative flap design and use of osteotomes are recommended. Prosthetic factors like implant positioning and emergence profile are also discussed. The document describes traditional and immediate loading approaches for restoration.
This document provides an overview of immediate implant placement. It defines key terminology, discusses the advantages of immediate placement which include preserving bone and soft tissue and reducing treatment time. Guidelines for extractions that allow for immediate placement are described, such as atraumatic extractions and osteotomy preparation techniques. Factors such as implant selection, the use of grafts, and loading protocols are summarized. Potential disadvantages including lack of control of implant position and difficulty obtaining primary stability are also mentioned. The document concludes with a review of literature on case reports evaluating immediate placement.
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,
Dental implants are prosthetic devices implanted into the jawbone to support dental prostheses like dentures or bridges. This document discusses dental implant terminology, the science of osseointegration where bone directly attaches to the implant, rationales for implants over other options, classification of implants, components, surgical procedures, and success criteria. Implants have advantages over traditional bridges and dentures by avoiding abutment tooth preparation, reducing bone loss, and improving function. Careful patient evaluation and treatment planning is required for optimal implant placement and long term success.
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.
The document discusses classifications and designs of mini-implant anchorage devices used in orthodontics. Mini-implants can be classified based on their origin as either osseointegrated dental implants or surgical mini-implants. Their design involves factors such as material (typically titanium alloy), diameter, length, head shape, and thread cut. Selection of mini-implant size and location depends on the patient's anatomy and desired orthodontic tooth movement.
Treatment Planning of Implants in Posterior QuadrantsDr.Abid P Patel
The document outlines criteria for treatment planning dental implants in posterior quadrants. Sufficient space must be evaluated in three dimensions - mesiodistal, buccolingual, and occlusogingival. Factors like implant number, position, occlusion, prosthesis type, and overall treatment plan must be considered. When adequately planned according to guidelines, implants can provide advantages over removable dentures by improving support and stability and preserving bone.
Osseointegration is defined as a direct connection between living bone and a load-bearing implant. Four main factors are required for successful osseointegration: a biocompatible material, a precisely adapted implant, atraumatic surgery, and an undisturbed healing phase. Implant survival depends on proper home care including maintaining good oral hygiene and regular recall visits. Clinical components of an implant system include the implant, abutment, and prosthesis-retaining screw. Implant placement involves careful treatment planning, atraumatic surgery using guides, and a healing period before uncovering and prosthetic construction.
Dental implants are placed into the jawbone to support crowns, bridges, dentures or facial prosthetics. There are several types but they generally involve a titanium implant being surgically placed into the jawbone in either a one-stage or two-stage procedure. In a two-stage procedure, the top of the implant is submerged under gingiva and uncovered in a second surgery once integrated. Proper placement, biocompatible materials, and avoiding overheating the bone are important for integration. Implants can replace single or multiple teeth and have advantages over other options but also have higher costs and longer treatment times.
Diagnosis and treatment planning in implants 2./prosthodontic 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
This document discusses various surgical procedures related to dental implants. It covers topics like implant site preparation, one-stage versus two-stage implant placement procedures, flap design and management, localized bone augmentation techniques, and complications that can occur. The key points are:
1. Implant site preparation should be done under sterile conditions using drills of increasing diameter to the final size while avoiding overheating of bone.
2. Implants can be placed using one-stage (nonsubmerged) or two-stage (submerged) protocols, with two-stage often preferred for complex cases or when bone grafting is needed.
3. Localized bone augmentation uses particulate grafts, block grafts,
Retention in maxillofacial prosthesis pptxpadmini rani
Maxillofacial prosthesis retention can be achieved through various intraoral and extraoral methods. Intraoral retention options include anatomic features like residual ridges as well as mechanical attachments. Common mechanical attachments are cast clasps, precision attachments, and magnets. Extraoral retention methods involve adhesives, implants, eyeglasses, and magnets depending on the location and extent of the prosthesis. The document discusses considerations for selecting the appropriate retention method based on factors like bone availability, location, and amount of hard and soft tissue.
Surgical aspect of implants and recent advancespulakmishra1988
This document discusses dental implants, including their history, uses, techniques, planning and surgical procedures. It provides details on implant types, the two-stage surgery process involving initial fixture installation and a later procedure to attach the abutment. Techniques for implant planning, drilling, tapping and fixture installation are described. Considerations for soft and hard tissue management are also covered.
The socket shield technique at molar sitesNaveed AnJum
The socket-shield technique for avoiding postextraction tissue alteration was first described in 2010. The technique was developed for hopeless teeth in anterior esthetic sites but has not yet been described for molar sites. Managing postextractive ridge changes in the posterior region by prevention or regeneration remains a challenge. The socket shield aims to offset these ridge changes wherever possible, preserving the patient’s residual tissues at immediate implants.
The document discusses standard implant surgical procedures. It covers topics such as bone classification related to implant dentistry, osseointegration, the implant kit including drills and surgical instruments, surgical procedures for one-stage and two-stage implant placement, healing after implant placement, implant surgical guides, and complications of implant procedures. The goal of implant surgery is to restore teeth to normal function by surgically placing implants into the jawbone which osseointegrate and allow for prosthetic replacement of missing teeth.
A dental implant is a surgical component that interfaces with the jawbone to support dental prosthetics like crowns, bridges, dentures, or act as an orthodontic anchor. Modern implants bond directly to bone through osseointegration, where titanium implants form a bond with bone. A variable healing time is required for osseointegration before attaching a prosthetic. Dental implants can replace single or multiple missing teeth and involve placing fixtures into the jawbone followed by attachment of abutments and prosthetics.
A dental implant is a surgical component that interfaces with the jawbone to support dental prosthetics like crowns, bridges, dentures, or act as an orthodontic anchor. Modern implants bond directly to bone through osseointegration, where titanium implants form a bond with bone. A variable healing time is required for osseointegration before attaching a prosthetic. Dental implants can replace single or multiple missing teeth and involve placement of a fixture into the jawbone followed by attachment of components like abutments and prosthetics.
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
Clinical amnagement of edentulous maxillectomy pt/ implant dentistry courseIndian 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.
Dental Implants Procedures and ComplicationsBALAKRISHNA341
This document discusses dental implants, including the stages of implant placement and factors considered during treatment planning and surgery. It describes the preoperative examination, implant placement procedures such as flap design and bone drilling, and factors such as healing time and abutment selection. Key stages include preoperative examination and planning, implant placement surgery, and maintenance of implants after restoration. Success relies on maintaining the health of the implant environment through regular recalls and cleaning.
Tuberopterygoid implants are dental implants placed in the upper jaw in the second molar area that anchor in the dense cortical bone of the pterygoid plates, avoiding the need for invasive sinus lift surgery. They allow for immediate loading and replacement of teeth up to the second molars. Key advantages include eliminating sinus grafting, replacing all teeth without cantilevers, using strong single-piece implants in rigid cortical bone, and enabling immediate loading with permanent crowns in just 3 days with a flapless technique.
Clinical management of edentulous maxillectomy / oral surgery courses 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
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case P...Shilpa Shiv
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case Presentations of a Novel Approach to Immediate Implant Placement at Multirooted Molar Sites, IJPRD 2013.
Dental implants are artificial fixtures placed surgically into the jawbone to replace missing teeth. There are different types of implants including subperiosteal, transosseous, and endosteal implants, with endosteal implants being the most common today. The process of osseointegration, where bone bonds to the implant surface without soft tissue interference, was discovered in 1952 and refined for successful dental implant treatment. The surgical procedure for placing implants involves two stages - the initial surgery to place the implant fixture followed by a second surgery once osseointegration is complete to place the abutment and crown. Factors like patient health, bone quality and quantity, surgical technique, and loading conditions can
SPLINT FABRICATION AND POST SURGICAL ORTHODONTICSShehnaz Jahangir
This document provides information on splint fabrication and post-surgical orthodontics for orthognathic surgery patients. It discusses the steps for making intermediate and final splints using model surgery, including mounting casts, performing mock surgery, and splint fabrication. It also outlines the goals and steps of post-surgical orthodontic treatment, including initial archwires and elastics to settle the occlusion, as well as retention considerations. The overall goals of post-surgical orthodontics are to establish the final occlusion and correct root positions.
Minimalist Business Slides XL by Slidesgo.pdfAbdullahWaad
The healing assistant is a temporary component placed on the implant during the healing phase to allow soft tissue closure and bone regeneration. It is later removed and replaced with the abutment.
IV. Abutment
The portion of the dental implant that connects to the implant fixture/body and extends through the soft tissue into the supracrestal region. It provides the mechanical means to attach and support a dental prosthesis.
V. Impression Coping
The impression coping is a temporary component placed on the implant or abutment during impression making to record the exact three-dimensional position and orientation of the implant for fabrication of the prosthesis.
VI. Prosthesis
The prosthesis is the final restoration
A must read seminar on Dental Implants for Under-Graduates and Post-Graduates.
If you have any doubts regarding Dental Implants or any topic if you are unable to understand then do feel free to contact me on my Email address: Dr.anujparihar@gmail.com
Dental implants are placed into the jawbone to support crowns, bridges, dentures or facial prosthetics. There are several types but they generally involve a titanium implant being surgically placed into the jawbone in either a one-stage or two-stage procedure. In a two-stage procedure, the top of the implant is submerged under gingiva and uncovered in a second surgery once integrated. Proper placement, biocompatible materials, and avoiding overheating the bone are important for integration. Implants can replace single or multiple teeth and have advantages over other options but also have higher costs and longer treatment times.
Diagnosis and treatment planning in implants 2./prosthodontic 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
This document discusses various surgical procedures related to dental implants. It covers topics like implant site preparation, one-stage versus two-stage implant placement procedures, flap design and management, localized bone augmentation techniques, and complications that can occur. The key points are:
1. Implant site preparation should be done under sterile conditions using drills of increasing diameter to the final size while avoiding overheating of bone.
2. Implants can be placed using one-stage (nonsubmerged) or two-stage (submerged) protocols, with two-stage often preferred for complex cases or when bone grafting is needed.
3. Localized bone augmentation uses particulate grafts, block grafts,
Retention in maxillofacial prosthesis pptxpadmini rani
Maxillofacial prosthesis retention can be achieved through various intraoral and extraoral methods. Intraoral retention options include anatomic features like residual ridges as well as mechanical attachments. Common mechanical attachments are cast clasps, precision attachments, and magnets. Extraoral retention methods involve adhesives, implants, eyeglasses, and magnets depending on the location and extent of the prosthesis. The document discusses considerations for selecting the appropriate retention method based on factors like bone availability, location, and amount of hard and soft tissue.
Surgical aspect of implants and recent advancespulakmishra1988
This document discusses dental implants, including their history, uses, techniques, planning and surgical procedures. It provides details on implant types, the two-stage surgery process involving initial fixture installation and a later procedure to attach the abutment. Techniques for implant planning, drilling, tapping and fixture installation are described. Considerations for soft and hard tissue management are also covered.
The socket shield technique at molar sitesNaveed AnJum
The socket-shield technique for avoiding postextraction tissue alteration was first described in 2010. The technique was developed for hopeless teeth in anterior esthetic sites but has not yet been described for molar sites. Managing postextractive ridge changes in the posterior region by prevention or regeneration remains a challenge. The socket shield aims to offset these ridge changes wherever possible, preserving the patient’s residual tissues at immediate implants.
The document discusses standard implant surgical procedures. It covers topics such as bone classification related to implant dentistry, osseointegration, the implant kit including drills and surgical instruments, surgical procedures for one-stage and two-stage implant placement, healing after implant placement, implant surgical guides, and complications of implant procedures. The goal of implant surgery is to restore teeth to normal function by surgically placing implants into the jawbone which osseointegrate and allow for prosthetic replacement of missing teeth.
A dental implant is a surgical component that interfaces with the jawbone to support dental prosthetics like crowns, bridges, dentures, or act as an orthodontic anchor. Modern implants bond directly to bone through osseointegration, where titanium implants form a bond with bone. A variable healing time is required for osseointegration before attaching a prosthetic. Dental implants can replace single or multiple missing teeth and involve placing fixtures into the jawbone followed by attachment of abutments and prosthetics.
A dental implant is a surgical component that interfaces with the jawbone to support dental prosthetics like crowns, bridges, dentures, or act as an orthodontic anchor. Modern implants bond directly to bone through osseointegration, where titanium implants form a bond with bone. A variable healing time is required for osseointegration before attaching a prosthetic. Dental implants can replace single or multiple missing teeth and involve placement of a fixture into the jawbone followed by attachment of components like abutments and prosthetics.
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
Clinical amnagement of edentulous maxillectomy pt/ implant dentistry courseIndian 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.
Dental Implants Procedures and ComplicationsBALAKRISHNA341
This document discusses dental implants, including the stages of implant placement and factors considered during treatment planning and surgery. It describes the preoperative examination, implant placement procedures such as flap design and bone drilling, and factors such as healing time and abutment selection. Key stages include preoperative examination and planning, implant placement surgery, and maintenance of implants after restoration. Success relies on maintaining the health of the implant environment through regular recalls and cleaning.
Tuberopterygoid implants are dental implants placed in the upper jaw in the second molar area that anchor in the dense cortical bone of the pterygoid plates, avoiding the need for invasive sinus lift surgery. They allow for immediate loading and replacement of teeth up to the second molars. Key advantages include eliminating sinus grafting, replacing all teeth without cantilevers, using strong single-piece implants in rigid cortical bone, and enabling immediate loading with permanent crowns in just 3 days with a flapless technique.
Clinical management of edentulous maxillectomy / oral surgery courses 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
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case P...Shilpa Shiv
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case Presentations of a Novel Approach to Immediate Implant Placement at Multirooted Molar Sites, IJPRD 2013.
Dental implants are artificial fixtures placed surgically into the jawbone to replace missing teeth. There are different types of implants including subperiosteal, transosseous, and endosteal implants, with endosteal implants being the most common today. The process of osseointegration, where bone bonds to the implant surface without soft tissue interference, was discovered in 1952 and refined for successful dental implant treatment. The surgical procedure for placing implants involves two stages - the initial surgery to place the implant fixture followed by a second surgery once osseointegration is complete to place the abutment and crown. Factors like patient health, bone quality and quantity, surgical technique, and loading conditions can
SPLINT FABRICATION AND POST SURGICAL ORTHODONTICSShehnaz Jahangir
This document provides information on splint fabrication and post-surgical orthodontics for orthognathic surgery patients. It discusses the steps for making intermediate and final splints using model surgery, including mounting casts, performing mock surgery, and splint fabrication. It also outlines the goals and steps of post-surgical orthodontic treatment, including initial archwires and elastics to settle the occlusion, as well as retention considerations. The overall goals of post-surgical orthodontics are to establish the final occlusion and correct root positions.
Minimalist Business Slides XL by Slidesgo.pdfAbdullahWaad
The healing assistant is a temporary component placed on the implant during the healing phase to allow soft tissue closure and bone regeneration. It is later removed and replaced with the abutment.
IV. Abutment
The portion of the dental implant that connects to the implant fixture/body and extends through the soft tissue into the supracrestal region. It provides the mechanical means to attach and support a dental prosthesis.
V. Impression Coping
The impression coping is a temporary component placed on the implant or abutment during impression making to record the exact three-dimensional position and orientation of the implant for fabrication of the prosthesis.
VI. Prosthesis
The prosthesis is the final restoration
A must read seminar on Dental Implants for Under-Graduates and Post-Graduates.
If you have any doubts regarding Dental Implants or any topic if you are unable to understand then do feel free to contact me on my Email address: Dr.anujparihar@gmail.com
Similar to prosthetic concepts in implant dentistry (20)
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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7. FP 1 ( FIXED PROSTHESIS 1 )
• Replace only anatomical
portion of the natural tooth
• Soft and hard tissue loss is
minimal
• Ideal placement possible
• Adequate volume and
position of residual bone
• Final restoration looks like
a natural crown
8. FP 2 ( FIXED
PROSTHESIS 2)
• RESTORES ANATOMICAL CROWN AND
PART OF THE ROOT
• DUE TO SOME AMOUNT OF BONE LOSS
• NO PINK
9. FP 3 ( FIXED PROSTHESIS 3 )
• Restorations appear
to replace natural
teeth crowns and
portions of soft
tissues.
• Delivered when
bone height is
reduced
10. But in the aesthetic zone, unlike FP – 2 prosthesis it can be
used in patients having normal to high lip-line because
it restores the gingival drape & interdental papillae by
pink restorative material & there by providing the teeth
having more natural appearance in shape & size.
12. RP 4 ( REMOVABLE
PROSTHESIS 4 )
• Removable prosthesis completely
supported by implants
• Restoration is rigid yet removable
13. Usually 5 – 6 implants
are needed in the
mandible & 6 – 8
implants are needed
in the maxilla to
fabricate a completely
implant supported
removable
overdenture (RP – 4
prosthesis ) in
patients with
favorable dental
criteria.
14. RP 5 (REMOVABLE PROSTHESIS 5 )
• Combination of
implant and soft
tissue support
• Reduced cost
• Bone continues to
resorb
• Requires periodic
maintenance
15. The amount of implant support is variable in
this prosthesis.
In case of edentulous mandible
a. Number of implants can be 2-4
b. They can be independent to each other
except the parallelism
c. They can be splinted together to provide
retention & stability
to the prosthesis.
In case of maxilla
a. Implant number can be 4 or more
b. They are usually splinted together
because of poor bone quality & severely
compromised forces direction.
18. CRITERIA FOR EVALUATION OF SUCCESSFUL
IMPLANTS AT STAGE 2 UNCOVERY
• Rigid fixation
• Absence of crestal bone loss
• Absence of pain
• Adequate zone of keratinizing gingiva
• Sulcus depth 4mm
• Absence of inflammation
• Proper hard and soft tissue contour.
19. Endosseous implants can be placed following either two-stage
technique requiring second-stage surgery or one-stage
technique, which does not involve a second surgical intervention
20. Uncovering of implants
Techniques chosen for uncovering the implant will depend on the
characteristics of the tissue that overlies the implant. The amount
of attached gingiva, the thickness of the overlying mucosa, and the
presence or the absence of interdental papillae are some of the
issues to be considered before uncovering an implant.
23. Punch Technique
When an adequate band—ie, at least 1 mm—of KM
surrounds the implant and there is no need to build up
the buccal root profile, a circular incision of the same
diameter as the implant may be made to remove the
tissue covering the implant.
24.
25.
26.
27.
28. Placing the correct per mucosal
extension is of utmost importance
• Helps to form the soft tissue drape specially in upper anterior zone.
• Acts as a guideline for diameter and height of the abutment.
• Emergence profile for the future crown.
• Prevention of tissue growth over implants.
• Tenting effect in GBR.
30. CRITERIA.
1. Diameter :- Healing screw diameter depends on the type and
volume of the tooth to replace. It should be wider than the implant
crest module.
Example: for a molar, a 6.0 mm diameter
screw is more appropriate than a 4.0 mm
screw.
31. 2. Appropriate collar height.
It assists in forming a soft tissue cuff. It
corresponds to the distance from the
top of the implant to the large
diameter of the healing cap. Ideally
1mm above the soft tissue level.
Example:
- if the implant is positioned 0.5 mm
below the crestal bone level and the
soft tissue height is 2mm, the
appropriate gingival height will be
2.5mm.
32. COMPLICATIONS
• EXCESS BONE FORMATION OVER THE COVER SCREW.
• SOFT TISSUE ABSCESS OR STITCH ABSCESS
• EARLY OR PREMATURE EXPOSSURE OF COVER SCREW
33. Many implant abutments are wider than the first-stage cover screw and may require
as much as 1 mm of horizontal space around the implant platform on the crest
module.
Any bone growth on the cover screws or over the surrounding region is removed
with surgical curettes or low-speed rotary uncovery burs designed to remove excess
bone, accompanied by cooled sterile saline irrigation.
As such, when bone is over or adjacent to the cover screw, the marginal bone must
be recontoured to allow complete seating of the abutment.
A bone profile drill with copious irrigation may also be used.
41. • The objective of implant level closed tray as well as open tray
impression techniques are to record & transfer the soft tissue
profile as well as the implant’s location & the implant’s internal
hex orientation from patient mouth to working cast.
55. Keep flat portion of
transfer coping labially
that help in re-alignment
later on in impression.
Block-out the transfer
coping hex opening with
a cotton pellet or soft
wax to facilitate access
after the impression.
56. Step-3 : making of impression
• Inject impression material
around the transfer coping.
• Fill the customized impression
tray with a heavy body
impression material and seat the
impression tray to take the
impression.
• Remove the set impression from
pt mouth. The impression will
captured the anatomy of
transfer coping , but the transfer
coping will not comes out with
the set impression because it
was screwed with the implant
body.
58. Transfer Coping
Implant Analog
The Transfer Coping
removed from the patient
mouth is now attached with
the implant analog &Place
the transfer
Coping-implant analog
assembly back into the
impression, aligning the flat
surface of the transfer coping
with the flat surface in the
impression
59. Implant Analog Inserted onto the Transfer Coping & then
aligning the flat surface of the transfer coping with the flat
surface in the impression
60. Soft tissue material is injected around the transfer
coping before pouring the stone master model.
Model fabrication
with
gingival mask
61. - Use the die stone that have greatest
compressive strength otherwise chances of
breakage of cast at the site of transfer
coping.
- TYPE-IV DIE STONE IS RECOMMENDED
Master cast :
62. Exact reproduction of
the patient‘s
situation after
removal of transfer
coping from the set
master cast
63. After removal of the transfer coping , place titanium
abutment onto the implant analog in the stone model. The
titanium abutment is then prepared on the cast .
It is important to leave enough height and thickness on the
titanium abutment to protect the hex hole. Over-modification
of the titanium abutment may result in a collapse of the
abutment or lack of surface area for cementation
64. Wax a coping over the prepared titanium abutment. Cast the
coping in precious or semiprecious alloy. Finish the coping
and seat passively onto the abutment
Apply porcelain
65. Try-in the crown, evaluate occlusion and esthetics.
Block-out the screw access hole with a cotton pellet
and cement it onto the titanium abutment.
Equilibrate occlusion as necessary.
79. In this technique, a custom tray or modified stock tray
with a screw access hole in the area above the
implant is required.
The Screw that holds the transfer Coping in place
while the impression is made is removed through the
access hole after the material sets.
The transfer Coping remains in the impression when it
is removed from the mouth.
The Implant Analog is screw to the embedded
transfer coping and a working model is poured.
80. First on the
Osseointegrated
implant place the
transfer coping and
screw it in the position
& verify its placement
radiographically similar
to closed tray
technique.
Long screw is used in
this technique
Step 1: placement of transfer coping
81. a custom tray or modified
stock tray with a screw
access hole in the area
above the implant is
required.
Step 2: selection of trays
Screw access hole
82. • An alginate impression in a stock
tray made.
• Then the transfer copings are
removed from the mouth and
placed in alginate impression
along implant analogs.
• This impression is then poured and
a study cast is made
Step 3 : fabrication of custom tray :
83. • On this study cast a custom tray is made
• In this custom tray holes over implant
position or topless area is made so that
access to the screw inside the transfer coping
is made possible.
84. • Coping screw holes are blocked with wax or cotton pellet.
• Inject the medium / light body materials around the transfer
coping & then the tray loaded with medium body impression
materials placed in mouth using the holes to locate the
correct position of tray.
• Remove the excess materials flows out through the hole
without disturbing the setting impression.
Step 4 : Making impression :
85. • After setting of impression materials remove the wax or
cotton pellets from the transfer coping screw holes.
• Then the Screw that holds the transfer Coping in place while
the impression is made is removed through the access hole
after the material sets. On doing so the transfer coping will no
more attached with the implant body.
• Next when impression is removed from patients mouth the
transfer coping embeded within the set impression will
comes out with the impression eg the set impression is
picking up the transfer coping that’s why pickup impression
technique.
86. The Implant Analog is
screw to the embedded
transfer coping and a
working model is poured
in dental stone,
providing a replica of the
implant’s location in the
patient’s mouth.
87.
88.
89. Abutment Level Impression
• An abutment is pre-selected by the dentist, placed and
torqued onto the implant. An appropriate abutment level
impression coping is used to transfer the position of the
abutment from the patient’s mouth to a model. The
restoration is fabricated to fit on top of the abutment.
90. Direct technique
Abutment level impression
Inside the patients mouth abutment is screwed to implant body
with a hand torque of 5 – 15 N-cm & checked radiographically
for proper placement. Once abutment seating is confirmed
the abutment is finally tighten upto 30 N-cm.
Abutment is prepared
91. Make the rubber base impression of the
prepared abutment , pour the cast in die
stone & on the resultant master cast
prosthesis is fabricated like conventional
prosthodontic method.
92. Advantages:
1. Preparation of the abutments is done intraorally.
2. Minimum prosthetic parts is required.
3. Similar to conventional crown and bridges prosthetic
techniques.
93. 1. Less accurate in comparison to indirect method.
2. Increased chair side time because the abutment is
need to be prepared intraorally.
3. Increased heat generation – affects hard & soft
tissue health.
4. The work needs to be done under indirect vision.
5. Traumatic injury to gingiva may compromise the
esthetic.
Disadvantage :
100. PREFABRICATED OR STOCK ABUTMENTS
EMERGENCE COMPONENT
1. the diameter of the implant platform (eg,
narrow, regular, or wide, determined from
your referring surgeon)
2. the collar or cuff height (the distance
between the implant platform and the
gingival margin)
PROSTHETIC COMPONENT
1. the interocclusal height (the distance
between the implant platform and the
opposing dentition)
2. whether a straight or angled abutment is
needed.
101. Abutment /
Preparation
height
Preparation angle
Gingival margin
Ideal abutment angle for retention is 6°
Prefabricated abutments commonly are designed with this angle
Consider an abutment height of min. 5 mm
Below 4 mm a screw-retained restoration is indicated
Keep preparation margin perigingival to facilitate removal of excess
cement and to limit flow of excess cement into the sulcus*
* S Holst, Univ Erlangen, Germany, 2012, personal communication
Preparation / geometric guidelines for cement-retained restorations
Clinical considerations on cement-retained
109. Abutments for overdenture
Ball abutment
Locator attachment
ERA attachment
Dalbo
O-Ring
EDS
Magnetic abutment
Dolder bar
3.17 4.85 5.82 6.14
6.22mm
Locator ERA Dalbo O-Ring
110. CONTRAINDICATION TO PREFABRICATED
ABUTMENTS
1. There is insufficient interocclusal space, where the abutment would not
have sufficient height to retain a crown.
2. The implant requires an angle of correction greater than 15º.
3. The collar height (the distance between the implant platform and the
more than 1 mm greater than the largest collar height offered by the
4. The need for splinting three or more implants in a quadrant when
required. If the clinician desires to splint three or more implants together
quadrant, preparation for parallelism can be quite challenging.
117. For angulation beyond 15 degress the cast
to base abutment is the abutment of
choice to customise an angled abutment.
118.
119.
120. What Are the Advantages of Custom Milled Abutments?
Custom milled abutments have many advantages:
•They help achieve a passive fit
•The final restorations are manufactured to the patient’s exact gingival
architecture, achieving an optimal emergence profile and a more
esthetically pleasing outcome
•It is easier to correct the angulation of the implants
•Fewer chair-side adjustments are required, and appointments can be
smoother and faster, helping to increase the efficiency of a dental office
129. 139
Disclaimer: Some products may not be regulatory cleared/released for sale in all markets.
Please contact the local Nobel Biocare sales office for current product assortment and availability.
Cement-retained
+
No screw access hole
More esthetic solution
Provisionals easier to fabricate
-
Cement excess removal issue
Cement excess may lead to inflammation and periimplantitis
Restoration more difficult to retrieve
Proper cement selection and cementation procedure might be a challenge
Always 2 piece superstructure
Needs min. 5mm abutment height
Source: Lee et al. Implant Dentistry / Volume 19, Number 1, 2010
Cement-retained: advantages - disadvantages
Prerequisites and considerations
130. Pauletto N, Lahiffe BJ, Walton JN. Complications associated with excess
cement around crowns on osseointegrated implants: A clinical report. Int J
Oral Maxillofac Implants 1999;14:865-868.
It was in 1999 when
retained cement was
first reported as a
source of peri-implant
mucosal swelling,
mucosal recession, and
bone loss
131. 141
141
Keep preparation margin perigingival, to facilitate removal of excess cement and to limit flow of
excess cement into the sulcus
Pictures courtesy of Dr Baldwin Marchack (1,2) and IvoclarVivadent (3)
1 2
3
Crown margin too deep, proper
removal of excess cement almost
impossible
Crown margin nicely located perigingivally Perigingivally located crown margin allows
for easy and proper clean-up of excess
cement
Management of cement excess
Clinical considerations on cement-retained
Location of preparation margin
3
132. 142
142
Limit amount of excess cement by appropriate application technique:
Place a retraction cord into the sulcus
Using a brush, apply a thin layer of cementation material onto the inner aspects of the
crown walls.
Alternatively control the amount of cement in the lumen by using a custom putty trial die
(see example on next slide)
Management of cement excess
Clinical considerations on cement-retained
Application techniques
Consider not filling the entire lumen of the crown with cement. Overfilling produces
excess cement material which can lead to complications.
X 4
Pictures from NobelProcera cementation guide
Picture (4) courtesy of IvoclarVivadent
133. Custom abutment (left)
Custom putty abutment
(right)
The custom putty abutment replica fitted inside complete crown, permitting extraoral
elimination of most of the excess cement. Only a thin layer of cement remains inside
complete crown, minimizing the amount of cement extruded into soft tissues.
A simple cementation method to prevent material extrusion into the periimplant tissues.
Suzanne Caudry, PhD, MSc, David Chvartszaid, DDS, MSc, and Nicholas Kemp, BDS, DDS
Faculty of Dentistry, University of Toronto, Toronto, Canada
The Journal of Prosthetic Dentistry, Inc. 2009. 102(2).130-1.
Reproduced with permission from the Editorial Council for The Journal of Prosthetic Dentistry, Inc.
143
Management of cement excess
Clinical considerations on cement-retained
Application techniques
134. Cement excess induced tissue inflammation
and periimplantitis.
It is key to avoid cement excess and to
remove cement excess thoroughly.
Consider this issue also specifically in
immediate loading cases (excess cement
potentially flowing into implant surgery site …)
144
The Positive Relationship Between Excess Cement and Peri-Implant Disease: A Prospective Clinical Endoscopic Study
Thomas G. Wilson Jr., J Periodontol 2009:1388-1392.
Excess dental cement was associated with signs of periimplant disease in the majority (81 %) of the cases. Clinical and
endoscopic signs of peri-implant disease were absent in 74 % of the test implants after the removal of excess cement.
Management of cement excess
Clinical considerations on cement-retained
162. 173
Disclaimer: Some products may not be regulatory cleared/released for sale in all markets.
Please contact the local Nobel Biocare sales office for current product assortment and availability.
Screw-retained
+
No cement excess (- no cement-excess induced inflammation)
Restoration easy to retrieve for maintenance etc.
Screw-retained crown / bridge (Procera Implant Bridge) as straight forward
and efficient one piece superstructure solution
Possible with < 4 mm abutment height, use in limited interocclusal space
Provisionals: better tissue response and communication with technician
-
Screw access hole (to be obturated)
Esthetic considerations (screw access hole)
Higher maintenance need (screw loosenings / fractures, higher risk of
restoration ceramic fractures)
Potential occlusal interferences around screw access hole obturation
Manipulation of components (screw, screw driver) in posterior area, sufficient
interocclusal space required
Source: Lee et al. Implant Dentistry / Volume 19, Number 1, 2010
Screw-retained: advantages - disadvantages
Prerequisites and considerations