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 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.
Indications & contra indications of implant supported prosthesis / implant de...Indian dental academy
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 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
A 16-year-old male presented with a chief complaint of wanting better tooth appearance. He brushed his teeth only twice a week and had generalized moderate chronic gingivitis. After a treatment plan of oral hygiene instruction, scaling and root planing, extraction of tooth #6, endodontic treatment of tooth #7, and restorations, follow-up showed improved oral hygiene and periodontal health with clearer observation of the changed oral situation. Unfortunately, follow-up photos were not taken.
Dental implants in the medically compromised patientKptaiping Perak
This review article evaluates the scientific evidence regarding potential contraindications to dental implants in medically compromised patients. The article finds that there are very few absolute medical contraindications to dental implants, though some conditions may increase the risk of treatment failure or complications. The control of systemic disease is likely more important than the disease itself. For many patients, the benefits of dental implants outweigh the risks. Careful medical evaluation is recommended prior to implant treatment in medically compromised patients.
Treatment planning in rpd/certified fixed orthodontic courses by Indian dent...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
An undergraduate student accidentally perforated the coronal third of a patient's tooth during root canal treatment, resulting in marginal tissue recession. The patient was referred for periodontal and restorative treatment. The perforation site was restored with glass ionomer cement. A subepithelial connective tissue graft was used to achieve total root coverage. Five months later, porcelain veneers were placed to restore esthetics. The multidisciplinary approach successfully restored both soft tissue and dental esthetics following an iatrogenic error.
This document presents two clinical case presentations. Case 1 involves a 65-year-old man with a chief complaint of difficulty eating due to missing posterior teeth. Examination found plaque-induced gingivitis, secondary caries, and loss of teeth. Treatment included scaling, root planing, restorations, and fixed bridges to replace missing teeth. Case 2 involves a 46-year-old man unhappy with his smile due to a visible metal screw. Examination found periodontitis, missing teeth, and a diastema. Treatment included veneers, crowns, a removable partial denture, and future bridges and implants to improve esthetics and function. Both cases provide diagnoses, treatment plans and options, and
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.
Indications & contra indications of implant supported prosthesis / implant de...Indian dental academy
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 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
A 16-year-old male presented with a chief complaint of wanting better tooth appearance. He brushed his teeth only twice a week and had generalized moderate chronic gingivitis. After a treatment plan of oral hygiene instruction, scaling and root planing, extraction of tooth #6, endodontic treatment of tooth #7, and restorations, follow-up showed improved oral hygiene and periodontal health with clearer observation of the changed oral situation. Unfortunately, follow-up photos were not taken.
Dental implants in the medically compromised patientKptaiping Perak
This review article evaluates the scientific evidence regarding potential contraindications to dental implants in medically compromised patients. The article finds that there are very few absolute medical contraindications to dental implants, though some conditions may increase the risk of treatment failure or complications. The control of systemic disease is likely more important than the disease itself. For many patients, the benefits of dental implants outweigh the risks. Careful medical evaluation is recommended prior to implant treatment in medically compromised patients.
Treatment planning in rpd/certified fixed orthodontic courses by Indian dent...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
An undergraduate student accidentally perforated the coronal third of a patient's tooth during root canal treatment, resulting in marginal tissue recession. The patient was referred for periodontal and restorative treatment. The perforation site was restored with glass ionomer cement. A subepithelial connective tissue graft was used to achieve total root coverage. Five months later, porcelain veneers were placed to restore esthetics. The multidisciplinary approach successfully restored both soft tissue and dental esthetics following an iatrogenic error.
This document presents two clinical case presentations. Case 1 involves a 65-year-old man with a chief complaint of difficulty eating due to missing posterior teeth. Examination found plaque-induced gingivitis, secondary caries, and loss of teeth. Treatment included scaling, root planing, restorations, and fixed bridges to replace missing teeth. Case 2 involves a 46-year-old man unhappy with his smile due to a visible metal screw. Examination found periodontitis, missing teeth, and a diastema. Treatment included veneers, crowns, a removable partial denture, and future bridges and implants to improve esthetics and function. Both cases provide diagnoses, treatment plans and options, and
Diagnosis and treatment planning of Removable Partial Denture dwijk
This document discusses the process of examining a patient and developing a treatment plan for a removable partial denture. It covers organizing the initial examination, evaluating medical and dental history, performing diagnostic tests and impressions, and analyzing the data to formulate a treatment plan. The goal is to thoroughly understand the patient's condition and needs to develop a successful treatment.
Treatment planning is the second most important part of orthodontic management. It involves defining treatment aims, such as overjet reduction, and developing a treatment plan to accomplish these aims using specific appliance systems. Some common problems addressed in treatment include improving dental health, relieving crowding, correcting malocclusions, and aligning teeth. The treatment plan should consider factors like oral health, the dental arches, and choice of appliance. Developing an effective treatment strategy involves collecting data, prioritizing problems, considering options, and defining a specific treatment plan.
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.
A 25-year-old male presented with sensitivity to cold drinks and air for the past year. Examination revealed pigmented gingiva due to smoking, gingival recession on teeth 11, 13, and 23 from rough brushing, and generalized chronic marginal gingivitis. The treatment plan included extracting partially impacted third molars 38 and 48 and their opposing teeth to prevent complications, placing composite fillings on teeth with occlusal caries, replacing a faulty restoration on tooth 36 with a metal-ceramic crown, and periodontal treatment including instructing better oral hygiene techniques.
This document summarizes the key aspects and considerations for autogenic dental transplants. It discusses the technique, which involves carefully dissecting rather than extracting the donor tooth and immediately placing it in the prepared recipient site while avoiding damage to the periodontal ligament. Success rates from previous studies ranging from 72-100% are reported. Factors like patient age, root development stage, fixation method, and avoidance of forces for 3-6 months are discussed as important to transplant success and outcomes like revascularization and root growth. Premolars and third molars are considered good candidates due to their dispensability and timing of development. While more common in Scandinavia, the document argues autogenic transplants can be a viable treatment option
This document presents a case involving the prosthodontic treatment of a 18-year-old female patient with dental pain and esthetic issues. The patient was examined and found to have caries, missing teeth, and periodontal issues. Treatment options considered included extraction, implants, removable partial dentures, and fixed bridges. A glass fiber post was selected to reinforce tooth #32 due to loss of coronal structure after root canal treatment. A core buildup was completed along with composite restoration. The treatment addressed the patient's chief complaints and restored esthetics and function.
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.
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.
Orthodontic management of dentofacial skeletal problemsMaherFouda1
An overview of orthodontic-surgical treatment in patients with dentofacial skeletal deformities that represents 18 to 24 months of treatment time, with most time spent in orthodontic management. The treatment involves 5 phases: 1) preorthodontic preparation to improve oral health, 2) presurgical orthodontics to reveal the skeletal deformity by removing dental compensations, 3) surgery, 4) postsurgical orthodontics, and 5) retention. The goal is to achieve both occlusal and aesthetic goals by coordinating the efforts of the orthodontist and surgeon.
1) The document summarizes research on early orthodontic intervention for patients with tooth-size discrepancies. It focuses on using rapid maxillary expansion (RME) in the mixed dentition stage to correct crowding issues.
2) Long-term studies found that RME followed by fixed appliances resulted in clinically significant increases in maxillary and mandibular arch width even 5+ years post-treatment. RME also had benefits like improving nasal breathing.
3) For patients with mild-moderate crowding, RME combined with other approaches like Schwarz appliances in early treatment resulted in increased arch widths that were maintained long-term. RME was found to be an effective option for treating mixed dentition patients
This study examined the effectiveness and efficiency of early treatment versus late treatment for Class II malocclusions. The researchers conducted a randomized controlled trial comparing early treatment using headgear or functional appliances to a control group receiving no early treatment. Results showed that while early treatment produced small changes to jaw growth, this initial advantage was not sustained. There were no differences found between the groups in final skeletal or dental measurements, need for extractions, treatment time, or quality of dental occlusion after treatment. Therefore, the study concluded that early treatment was generally no more effective than conventional late treatment for most cases of Class II malocclusion.
This document discusses the diagnosis and treatment of aggressive periodontitis. Key points include:
- Aggressive periodontitis is characterized by rapid bone loss and minimal plaque. Microbial testing can identify pathogens like P. gingivalis.
- Treatment involves scaling, root planing, surgery, and adjunctive antibiotics like amoxicillin with metronidazole. Regenerative therapies and local drug delivery aim to regenerate bone and treat pathogens.
- Maintenance therapy through frequent cleanings and home care is important to control the disease long term. Some severe cases may be refractory to standard treatment and require further testing and customized therapies.
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.
This document provides an introduction to a book on prosthodontic treatment of patients presented by the Graduate Program in Oral Rehabilitation at the Hebrew University-Hadassah School of Dental Medicine in Jerusalem, Israel. The book is divided into four parts based on the primary problem of each patient: periodontal breakdown, dysfunctional habits, extensive tooth loss, and congenital disorders. The basis for all prosthodontic treatment is a healthy periodontium. The goal is to identify the etiology of each patient's condition and develop a comprehensive treatment plan tailored to the individual patient.
This document discusses treatment planning in orthodontics. It begins by defining treatment planning and outlining its goals, which include achieving functional occlusion, jaw function, and aesthetics. It then describes the logical sequence of treatment planning, which involves prioritizing problems, considering treatment possibilities, evaluating interactions, and developing alternative plans while considering risks and costs. Key aspects of treatment planning discussed include pathological versus developmental problems, setting treatment priorities, evaluating treatment possibilities, compromising when goals cannot all be fully achieved, and the importance of timing treatment appropriately based on a patient's age. The document also outlines principles of orthodontic triage and maximizing esthetic outcomes at both the macro and micro levels.
This document summarizes the keynote speech given at an early treatment symposium. The speaker notes that many attendees are there due to a personal interest in early treatment, but questions what the nature of this interest is. He suggests focusing the discussion on asking questions, rather than expecting experts to provide definitive answers. Specifically, he proposes questioning whether early treatment is truly better than late treatment for Class II malocclusions. He argues there is a lack of evidence supporting many claims made about the benefits of early treatment, such as the ability of functional appliances to augment mandibular growth. The speaker concludes there may be occasional benefits to early treatment but not enough to support it as the routine approach without stronger evidence.
This document provides an overview of a book titled "Evidence-Based Decision Making: A Translational Guide for Dental Professionals". The book teaches dental professionals the essential skills of evidence-based decision making, including how to form clinical questions based on a patient case, search efficiently for relevant evidence, critically appraise evidence, apply evidence to patient care, and evaluate their EBDM performance. Each chapter contains objectives, activities, and case examples to reinforce skills. The goal is for readers to complete the full EBDM process for different clinical question types.
The document discusses the stability of open bite treatment. It finds that:
1) Relatively few scientific studies have evaluated the stability of open bite treatment. The studies that do exist show that 35-60% of non-surgically treated patients experience a relapse of their open bite.
2) Various therapies have been proposed to improve stability, such as crib therapy and myofunctional therapy, but no long-term studies conclusively prove their effectiveness.
3) While early treatment is generally indicated for open bites depending on severity, age, etc., stability remains a clinical problem as about 20-40% of patients, both surgically and non-surgically treated, will experience a relapse.
The document summarizes discussions from an early treatment symposium regarding the treatment of skeletal open bite malocclusions. It addresses questions about defining early treatment, the differences between dental and skeletal open bites, benefits of early treatment for hyperdivergent open bites, and appropriate treatment approaches. The optimal treatment is said to be beginning between ages 7-8 and includes rapid maxillary expansion, headgear, and light muscle exercises to control vertical growth and encourage counterclockwise mandibular rotation. Early intervention is advocated to modify growth and prevent needing future surgery.
Predictable and Accurate 3D Guided implant placement for a 3-D worldKei Lim
We live in a 3 dimensional world yet still place dental implants using 2D techniques involving guessing. New 3D guided implant placement allows for accurate and predictable implant positioning in all 3 planes using a surgical guide. This seminar will cover how to create a 3D surgical guide from scans or impressions, the equipment needed, and a hands-on demonstration of placing an implant using a 3D guide for improved accuracy over conventional techniques.
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 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.
Diagnosis and treatment planning of Removable Partial Denture dwijk
This document discusses the process of examining a patient and developing a treatment plan for a removable partial denture. It covers organizing the initial examination, evaluating medical and dental history, performing diagnostic tests and impressions, and analyzing the data to formulate a treatment plan. The goal is to thoroughly understand the patient's condition and needs to develop a successful treatment.
Treatment planning is the second most important part of orthodontic management. It involves defining treatment aims, such as overjet reduction, and developing a treatment plan to accomplish these aims using specific appliance systems. Some common problems addressed in treatment include improving dental health, relieving crowding, correcting malocclusions, and aligning teeth. The treatment plan should consider factors like oral health, the dental arches, and choice of appliance. Developing an effective treatment strategy involves collecting data, prioritizing problems, considering options, and defining a specific treatment plan.
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.
A 25-year-old male presented with sensitivity to cold drinks and air for the past year. Examination revealed pigmented gingiva due to smoking, gingival recession on teeth 11, 13, and 23 from rough brushing, and generalized chronic marginal gingivitis. The treatment plan included extracting partially impacted third molars 38 and 48 and their opposing teeth to prevent complications, placing composite fillings on teeth with occlusal caries, replacing a faulty restoration on tooth 36 with a metal-ceramic crown, and periodontal treatment including instructing better oral hygiene techniques.
This document summarizes the key aspects and considerations for autogenic dental transplants. It discusses the technique, which involves carefully dissecting rather than extracting the donor tooth and immediately placing it in the prepared recipient site while avoiding damage to the periodontal ligament. Success rates from previous studies ranging from 72-100% are reported. Factors like patient age, root development stage, fixation method, and avoidance of forces for 3-6 months are discussed as important to transplant success and outcomes like revascularization and root growth. Premolars and third molars are considered good candidates due to their dispensability and timing of development. While more common in Scandinavia, the document argues autogenic transplants can be a viable treatment option
This document presents a case involving the prosthodontic treatment of a 18-year-old female patient with dental pain and esthetic issues. The patient was examined and found to have caries, missing teeth, and periodontal issues. Treatment options considered included extraction, implants, removable partial dentures, and fixed bridges. A glass fiber post was selected to reinforce tooth #32 due to loss of coronal structure after root canal treatment. A core buildup was completed along with composite restoration. The treatment addressed the patient's chief complaints and restored esthetics and function.
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.
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.
Orthodontic management of dentofacial skeletal problemsMaherFouda1
An overview of orthodontic-surgical treatment in patients with dentofacial skeletal deformities that represents 18 to 24 months of treatment time, with most time spent in orthodontic management. The treatment involves 5 phases: 1) preorthodontic preparation to improve oral health, 2) presurgical orthodontics to reveal the skeletal deformity by removing dental compensations, 3) surgery, 4) postsurgical orthodontics, and 5) retention. The goal is to achieve both occlusal and aesthetic goals by coordinating the efforts of the orthodontist and surgeon.
1) The document summarizes research on early orthodontic intervention for patients with tooth-size discrepancies. It focuses on using rapid maxillary expansion (RME) in the mixed dentition stage to correct crowding issues.
2) Long-term studies found that RME followed by fixed appliances resulted in clinically significant increases in maxillary and mandibular arch width even 5+ years post-treatment. RME also had benefits like improving nasal breathing.
3) For patients with mild-moderate crowding, RME combined with other approaches like Schwarz appliances in early treatment resulted in increased arch widths that were maintained long-term. RME was found to be an effective option for treating mixed dentition patients
This study examined the effectiveness and efficiency of early treatment versus late treatment for Class II malocclusions. The researchers conducted a randomized controlled trial comparing early treatment using headgear or functional appliances to a control group receiving no early treatment. Results showed that while early treatment produced small changes to jaw growth, this initial advantage was not sustained. There were no differences found between the groups in final skeletal or dental measurements, need for extractions, treatment time, or quality of dental occlusion after treatment. Therefore, the study concluded that early treatment was generally no more effective than conventional late treatment for most cases of Class II malocclusion.
This document discusses the diagnosis and treatment of aggressive periodontitis. Key points include:
- Aggressive periodontitis is characterized by rapid bone loss and minimal plaque. Microbial testing can identify pathogens like P. gingivalis.
- Treatment involves scaling, root planing, surgery, and adjunctive antibiotics like amoxicillin with metronidazole. Regenerative therapies and local drug delivery aim to regenerate bone and treat pathogens.
- Maintenance therapy through frequent cleanings and home care is important to control the disease long term. Some severe cases may be refractory to standard treatment and require further testing and customized therapies.
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.
This document provides an introduction to a book on prosthodontic treatment of patients presented by the Graduate Program in Oral Rehabilitation at the Hebrew University-Hadassah School of Dental Medicine in Jerusalem, Israel. The book is divided into four parts based on the primary problem of each patient: periodontal breakdown, dysfunctional habits, extensive tooth loss, and congenital disorders. The basis for all prosthodontic treatment is a healthy periodontium. The goal is to identify the etiology of each patient's condition and develop a comprehensive treatment plan tailored to the individual patient.
This document discusses treatment planning in orthodontics. It begins by defining treatment planning and outlining its goals, which include achieving functional occlusion, jaw function, and aesthetics. It then describes the logical sequence of treatment planning, which involves prioritizing problems, considering treatment possibilities, evaluating interactions, and developing alternative plans while considering risks and costs. Key aspects of treatment planning discussed include pathological versus developmental problems, setting treatment priorities, evaluating treatment possibilities, compromising when goals cannot all be fully achieved, and the importance of timing treatment appropriately based on a patient's age. The document also outlines principles of orthodontic triage and maximizing esthetic outcomes at both the macro and micro levels.
This document summarizes the keynote speech given at an early treatment symposium. The speaker notes that many attendees are there due to a personal interest in early treatment, but questions what the nature of this interest is. He suggests focusing the discussion on asking questions, rather than expecting experts to provide definitive answers. Specifically, he proposes questioning whether early treatment is truly better than late treatment for Class II malocclusions. He argues there is a lack of evidence supporting many claims made about the benefits of early treatment, such as the ability of functional appliances to augment mandibular growth. The speaker concludes there may be occasional benefits to early treatment but not enough to support it as the routine approach without stronger evidence.
This document provides an overview of a book titled "Evidence-Based Decision Making: A Translational Guide for Dental Professionals". The book teaches dental professionals the essential skills of evidence-based decision making, including how to form clinical questions based on a patient case, search efficiently for relevant evidence, critically appraise evidence, apply evidence to patient care, and evaluate their EBDM performance. Each chapter contains objectives, activities, and case examples to reinforce skills. The goal is for readers to complete the full EBDM process for different clinical question types.
The document discusses the stability of open bite treatment. It finds that:
1) Relatively few scientific studies have evaluated the stability of open bite treatment. The studies that do exist show that 35-60% of non-surgically treated patients experience a relapse of their open bite.
2) Various therapies have been proposed to improve stability, such as crib therapy and myofunctional therapy, but no long-term studies conclusively prove their effectiveness.
3) While early treatment is generally indicated for open bites depending on severity, age, etc., stability remains a clinical problem as about 20-40% of patients, both surgically and non-surgically treated, will experience a relapse.
The document summarizes discussions from an early treatment symposium regarding the treatment of skeletal open bite malocclusions. It addresses questions about defining early treatment, the differences between dental and skeletal open bites, benefits of early treatment for hyperdivergent open bites, and appropriate treatment approaches. The optimal treatment is said to be beginning between ages 7-8 and includes rapid maxillary expansion, headgear, and light muscle exercises to control vertical growth and encourage counterclockwise mandibular rotation. Early intervention is advocated to modify growth and prevent needing future surgery.
Predictable and Accurate 3D Guided implant placement for a 3-D worldKei Lim
We live in a 3 dimensional world yet still place dental implants using 2D techniques involving guessing. New 3D guided implant placement allows for accurate and predictable implant positioning in all 3 planes using a surgical guide. This seminar will cover how to create a 3D surgical guide from scans or impressions, the equipment needed, and a hands-on demonstration of placing an implant using a 3D guide for improved accuracy over conventional techniques.
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 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.
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.
Indications & contra indications of implant supported prosthesis / implant de...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.
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
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.
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.
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
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.
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.
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 factors to consider when selecting cases for endodontic treatment. It begins by introducing the importance of proper case selection to avoid treatment failures. Key considerations for case selection include assessing the need for the tooth, its restorability, periodontal health, and the clinician's ability to perform the necessary procedures. Factors associated specifically with teeth include indications for treatment, as well as contraindications like insufficient support, improper positioning, excessive calcification or abnormal canal morphology. Patient health factors that may impact treatment include medical history, physical status, and conditions requiring antibiotic prophylaxis like cardiovascular diseases. The document provides guidelines on evaluating these case selection factors to optimize endodontic treatment outcomes.
Orthognathic treatment for skeletal class iii malocclusion nehal fouad copynehal albelasy
Orthognathic surgery involves combined orthodontic and surgical treatment for dentofacial deformities. It can correct skeletal imbalances and improve facial aesthetics. Careful planning is required between the orthodontist and surgeon to move the teeth into optimal positions before surgery and refine the bite afterwards. The document discusses patient evaluation, treatment planning, the roles of orthodontics and surgery, and ensuring stability after treatment.
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, treatment planning and radiographic evaluation/ cosmetic dentistry...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.
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.
Full mouth fixed implant rehabilitation in a patientUE
This case report describes the full mouth rehabilitation of a 37-year old female patient who had lost most of her teeth due to generalized aggressive periodontitis. After extracting all remaining teeth, the patient received 12 dental implants, with 6 placed in each jaw. Fixed detachable prostheses were fabricated connecting all 12 implants. The patient was satisfied with the final result and remained stable at the 10 month follow up, though continuous maintenance care is critical for long term success given the risk of peri-implantitis in patients with periodontal disease.
This document discusses factors affecting the selection of patients for implant retained prostheses. It outlines that a thorough patient evaluation including medical history, dental evaluation through examination and imaging, and informed consent is required. The dental evaluation assesses bone quality and quantity, occlusion, and adjacent teeth. Indications for implants include missing teeth from congenital defects, trauma, or being edentulous. Contraindications include certain medical conditions, smoking, drugs/alcohol, or inadequate bone. Proper patient selection is key for implant success and satisfying treatment outcomes.
Similar to Selection of anterior teeths./ fixed orthodontics courses (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.
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Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry,
Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
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Dear Doctor,
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Course includes:
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--
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
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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
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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
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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
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The chapter Lifelines of National Economy in Class 10 Geography focuses on the various modes of transportation and communication that play a vital role in the economic development of a country. These lifelines are crucial for the movement of goods, services, and people, thereby connecting different regions and promoting economic activities.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
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.
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
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
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Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
Selection of anterior teeths./ fixed orthodontics courses
1. Selection of patient for intraoral
implants
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
2. Introduction
The use of dental implants to provide support for replacement of
missing teeth is becoming an important component of modern
dentistry. As a result of advances in research on implant design,
materials, and techniques the use of these devices has increased
dramatically in the past few years and is expected to expand further
in the future. Many types of implants are now available for
application to different clinical cases, and an increasing number of
dentists have become involved in this form of treatment.
Many individuals with edentulism can be treated with partial or
complete traditional removable dentures or fixed bridges. However,
these prostheses are not satisfactory for a significant number of
individuals who have lost the tooth-bearing portions of the bone and
simply cannot manage removable prostheses, or are medically
compromised and cannot properly masticate food. Moreover, there is
a strong suggestion that a substantial number of patients prefer
implant- supported prostheses over soft tissue supported prostheses.
www.indiandentalacademy.com
3. 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.
Criteria of success vary with different implant systems.
Therefore, it is difficult to compare certain types of implants for
which success criteria and indications may be different.
Dental implants may be classified by type as endosseous,
subperiosteal, transosteal, intramucosal, endodontic, and bone
substitutes
www.indiandentalacademy.com
5. These implant types are subdivided as follows:
• Endosseous:
Root form.
Blade (plate) form.
Ramus frame.
• Subperiosteal:
Complete.
Unilateral.
Circumferential.
• Transosteal:
Staple.
Single pin.
Multiple pin.www.indiandentalacademy.com
6. 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.
•Postinsertion maintenance.
www.indiandentalacademy.com
7. All practitioners involved in patient care should be knowledgeable
regarding these factors and their interrelationships. 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
8. 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
9. Indications for each implant type are specified below:
• ENDOSSEOUS, root form:
o Adequate bone to support the implant with width and height
being the primary dimensions of concern.
o Maxillary and mandibular arch locations.
o Completely or partially edentulous patients.
• ENDOSSEOUS, blade (plate) form:
o Adequate bone to support the implant with width and length
being the primary dimensions of concern.
o Maxillary and mandibular arch locations.
o Completely or partially edentulous patients.
www.indiandentalacademy.com
10. • ENDOSSEOUS, ramus frame:
oAdequate anterior bone to support the implant with width
and height being the primary dimensions of concern.
oMandibular arch location.
oCompletely edentulous patients.
• SUBPERIOSTEAL, complete, unilateral, circumferential:
oAtrophy of bone but with adequate bone to support the
implant.
oMaxillary and mandibular arch locations.
oCompletely and partially edentulous patients.
oStable bone for support.
www.indiandentalacademy.com
11. • TRANSOSTEAL, staple, single pin, multiple pin:
ο Adequate anterior bone to support the implant.
o Lack of adequate training of practitioner.
ο Conditions, diseases, or treatment that severely
compromise healing, e.g., including radiation therapy.
ο Poor patient motivation.
ο Psychiatric disorders that interfere with patient
understanding and compliance with necessary
procedures.
ο Unrealistic patient expectations.
ο Unattainable prosthodontic reconstruction.
ο Inability of patient to manage oral hygiene.
o Patient hypersensitivity to specific components of the
implant.
www.indiandentalacademy.com
12. Implant treatment is delivered in several ways:
(1) By multidisciplinary teams of dentists in which an oral
surgeon or periodontist performs the surgical component of the
implant and a prosthodontist performs the prosthetic component;
(2) By individual implantologists with extensive training in
both the surgical and prosthetic components who perform all
aspects of the procedure;
Patient selection should be restricted to those patients who
show a need and motivation for the implant procedures. The
evaluation of the recipient should include a survey of adequate bone
structure, medical history, and, where indicated, medical laboratory
studies and consultation with the patient's physician. The use of
computerized tomography for evaluation of maxillary and
mandibular anatomy is suggested when more accurate information
regarding implant placement is needed. The patient's dental
evaluation also should include a psychosocial appraisal of his or her
suitability for implant procedures when psychological symptoms
are present. www.indiandentalacademy.com
13. Osseointegration is the
direct structural and
functional connection
between ordered, living
bone, and surface of a load
carrying implant
www.indiandentalacademy.com
18. Baseline vital signs of
blood pressure. Pulse
and temperature
should be taken in the
evaluation stage
www.indiandentalacademy.com
19. The sequential multiple
analyzer allows for
analysis of specific blood
components, which may
be helpful in diagnosing
underlying systemic
diseases
www.indiandentalacademy.com
29. In partially edentulous
patients an evaluation
of pocket depth should
be made with a
Michigan O Probe with
Williams markings
www.indiandentalacademy.com
32. Mobility patterns
may be ascertained
by using a mirror
handle and a
periodontal probe
handle placed at
opposite ends of
the tooth.
www.indiandentalacademy.com
33. The patients past
personal oral
hygeine habits and
periodontal health
may be accurate
predictors of
his/her projected
compliance in the
maintenance of
osseointegrated
implants.
www.indiandentalacademy.com
35. Intra oral and extra
oral photographs
should be taken pre-
operatively, intra-
operatively and post
operatively
www.indiandentalacademy.com
36. Diagnostic study
models are helpful in
treatment planning
an projecting goals to
the patient pre-
operatively. They
also aid in this
retrospective analysis
of the progress of
therapy.
www.indiandentalacademy.com
38. Diagnostic wax
up aids in the
proper projection
of functional and
aesthetic goals
www.indiandentalacademy.com
39. In planning the
implant case we
must think is
reverse, i.e., we
need to plan the
final outcome
prior to the
placement of
fixtures.
www.indiandentalacademy.com
40. Diagnositc wax up
may then be
duplicated and
appropriate surgical
stents created.
www.indiandentalacademy.com
41. The facebow fork with
wax, compound or any
other accurate
recording medium is
placed in the mouth
and pressed against the
maxillary arch. The
facebow is centered on
the face and then held
in position and
tightened.
www.indiandentalacademy.com
42. A centric relation
record is started by
pressing wax against
the maxillary teeth.
The mandible is
manipulated into
centric relation
position and guided
into the wax.
www.indiandentalacademy.com
43. Wax record is then
trimmed through
the buccal cusp tip
of the maxillary
teeth. The wax
record is tried
back in the mouth
to verify its
accuracy.
www.indiandentalacademy.com
44. Wax record is floated
in room temperature
water to prevent
distortion
www.indiandentalacademy.com
45. The mounts are
poured, trimmed
and mounted in
the conventional
manner.
www.indiandentalacademy.com
48. Partially edentulous
situation, the
panoramic radiograph
can be of value in
radiographic
assessment of gross
osseous pathology,
appropriate tooth
position and some
indication as to
appropriate fixture site
location and length.
www.indiandentalacademy.com
61. Radiological stents
prepared for CT
scans should be
prepared with gutta
percha radiographic
markers rather than
with stainless steel
balls to prevent
scatter.
www.indiandentalacademy.com
62. Biomechanical considerations
The purpose of inserting implants into the jaw bone is to
establish long lasting support for the patients prosthetic teeth.
From a mechanical point of view is it thus essential to
consider the strength of the elements involved and load
supplied in order to establish the desired long term function.
When placing the fixtures in the bone the surgeon
establishes the base for the future function of the implant
supported prosthesis. The number and positions of the fixture
and anchorage quality are defined at the time the surgical
procedure is carried out. An understanding of basic
biomechanical relationships is therefore essential for the
surgeon striving for long term success for the patient.
www.indiandentalacademy.com
63. The following guidelines are valuable for minimizing the risk
of overload as well as minimizing its possible consequences:
1. The lever arm principle is affective for estimating the
distribution of forces between implants as well as on each
individual implant.
2. The force direction to strive for is axial on the fixtures.
3. The key factor for achieving axial load is spreading the
implant in both mesial / distal and buccal / lingual directions.
4. Fixtures along the straight line such as two fixture solutions
may provide critical problems. Placements of at least one
offset fixture is crucial in such cases.
5. Preservation of as much high quality cortical bone as possible
at the coronal neck is essential for optimizing the
biomechanical strength of the system
6. Bi-cortical anchorage of the fixture is advantageous for
minimizing the stress level of the bone.www.indiandentalacademy.com
64. In the full arch prosthesis, the implants constitute bridge
posts which share the applied prosthetic loads as axial forces
between them. Placing the implants evenly along an arch enables
this axial load distribution. In partial prosthesis with shorter span,
this geometrical implant spread is not always possible. In such
cases it is appropriate to look at the fixture as being an artificial
tooth root rather than a bridge post, because it may have to
withstand load in all direction from the connected prosthesis.
Implant supported partial prosthesis are therefore more sensitive
to the precise and detailed placement and anchorage of the fixtures
than are full arch prosthesis.
www.indiandentalacademy.com
65. SINGLE FREE STANDING FIXTURE
The single tooth replacement in the anterior part of the jaw
means the replacement of a missing natural tooth with a fixture
of approximately the same dimensions as the missing natural
tooth. If the fixture in such a case is as long as the missing
natural root and has the same bone support as the natural root
once did, sufficient bone strength can be expected. Thus the
load limits will not be defined by the bone in such a situation.
In the posterior part of the jaw, however, a single fixture
does not correspond to the lost root support of a molar which
ordinarily has multiple roots of approximately the same
dimensions as a fixture. Extension of the prosthetic tooth
beyond the outer diameter of the abutment introduces
cantilever affects and fixture bending movement. Considering
these factors in combination with the fact that loading factors
are at their greatest in the posterior region of the mouth, it is
easy to understand that a single fixture in the molar region may
be subjected to excessive forces.
www.indiandentalacademy.com
66. TWO FIXTURES
Two fixtures supporting the prosthesis will always define a line
connecting the surface of the implant and around which the prosthesis load
can cause a bending movement. Such a movement will occur if a vertical load
is applied offset to this center line. Also a transverse force component will
always be derived from occlusal contact force as a result of the inclination of
the cusps. The transverse force will lead to a bending of the implant as well. If
prosthesis has an extension the leverage will enhance any transverse force
applied at the end of the extension.
Thus the two fixture solution makes bending movements on the
implants all but inevitable and substantial stress magnification can be
developed due to lever arm affects in some situations. In corresponding
positions, natural teeth are always supported by multiple tooth roots, spread
along the extension of the teeth. Unfortunately, the two fixture solution is
incapable of giving such optimal support leading to high stress levels. Ins as
much as this situation often occurs in the posterior part of the mouth where
the occlusal forces are at their greatest, both proper support of the fixture
threads in cortical bone and bi-cortical anchorage are essential to assure
sufficient bone strength at the implant site. Bi-cortical anchorage may
sometimes be achieved by buccally/lingually placed fixtures.
www.indiandentalacademy.com
67. THREE OR MORE FIXTURES
To eliminate the risk of excessive bending at a partial
implant supported prosthesis the placement of a third fixture is
recommended. This third fixture makes it possible to spread the
fixture support analogously. If three fixtures are anatomically
possible they should be placed slightly out of line with an offset of
a minimum of 2-3 mm. By doing so the prosthesis will be
supported by a tripod and any offset axial force or any transverse
force will be counter acted by axial forces on the fixtures. The
placement of third offset fixture brings the situation back to the
preferred vertical load distribution among the bridge posts
supporting the prosthesis.
www.indiandentalacademy.com
68. OVERDENTURE
Transverse forces and bending movement
The purpose of supporting an overdenture by implants is
to retain the prosthesis and to stabilize its position. The
stabilizing function means that transverse forces from biting or
chewing will act in the posterior/anterior direction at the
attachment level. Thus in the case of only two fixtures supporting
the overdenture, the fixtures will be subjected to bending
movements. If a third fixture is possible, and placed offset to the
other two, it is possible to compensate for this transverse force by
axial forces as in the partial cases. To benefit from this third
fixture the implants have to be connected to each other by a bar
or bridge.
www.indiandentalacademy.com
69. Load magnitude and bone quality
Transverse forces in the case of an overdenture maybe
of a large magnitude since the implants have to withstand the
total transverse force applied to the prosthesis. Therefore, the
anchorage of the fixtures in the bone is crucial in this form of
treatment and long fixtures and short abutments are
preferred. In weak bone the third fixture and a bar
construction should be utilized in order to minimize the
loading of the bone. The implant supported overdenture
represents a therapy with potential high loads and should be
carefully planned in situations with weak bone such as in the
maxilla.
www.indiandentalacademy.com
70. In completely edentulous patients a removable implant supported
prosthesis offers several advantages over a fixed restoration:
1. Fewer implants are required
2. Prosthodontic appointments are shorter, components costs are
decreased, prosthesis are less complicated and treatment is less
expensive for the patient as a consequence.
3. Long term professional maintenance or treatment of
complications is facilitated.
4. Daily home care is easier.
5. Patient aesthetics can be enhanced with labial flanges and denture
teeth compared with customized metal or porcelain teeth. The
labial contours can replace lost bone width and height and
support the labial soft tissues without hygienic compromise.
6. The prosthesis can be removed at night to manage parafunction.
www.indiandentalacademy.com
71. The patient should not be encouraged to accept a fixed
prosthesis if a removable prosthesis can adequately satisfy the
patients needs and desires. Ideally the fixed partial denture is
completely implant supported rather than joining implants to teeth
. This concept leads to the use of more implants in the treatment
plan. Although this may be a cost disadvantage, there are
significant advantages. The added implants in the edentulous site
result in fewer pontics, more retentive units in the restoration, and
less stress to the supporting bone. As a result, complications are
minimized and implant and prosthesis longevity are increased.
The final restoration must be visualized at the onset. After
this first importance to, the individual areas of abutment support
are determined. If natural teeth are present in those areas, they
are evaluated using the criteria of traditional prosthodontics. If no
natural teeth are in the areas of primary support, the bone is
evaluated to assess which type of implant may be placed to support
the intended prosthesis. www.indiandentalacademy.com
72. BONE DENSITY
Available bone is particularly important in implant dentistry and
is describes the external architecture or volume of the edentulous
areas considered for implants. In addition, bone has an internal
structure described in terms of quality or density which reflects
the strength of the bone.
Following the standard surgical and prosthodontic protocol,
Adell et al reported an approximate 10% greater success in the
anterior mandible as compared to the anterior maxilla. Lower
success rates were also noted in the posterior mandible as
compared to the anterior mandible with the same protocol was
followed by Schnitman et al. The highest clinical failure rates have
been noted in the posterior maxilla.
www.indiandentalacademy.com
73. BONE CLASSIFICATION SYSTEMS RELATED TO
IMPLANT DENTISTRY
Linkow in 1970, classified bone density into three
categories:
Class I bone structure: this ideal bone type consists of evenly
spaced trabeculae with small cancellated spaces.
Class II bone structure: the bone has slightly larges cancellated
spaces with less uniformity of the osseous pattern.
Class III bone structure: large marrow filled spaces exist
between bone trabeculae.
www.indiandentalacademy.com
74. Lakholm and Zarb, in 1985, listed four bone qualities found in
anterior regions of the jaw bone.
Quality 1: composed of homogenous compact bone.
Quality 2: thick layer of compact bone surrounding a core of
dense trabecular bone.
Quality 3: thin layer of cortical bone surrounding dense
trabecular bone of favourable strength.
Quality 4: thin layer of cortical bone surrounding a core of low
density trabecular bone.
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75. Misch bone density classification (1988)
D1: Dense cortical bone
D2: Thick dense to porous cortical bone on crest and course
trabecular bone within.
D3: Thin porous cortical bone on crest and fine trabecular
bone within.
D4: Fine trabecular bone
D5: Immature, non-mineralized bone.
In order to communicate more broadly to the profession
related to the tactile sense of different bone densities this
classification is compared to materials of varying densities.
www.indiandentalacademy.com
76. Drilling and placing implants into D1 bone is similar to drilling
and into Oak or Maple wood.
D2 bone is similar to the tactile sensation of drilling into white
pine or Spruce.
D3 bone is similar to drilling into Balsa wood.
D4 bone is similar to drilling into Styrofoam.
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77. RADIOGRAPHIC BONE DENSITY
Periapical or panoramic radiographs are not very beneficial to
determine bone density because the lateral cortical plates often obscure
the trabecular bone density.
Bone density may be more precisely determined by tomographic
radiographs, especially computerized tomograms. Ct produces axial
images of the patients anatomy perpendicular to the long axis of the
body. Each CT axial image has 260,000 pixels and each pixel has a CT
number (Hounsfield unit) related to the density of the tissues within the
pixel. In general the higher the CT number, denser the tissue.
D1: More than 1250 Hounsfield unit
D2: 850 –1250 Hounsfield unit
D3: 350-850 Hounsfield unit
D4: 150-350 Hounsfield unit
D5: less than 150 Hounsfield unit
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78. CROWN IMPLANT BODY RATIO
The crown implant body ratio impacts the appearance of
the final prosthesis and the amount of movement of force on the
implant and surrounding crestal bone. The crown height is
measured from the occlusal or incisal plane to the crest of the
ridge and the endosteal implant height from the crest of the ridge
to its apex. The greater the crown height the greater the
movement force of lever arm to lateral force. Aesthetically, the
prosthesis is likely to replace the sole anatomic crowns of natural
teeth when a greater crown implant ratio is present. As the crown
implant ratio increases the number of implants and / or wider
implants should be inserted to counter act the increase in stress.
www.indiandentalacademy.com
79. AVAILABLE BONE HEIGHT
The minimum height of available bone for endosteal
implants is in part related to the density of the bone. The more
dense bone may accommodate a shorter implant and the least
dense bone requires a longer implant. Once the minimum
implant height is established for each implant design, the width
is more important than additional length. The height of the
available bone is measured from the crest of the edentulous
ridge to the opposing landmark such as the maxillary sinus or
mandibular canal in the posterior regions. The anterior regions
are limited by the nasal nares or the inferior border of the
mandible. The mandibular first premolar region may present
reduced height of available bone compared with the anterior
region because of the anterior loop of the mandibular canal as
it passes below the foramen and proceeds superiorly then
distally before it exits through the mental foramen.www.indiandentalacademy.com
80. AVAILABLE BONE WIDTH
The width of available bone is measured between the
facial and lingual plates at the crest of the potential implant site.
Once adequate height is available for implants, primary criteria
affecting long term survival of endosteal implants is the width of
the available bone. Root form implants of 4mm crestal diameter,
usually require 5mm of bone width to ensure sufficient bone
thickness and blood supply around the implant for predictable
survival.
www.indiandentalacademy.com
81. AVAILABLE BONE ANGULATION
Bone angulation is aligned with the forces of occlusion and
is parallel to the long axis of the prosthodontic restoration.
Alveolar bone angulation represents the root trajectory in
relation to the occlusal plane. Rarely this bone angulation
remains constant after the loss of teeth especially in the anterior
edentulous maxillary arch. The limiting factor of angulation of
force between the body and the abutment of an implant is
correlated to the width of the bone. The implant body may be
inserted so as to reduce the divergence of the abutments.
Therefore, the acceptable bone anglation and the wider ridge
may be as much as 30º.
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82. PRE-IMPLANT CONSIDERATIONS
The pre-implant prosthodontic evaluation of the
patients overall condition closely resembles traditional
dentists. However, specific conditions may modify and
hinder the course of implant treatment if overlooked and
should be considered before a final treatment plan in
presented to the patient.
www.indiandentalacademy.com
83. The conditions include the following:
1. Existing occlusion
2. Existing occlusal plane, orientation
3. Interarch space
4. Existing vertical dimension of occlusion
5. Maxillomandibualr arch relationship
6. TMJ status
7. Existing prosthesis
8. Arch form
9. Implant ideal permucosal position
10. Missing teeth – location
11. Missing teeth - number
12. Lip line at rest and during speech
13. Mandibular flexion
14. Soft tissue support.
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84. Centric occlusion is the tooth position of maximal
intercupsation . Its relationship to centric relation is noteworthy
to the restoring prosthodontist because of the potential need of
occlusal adjustments to eliminate deflective tooth contours.
A proper curve of spee and curve of Wilson are indicated
for proper aesthetics and to prevent posterior lateral interferences
during excursions. The occlusal plane is evaluated in relationship
to the final implant prosthesis. Odontoplasty, endodontic therapy
and /or crowns are indicated to remedy tipping and /or extrusions
of adjacent or opposing natural teeth. A pretreatment diagnostic
wax-up is strongly suggested to evaluate these needed changes
before implant placement.
The interarch space depends on the type of restoration and
requires at least 7mm in the posterior regions and 8-10mm in the
anterior regions of the mouth for fixed restorations. This permits
enough space for occlusal material strength and aesthetics,
abutment height retention and hygiene considerations.
www.indiandentalacademy.com
85. Removable prosthesis often require 12mm or more of interarch
space for denture teeth and acrylic base strength, attachments, bars and
hygiene considerations.
Several conditions relate to arch relationship. Arch relationship
often concerns the anterior regions of the maxilla and mandible. The
anterior edentulous maxilla resorb towards the palate. The width of the
alveolar ridge decreases 40% within a few years primarily at the
expense of the labial plate. Consequently, implants are often placed
lingual to the original tooth position. Final restoration is consequently
over contoured to place the incisal 2/3rd
in the ideal position for
aesthetics. The incisal edge position is facial to the remaining bone. This
results in a cantilevered force on the anterior implant body. An anterior
cantilever on implants in the mandibular arch may correct and Angle’s
Class II jaw relationship. Transversal arch relationships include the
existence of posterior cross bites which occur frequently in implant
dentistry. When mandibular sub-periosteal implants are used for
implant support posterior teeth maybe placed in a cross bite to decrease
the moment forces developing on the maxillary posterior teethwww.indiandentalacademy.com
86. Existing prosthesis are evaluated for proper design and
function. A removable partial soft tissue supported restoration
opposing the proposed implant supported prosthesis is of particular
interest. The occlusal forces vary widely as the underlying bone
remodels. The aesthetics of the existing prosthesis that will be
replaced by implant supported restoration are evaluated. The
contour, arrangement and position of the teeth in an acceptable
restoration all influence the future implant prosthesis design.
The position of the implant abutment is of particular
importance for prosthesis. An implant placed in improper position
can compromise the final results in aesthetics, biomechanics and
maintenance. The most compromising position for an implant is too
facial resulting in compromised aesthetics, phonetics, lip support
and function. An angulated abutment may help improve the
condition if the improper placement is not severe. But the facial
gingival contour remains compromised.
www.indiandentalacademy.com
87. The number and location of missing tooth influence the
prosthodontic treatment plan of the patient. For most cases the
second molar is not replaced in posterior implant supported
prosthesis. The mandibular first molar is designed to occlude
with the marginal ridge of a natural second molar to prevent
extrusion.
The lip positions are evaluated including resting lip line,
maxillary high lip line and mandibular low lip line. The resting
lip line is especially noted if maxillary anterior teeth are to be
replaced.
Ridge parallelism is also evaluated. Having both ridges
parallel to the occlusal plane is most favourable. If both ridges
are divergent, stability of the denture will be greatly affected.
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88. Review of literature
Jacob RF Reece GP Taylor TD Miller MJ
Mandibular restoration in the cancer patient: microvascular surgery
and implant prostheses. (In: Tex Dent J (1992 Jun) 109(6):23-6)
This article deals with state of the art reconstruction and
rehabilitation of the head and neck cancer patient who requires
mandibular resection. The mandible can be reconstructed by
microvascular free tissue transfer of bone and soft tissue from
distant body sites. The dental units and missing soft tissue contours
can be supported by osseointegrated implants placed in the grafted
bone. This article discusses the rationale for patient selection and
sequencing of this complex and rewarding rehabilitation.
www.indiandentalacademy.com
89. Larsen PE Stronczek MJ Beck FM Rohrer M
Osteointegration of implants in radiated bone with and without
adjunctive hyperbaric oxygen. (In: J Oral Maxillofac Surg (1993 Mar)
51(3):280-7)
A study was undertaken to evaluate the integration of
endosseous implants in rabbit tibias that had received a tumoricidal
dose of radiation. The effect of hyperbaric oxygen on integration in this
compromised situation was also evaluated. Despite clinical and
radiographic evidence of success of all implants, there was a significant
decrease in amount of histologic bony integration of implants placed in
the tibias that had received radiation therapy when compared to
contralateral control implants. Adjunctive hyperbaric oxygen therapy
significantly improved the amount of histologic integration of implants
placed within the radiated tibias evaluated at 10 and 16 weeks after
placement. Hyperbaric oxygen was also associated with better soft
tissue wound healing in the radiated surgical site. Increased integration
time significantly improved the amount of histologic integration in the
animals that did not receive hyperbaric oxygen.www.indiandentalacademy.com
90. Johnsson K Hansson A Granstrom G Jacobsson M Turesson I
The effects of hyperbaric oxygenation on bone-titanium implant
interface strength with and without preceding irradiation.
(In: Int J Oral Maxillofac Implants (1993) 8(4):415-9)
This study investigated the influence of a single 15-Gy dose
of irradiation on the capacity of titanium screws to integrate in
irradiated bone tissue. The biomechanical force necessary to
unscrew the titanium implants 8 weeks after placement was 54%
lower for implants in irradiated bone tissue compared to implants
in nonirradiated bone tissue. Postirradiation use of hyperbaric
oxygen treatment (2-hour daily treatments for 21 days) increased
the biomechanical force necessary to unscrew the titanium
implants by 44% in irradiated bone and by 22% in nonirradiated
bone.
www.indiandentalacademy.com
91. Franzen L Rosenquist JB Rosenquist KI Gustafsson I
Oral implant rehabilitation of patients with oral malignancies
treated with radiotherapy and surgery without adjunctive
hyperbaric oxygen. (In: Int J Oral Maxillofac Implants (1995 Mar-
Apr) 10(2):183-7)
Five patients treated with radiotherapy and surgery for oral
malignant tumors had a total of 20 Brånemark implants placed in
irradiated bone of the mandible. The radiotherapy dose varied
between 25 and 64 Gy (mean 40.3 Gy) with a biologically effective
dose varying between 33.4 and 106.9. One implant did not
osseointegrate, but 19 remain stable after 3 to 6 years of
observation. The oral surgery procedures were carried out without
adjunct hyperbaric oxygen therapy, and the successful results
support the view that such adjunctive measures are not always
necessary in the oral rehabilitation after radiotherapy.
www.indiandentalacademy.com
92. Esposito M, Hirsch JM, Lekholm U, Thomsen P
Biological factors contributing to failures of osseointegrated oral implants. (I).
Success criteria and epidemiology. (European Journal of Oral Sciences
106(1):527-51, 1998 Feb)
Radiographic examinations together with implant mobility tests seem to
be the most reliable parameters in the assessment of the prognosis for
osseointegrated implants. Biologically related implant failures calculated on a
sample of 2,812 implants were relatively rare: 7.7% over a 5-year period (bone
graft excluded). The predictability of implant treatment was remarkable,
particularly for partially edentulous patients, who showed failure rates about half
those of totally edentulous subjects. Analysis also confirmed (for both early and
late failures) the general trend of maxillas, having almost 3 times more implant
losses than mandibles, with the exception of the partially edentulous situation
which displayed similar failure rates both in upper and lower jaws. Surgical
trauma together with anatomical conditions are believed to be the most
important etiological factors for early implant losses (3.60% of 16,935 implants).
The low prevalence of failures attributable to peri-implantitis found in the
literature together with the fact that, in general, partially edentulous patients
have less resorbed jaws, speak in favour of jaw volume, bone quality, and
overload as the three major determinants for late implant failures in the
Branemark system. Conversely, the ITI system seemed to be characterized by a
higher prevalence of losses due to peri-implantitis. These differences may be
attributed to the different implant designs and surface characteristics.
www.indiandentalacademy.com
93. Esposito M, Hirsch JM, Lekholm U, Thomsen P
Biological factors contributing to failures of osseointegrated oral implants.
(II). Etiopathogenesis. (Eur J Oral Sci 1998;106(3):721-64.)
The aim of the present review is to evaluate the English language
literature regarding factors associated with the loss of oral implants. An
evidence-based format in conjunction, when possible, with a meta-analytic
approach is used. The review identifies the following factors to be
associated with biological failures of oral implants: medical status of the
patient, smoking, bone quality, bone grafting, irradiation therapy,
parafunctions, operator experience, degree of surgical trauma, bacterial
contamination, lack of preoperative antibiotics, immediate loading,
nonsubmerged procedure, number of implants supporting a prosthesis,
implant surface characteristics and design. Excessive surgical trauma
together with an impaired healing ability, premature loading and infection
are likely to be the most common causes of early implant losses. Whereas
progressive chronic marginal infection (peri-implantitis) and overload in
conjunction with the host characteristics are the major etiological agents
causing late failures. Furthermore, it appears that implant surface
properties (roughness and type of coating) may influence the failure
pattern. Various surface properties may therefore be indicated for different
anatomical and host conditions. Finally, the histopathology of implant
losses is described and discussed in relation to the clinical findings.www.indiandentalacademy.com
94. Tong DC, Rioux K, Drangsholt M, Beirne OR
A review of survival rates for implants placed in grafted maxillary
sinuses using meta-analysis. (International Journal of Oral &
Maxillofacial Implants 13(2):175-82, 1998 Mar-Apr)
A variety of materials and procedures are used to create
adequate bone volume in the maxillary sinus for placement of
endosseous implants in the posterior atrophic maxilla. This review
used the structured method of meta-analysis to evaluate the survival of
the implants placed into various materials that have been used in the
maxillary sinus with the sinus lift procedure. A MEDLINE computer
search of the English literature yielded 28 studies that reported using
the maxillary sinus augmentation procedure to increase bone volume
for placement of endosseous implants; only 10 of these met the
inclusion criteria for meta-analysis. Data regarding immediate or
delayed placement of implants were combined to simplify analysis.
Implant survival was 90% for autogenous bone (484 implants in 130
patients followed for 6 to 60 months), 94% for the combination of
hydroxyapatite (HA) and autogenous bone (363 implants in 104
patients followed for 18 months), 98% for the combination of
demineralized freeze-dried bone (DFDB) and HA (215 implants in 50
patients followed for 7 to 60 months), and 87% for HA alone (30
implants in 11 patients followed for 18 months).
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95. Lindh T, Gunne J, Tillberg A, Molin M
A meta-analysis of implants in partial edentulism.
Clinical Oral Implants Research 9(2):80-90, 1998 Apr
A meta-analytic technique was used to estimate the
survival of implants supporting bridges or single crowns in
partially edentulous patients. A survey of the literature
revealed 66 studies, published between 1986 and 1996. Nine
studies on single implants and 10 studies on fixed partial
dentures met the inclusion criteria for the meta-analysis.
Data from a total of 2686 implants, 570 single crowns (SC)
and 2116 in fixed partial dentures (FPD), were analyzed. In
order to calculate annual survival rates for individual
studies a life-table analysis was conducted. Maximum
follow-up time ranged between 1 and 8 years. After 1 year
the success rate was calculated to be at least 85.7% for FPD
and 97.2% for SC. When the results from the FPD studies
were pooled the survival rate was 93.6% after 6-7 years. The
corresponding value for SC was 97.5%.www.indiandentalacademy.com
96. Cochran DL
A comparison of endosseous dental implant surfaces. (Journal of Periodontology
70(12):1523-39, 1999 Dec)
Endosseous dental implants are available with various surface characteristics
ranging from relatively smooth machined surfaces to more roughened surfaces created by
coatings, blasting by various substances, by acid treatments, or by combinations of the
treatments. Meta-analyses were performed on all implants in all locations, on implants
placed only in the maxilla or the mandible, and, finally, on implants placed in the maxilla
compared to implants placed in the mandible. Evaluation of the data revealed that
predictably high success rates can be achieved for implants with both rough and smooth
titanium surfaces and for hydroxyapatite-coated implants. When studies were clustered by
specific indications or patient populations, rough surfaced implants had significantly
higher success rates compared to implants with more smooth surfaces except in the case
of single tooth replacements where the success rates were comparable. In general,
implants placed in the mandible had significantly higher success rates than implants
placed in the maxilla. However, in the partially edentulous patient group, titanium implants
with a rough surface had significantly higher success rates in the maxilla compared to the
mandible and, in cases of single tooth replacement, success rates were similar in the
maxilla and in the mandible as was the case for hydroxyapatite-coated implants. The
documented advantage of implants with a roughened surface in animal and in vitro
experiments has been demonstrated in clinical cases when studies were compared in
which specific indications or patients were treated. Additionally, implants placed in the
mandible have, in general, higher success rates than implants placed in the maxilla, with
only a few exceptions noted. These data from human clinical experiences support the
documented advantage of implants with a roughened surface in animal and in vitro
experimentation and indicate that the magnitude of the advantage is significant for patient
care.
www.indiandentalacademy.com
97. Esposito M, Hirsch J, Lekholm U, Thomsen P.
Differential diagnosis and treatment strategies for biologic
complications and failing oral implants: a review of the literature.
(Int J Oral Maxillofac Implants 1999;14(4):473-90)
The aim of this article was to review the literature on differential
diagnosis and treatment of biologic complications and failing implants.
All types of publications, with the exception of abstracts, published in
English up to December 1998, were included. A multi-layered search
strategy was used. Controlled clinical trials (CCTs) were searched in the
Cochrane Oral Health Group's Specialized Register of Trials. This
database contains all CCTs identified in MEDLINE and EMBASE.
PubMed was searched using various key words and the "related
articles" feature. All identified publications were obtained and none
were excluded. Infection, impaired healing, and overload are considered
the major etiologic factors for the loss of oral implants. Only a few
clinical and animal investigations were found that tested the validity of
the proposed therapeutic approaches. The treatment of failing implants
is still based mainly on empirical considerations, often derived from
periodontal research, from data extrapolated from in vitro findings, or
from anecdotal case reports performed on a trial-and-error basis.www.indiandentalacademy.com
98. Ivanoff C-J. - Gröndahl K. - Bergström C. - Lekholm U. - Brånemark P-I.
Influence of bicortical or monocortical anchorage on maxillary implant
stability: A 15-year retrospective study of Brånemark system implants.
(February 2000 - Int. J of Oral & Maxillofacial Implants - Vol. 15 No. 1 pp
103-110.)
` Numerous factors relating to bone quality have been cited with
respect to stress distribution at the bone-to-implant interface. One such
factor is the role and influence of cortical fixation, both mono- (MCF) and
bi-cortical fixation (BCF). To date BCF has been deemed by clinicians to
be beneficial and experimentally it has been shown to yield increased
torque resistance and an increase in percentage bone-to-implant contact.
However calculations from Finite Element Analyses (FEA) and
photoelastic studies have yielded conflicting results, indicating that BCF
may be less than ideal, with an influence over the pattern of stress
concentration which becomes located in the crestal regions. This has been
associated with an under stimulation of the cancellous compartment. Few
data exist from long-term clinical studies. To this end a retrospective
assessment of data gathered over 15 years was undertaken to compare the
outcome for implants placed in the maxilla benefiting from either MCF or
BCF.
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99. Creugers NH, Kreulen CM, Snoek PA, de Kanter RJ
A systematic review of single-tooth restorations supported
by implants. (Journal of Dentistry 28(4):209-17, 2000 May)
A three-step inclusion/exclusion procedure was
applied to identify papers that represented: good scientific
practice (GSP), reported results of all patients, implants and
crowns for more than 2years, and had sufficient data to
generate life-table analyses. The outcomes were 'implant
failure' and 'crown completion'. Nine studies survived.
These data showed an overall mean GSP of 0.37 with a
predicted 4year implant survival of 97% (n=459), and an
uncomplicated crown maintenance of 83% (n=240). Single-
tooth implants show an acceptable short-term survival of
4years, but crown complications are common.
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100. Lee JJ, Rouhfar L, Beirne OR
Survival of hydroxyapatite-coated implants: a meta-analytic
review. (Journal of Oral & Maxillofacial Surgery 58(12):1372-
9; discussion 1379-80, 2000 Dec)
The survival rates reported for HA-coated implants
were similar to the survival rates reported for uncoated
titanium implants. If resorption of the HA coating causes
late failure of implants, the yearly interval survival rates
should have decreased with increased years of follow-up.
This decrease was not observed in the longitudinal human
clinical trials that met the selection criteria for this study.
Detailed analysis of these clinical trials did not show that
HA-coating compromises the long-term survival of dental
implants.
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101. Sadowsky SJ
Mandibular implant-retained overdentures: a literature
review.
(Journal of Prosthetic Dentistry 86(5):468-73, 2001 Nov)
The implant-retained overdenture for the mandible has
been shown to be a highly successful prosthetic treatment
similar to the fixed implant denture. However, controversy
persists as to its design and indications. Few literature
reviews have been published on the topic. This article
critically analyzes the existing mandibular implant
overdenture literature relative to bone preservation, effect on
antagonist jaw, number of implants required, anchorage
systems, maintenance, and patient satisfaction. A MEDLINE
search was completed (from 1987 to 2001), along with a
manual search, to locate relevant English-language articles
on mandibular implant overdentures. Twelve treatment
concepts are elucidated from a distillation of the literature
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102. Boioli LT, Penaud J, Miller N
A meta-analytic, quantitative assessment of osseointegration establishment and
evolution of submerged and non-submerged endosseous titanium oral implants.
(Clinical Oral Implants Research 12(6):579-88, 2001 Dec)
Two implant placement methods are used in oral implantology:
submerged (S, two-stage surgical procedure) and non-submerged (NS, one-stage
surgery). However, a quantitative assessment of their influence on implant
osseointegration, summarising the whole present experience, is not directly
possible, owing to the lack of normalisation of the published results. To overcome
this difficulty, selection criteria have been applied to the latter in a process of a
meta-analysis of specialised literature, in order to authorise a pooled treatment
with an adequate statistical method. Survival life tables are established (up to 15
and 10 years respectively for S and NS implants placed in normal situations) for
extended samples (13049 S and 5515 NS implants). Early (before loading) failure
rates and 95% confidence level ranges of cumulative implant survival rates are
shown. For both categories, the quality of the placement stage remains critical to
ensure optimal osseointegration behaviour. Both categories match current
survival requirements, but with a quite different behaviour over time. NS implants,
while osseointegrating better initially, are subject to causes of osseointegration
loss, which persist over a longer period of time. Implant design characteristics
(including the type of surface) seem to be more relevant than the placement
procedure for the implant's behaviour. This is in agreement with recent
histological and preliminary clinical results, and should be confirmed by further
studies. www.indiandentalacademy.com
103. Quirynen M, De Soete M, van Steenberghe D.
Infectious risks for oral implants: a review of the literature. (Clin Oral Implants
Res. 2002 Feb;13(1):1-19)
The use of oral implants in the rehabilitation of partially and fully
edentulous patients is widely accepted even though failures do occur. The
chance for implants to integrate can for example be jeopardised by the intra-
oral presence of bacteria and concomitant inflammatory reactions. The
longevity of osseointegrated implants can be compromised by occlusal
overload and/or plaque-induced peri-implantitis, depending on the implant
geometry and surface characteristics. Animal studies, cross-sectional and
longitudinal observations in man, as well as association studies indicate that
peri-implantitis is characterised by a microbiota comparable to that of
periodontitis (high proportion of anaerobic Gram-negative rods, motile
organisms and spirochetes), but this does not necessarily prove a causal
relationship. However, in order to prevent such a bacterial shift, the following
measures can be considered: periodontal health in the remaining dentition (to
prevent bacterial translocation), the avoidance of deepened peri-implant
pockets, and the use of a relatively smooth abutment and implant surface.
Finally, periodontitis enhancing factors such as smoking and poor oral
hygiene also increase the risk for peri-implantitis. Whether the susceptibility
for periodontitis is related to that for peri-implantitis may vary according to
the implant type and especially its surface topography.
www.indiandentalacademy.com
104. References
1. Jacob RF Reece GP Taylor TD Miller MJ
Mandibular restoration in the cancer patient: microvascular
surgery and implant prostheses. (In: Tex Dent J (1992 Jun)
109(6):23-6)
2. Larsen PE Stronczek MJ Beck FM Rohrer M
Osteointegration of implants in radiated bone with and without
adjunctive hyperbaric oxygen. (In: J Oral Maxillofac Surg
(1993 Mar) 51(3):280-7)
3. Johnsson K Hansson A Granstrom G Jacobsson M Turesson I
The effects of hyperbaric oxygenation on bone-titanium implant
interface strength with and without preceding irradiation. (In:
Int J Oral Maxillofac Implants (1993) 8(4):415-9)
www.indiandentalacademy.com
105. 4. Franzen L Rosenquist JB Rosenquist KI Gustafsson I
Oral implant rehabilitation of patients with oral malignancies
treated with radiotherapy and surgery without adjunctive
hyperbaric oxygen. (In: Int J Oral Maxillofac Implants (1995
Mar-Apr) 10(2):183-7)
5. Esposito M, Hirsch JM, Lekholm U, Thomsen P
Biological factors contributing to failures of
osseointegrated oral implants. (I). Success criteria and
epidemiology. (European Journal of Oral Sciences
106(1):527-51, 1998 Feb)
6. Esposito M, Hirsch JM, Lekholm U, Thomsen P
Biological factors contributing to failures of
osseointegrated oral implants. (II). Etiopathogenesis. (Eur J
Oral Sci 1998;106(3):721-64.)www.indiandentalacademy.com
106. 7. Tong DC, Rioux K, Drangsholt M, Beirne OR
A review of survival rates for implants placed in grafted
maxillary sinuses using meta-analysis. (International Journal
of Oral & Maxillofacial Implants 13(2):175-82, 1998 Mar-Apr)
8. Lindh T, Gunne J, Tillberg A, Molin M
A meta-analysis of implants in partial edentulism. (Clinical
Oral Implants Research 9(2):80-90, 1998 Apr)
9. Cochran DL
A comparison of endosseous dental implant surfaces.
(Journal of Periodontology 70(12):1523-39, 1999 Dec)
10. Esposito M, Hirsch J, Lekholm U, Thomsen P.
Differential diagnosis and treatment strategies for
biologic complications and failing oral implants: a review of the
literature. (Int J Oral Maxillofac Implants 1999;14(4):473-90)
www.indiandentalacademy.com
107. 11. Ivanoff C-J. - Gröndahl K. - Bergström C. - Lekholm U. -
Brånemark P-I.
Influence of bicortical or monocortical anchorage on
maxillary implant stability: A 15-year retrospective study
of Brånemark system implants. (February 2000 - Int. J of
Oral & Maxillofacial Implants - Vol. 15 No. 1 pp 103-110.)
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110. CONCLUSION
Patients who are partially or fully edentulous are
better served with tissue integrated prosthesis rather than
other classical forms of therapy. However, not all patients can
or should be considered suitable 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 alternate treatment modality.
The patient must be viewed in totality and the end
result visualized prior to the surgery. The “reverse approach”
means the anticipated prosthetic result should be determined
prior to surgery.
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111. For more details please visit
www.indiandentaacademy.com
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