2. When do we need?
• Mesial drifted teeth leaving limited space to second implant
• Failed implant between teeth and succeeding implant
• Insufficient bone with no possibility for graft
• Patient cannot afford graft or multiple implants
5. • Tooth attachment with PDL acts as viscoelastic shock absorber
• Thus decreasing the amount of stress distributed to surrounding bone
especially in Crestal area.
• And allowing higher degree of movement (up to 20 times more)
Main differences:
Tooth
6. • Implant direct connection to bone (Osseointegration) is rigid.
• Allowing less movement and absorbing much less stresses.
• Conduction of stresses to bone.
• Concentrating forces at the crestal bone as it is the hinge point in case of
lateral forces
Main differences:
Implant
10. How to think: factors to consider
• Tooth mobility: teeth should not be mobile, if it is, it should be treated as
splinting case (Add more implants to splint). Consider stress breakage
design options.
• level of parafunctional activity
• number of implants and teeth being used in the restoration.
11. 1- increase number of implants
• Increasing resistance arm (increasing implants to teeth ratio) in a way that
makes the prosthesis does not need the teeth for support
13. Connect only with healthy teeth
• In terms of periodontium and supporting bone
14. Decrease lateral forces
Amount of axial movement for teeth: 8-28 micron
Amount of lateral movement for teeth: 65-108 micron
Amount of limited movement for implant: 0-5 micron
15. A- avoid in patients with para-functional stresses
19. Use non rigid connection
non rigid
connection
allows teeth
to move and
act as stress
breaker..
But..
20. Allowing intrusion
-The rate of
intrusion is
between 3-5.2%
- It jumps to 50%
in case of para-
functional habits
- Different theories
for intrusion
- Effect of Rachet:
teeth not returning
to its position due
to friction between
connector parts
21. Modification on non rigid connector
N.B: Need to be only in short span cases as if it is long span this will increase stresses on the connector
22. Use of rigid connection
• Tooth-tooth cemented bridge has the same mobility rate as tooth-implant
connected bridges as declared by finite element analysis
• Also permanent cementation prevents intrusion.
23. Rigid connectionNon Rigid connection
- Allow teeth intrusion
- Decrease bone resorption
- Prevent teeth intrusion
- May cause relatively more
bone resorption
36. References..
• Spear, frank (2015). speareducation.com. ConnectingTeeth and Implants:
Yes, No, Maybe?. Retrieved from link
• Serhat Ramoglu, SimgeTasar, Selim Gunsoy, Oguz Ozan, and Gokce Meric,
“Tooth-Implant Connection: A Review,” ISRN Biomaterials, vol. 2013,
Article ID 921645, 7 pages, 2013. doi:10.5402/2013/921645
•