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    Implant Supported Fixed Prosthesis

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    Shabeel Pn
    Implant supported fixed prostheses provide an alternative treatment for edentulism. They involve surgically placing titanium implants into the jawbone that fuse with the bone (osseointegration) to support crowns, bridges, or dentures. The treatment is complex, requiring careful patient selection, diagnostic imaging, surgical placement of multiple implants, and fabrication of a fixed prosthesis to restore chewing function and aesthetics. While implant treatment offers improvements over removable dentures, it is also more expensive and technical in nature, with success dependent on close teamwork between surgeon and prosthodontist.

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    Implant Supported Fixed Prosthesis

    Uploaded by

    Shabeel Pn
    303 views32 pages
    Implant supported fixed prostheses provide an alternative treatment for edentulism. They involve surgically placing titanium implants into the jawbone that fuse with the bone (osseointegration) to support crowns, bridges, or dentures. The treatment is complex, requiring careful patient selection, diagnostic imaging, surgical placement of multiple implants, and fabrication of a fixed prosthesis to restore chewing function and aesthetics. While implant treatment offers improvements over removable dentures, it is also more expensive and technical in nature, with success dependent on close teamwork between surgeon and prosthodontist.

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    Implant supported fixed prostheses provide an alternative treatment for edentulism. They involve surgically placing titanium implants into the jawbone that fuse with the bone (osseointegration) to support crowns, bridges, or dentures. The treatment is complex, requiring careful patient selection, diagnostic imaging, surgical placement of multiple implants, and fabrication of a fixed prosthesis to restore chewing function and aesthetics. While implant treatment offers improvements over removable dentures, it is also more expensive and technical in nature, with success dependent on close teamwork between surgeon and prosthodontist.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    303 views32 pages

    Implant Supported Fixed Prosthesis

    Uploaded by

    Shabeel Pn
    Implant supported fixed prostheses provide an alternative treatment for edentulism. They involve surgically placing titanium implants into the jawbone that fuse with the bone (osseointegration) to support crowns, bridges, or dentures. The treatment is complex, requiring careful patient selection, diagnostic imaging, surgical placement of multiple implants, and fabrication of a fixed prosthesis to restore chewing function and aesthetics. While implant treatment offers improvements over removable dentures, it is also more expensive and technical in nature, with success dependent on close teamwork between surgeon and prosthodontist.

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    Download as ppt, pdf, or txt
    of 32

    IMPLANT SUPPORTED

    FIXED PROSTHESIS
    http://hi-
    dentfinishingschool.blogspot.
    com
    /
    http://apexiondental.com/
    INTRODUCTION
     EVIDENCE OF IMPLANTS SEEN IN
    ANCIENT CIVILISATION LIKE INCAS
    AND MAYANS
     MODERN IMPLANTOLOGY HAS
    EVOLVED FROM 1980 ONWARDS
     IN 1940 DAHLSE INTRODUCED
    SUBPERIOSTEAL IMPLANTS
     LINKOW INTRODUCED BLADE
    IMPLANTS
     1980PER INGVAR BRANEMARK
    INTRODUCED CONCEPT OF
    OSSEOINTEGRATION

    DEFINITION:A SUBSTANCE THAT IS PLACED


    INTO THE JAWS TO SUPPORT A CROWN OR
    FIXED OR REMOVABLE DENTURE
    INDICATIONS :
    1. FOR COMPLETELY EDNTULOUS PATIENTS
    WITH ADVANCED RESIDUAL RIDGE
    RESORPTION
    2.FOR PARTIALLY EDENTULOUS ARCHES
    WHERE REMOVABLE PARTIAL
    DENTURE MAY WEAKEN THE
    ABUTMENT TEETH
    3.FOR SINGLE TOOTH PREPARATION
    4.PATIENTS DESIRE
    CLASSIFICATION
     DEPENDING ON PLACEMENT WITHIN THE
    TISSUES :
    1. EPIOSTEAL IMPLANTS :DENTAL
    IMPLANT THAT RECEIVES ITS PRIMARY
    SUPPORT BY RESTING ON IT Eg:sub periosteal
    implants
    2. TRANSOSTEAL IMPLANTS:IT’S A DENTAL
    IMPLANT THAT PENETRATES BOTH
    CORTICAL PLATES AND PASSES THROUGH
    ENTIRE THICKNESS OF ALVEOLAR BONE
    3.ENDOSTEAL IMPLANTS:IT IS DENTAL
    IMPLANT THAT EXTENDS IN TO THE BASAL
    BONE
    4.ROOT FORM IMPLANT:THEY ARE USED
    OVER VERTICAL COLUMN OF BONE
    5.PLATE FORM IMPLANT:THEY ARE USED FOR
    HORIZONTAL COLUMN OF BONE
     PARTS OF IMPLANTS
    1. IMPLANT OR FIXTURE

    2. HEALING SCREW

    3. HEALING CAPS

    4. ABUTMENTS

    5. IMPRESSION POST
    CONSIDERATION FOR SYSTEMIC
    ,LOCAL AND PROSTHODONTIC
    TREATMENT
    MEDICAL HISTORY
    CONTRAINDICATING TRETMENT:
     Systemic condition that precludes a mnor

    surgical procedures eg:diabetics,blood


    dyscrasias,immunologically compromised
     History of chemical dependency

     History of orofacial irradiation

     Psychatric prosthesis
    LOCAL CONSIDERATION
     Size of oral opening and interarch spaces
     Status of opposing dentition
    (supraeruption,occlusal relation )
     Quality and quantity of proposed host site
     Height of smile line
    PROSTHETIC CONSIDERATION
     POSSIBLE SHORTCOMING IN
    APPEARANCE ,OCCLUSION SUPPORT
    OF PREVIOUS DENTURES
     RELATIONSHIP OF PROSTHETIC TEETH
    POSITION TO UNDERLYING RESIDUAL
    RIDGES
    PATIENT SELECTION
     Patient who benefits most significantly are
    those with maladaptive denture experience
     Current research suggests any patient whose
    systemic health does not preclude minor
    surgical intervention and whose proposed host
    bone sites can quantitatively or qualitatively
    accommodate dimension of dentists implant
    system can be regarded as candidate for
    ossoeintegration
    DIAGNOSTICS AIDS
     Diagnostic casts and previous prosthesis
    analysis
     Panoramic and cephalometric films
     CAT scans
     These technique offer the surgeon additional
    infection about potential sites for implant
    placement
    Treatment decision influenced by :
     Magnitude of residual ridge resorption
     Relationship to key anatomical landmarks
    incisive foramen,maxillary sinus ,mental
    foramen ,inferior alveolar canal
     Percieved quality of host bone sites
    Preliminary prosthodontic design
    1. Number of implant abutment :
    Clinical success with implant supported fixed prosthesis suggests
    a quasi-general formula
    *five implants placed between mental foramina to support a
    10-12 unit fixed mandibular prosthesis
    Formula did not address
     Arch form
     Length of implant
     Length of cantilever
     In maxilla additional provision that six or more implants
    compromise a starting point for a fixed design
    2.Location of implants :favorable when its distribution
    or configuration is curved rather than flat .
    The former allows more occlusal units and optimal
    cantilever design
    A flat arch form is better for over denture design

    3.Quality of host sites: loosely textured cancellous


    bone potentially vulnerable osseointegrated response
    length of cantilever depends on patient occlusal activity
    because patient exhibits different degrees of loading
    4.Quantity of host bone:residual ridge reduction is a problem in
    maxilla where grafting is required if fixed prosthesis is
    planned
    Surgical approaches include sinus lift procedure and
    consideration of implants in zygoma or pterygoid plate
    5.Amount of circumoral activity :
    In maxilla both combination of high lip line and advanced
    residual ridge resorption .
    Former requires use of visible labial flange
    Patient with extensive vertical horizontal anterior maxillary
    resorption
    Presurgical treatment
     The edentulous mouth is prepared for
    osseointegration technique by ensuring tissue
    health
     Soft and hard tissue lesion may have an impact
    on surgical phase of osseointegration
     If there is inadequate bone surgical procedure
    designed to generate bone
     Once an appropriate site is established a
    surgical template is prepared
    Surgical stages
     First flaps are raised and holes are carefully and gently drilled
    into selected host bone sites, the holes confirm to chosen
    implants dimension and accommodate threaded tooth root
    analogue
     The reflected mucoperiosteal flaps are readapted to completely
    cover the implant which are to be submerged and unloaded
    during healing period
     Implants are provisionally sealed with cover screen during
    healing period.
     soft tissues are sutured and left to heal undisturbed .during 4-6
    months healing period designated time required for
    osseointegration to occur in maxilla and mandible denture is
    relieved liberally
     When second stage surgery is required transepithelial
    abutment of selected dimension are attached to
    implants and prosthodontics started

    Prosthodontics protocol
    Objectives
    Fabrication of cast prosthesis base that joins the implant
    together and provides distal cantilever extension
    .artificial teeth and soft tissue analogue then
    processed onto framework
    Clinical protocol used are
     Impression are made in dentist material of choice .an
    occlusal opening provides access to transfer coping
    that are screwed to abutments .transfer coping are
    withdrawn in impression and filled with lab
    analogues the impression is powered in artificial
    stone
     A trial denture base stabilised with two prosthetic
    coping used to register jaw relation records .same
    base is used for trial arrangement of artificial teeth
    .After confirmation of jaw relation records an index
    of position of artificial teeth is made
     Proposed framework is designed in context of teeth
    index position and cast ,surrounded by acrylic
    resin .metallic frame are cast in silver-palladium alloy
    or class iv gold alloy
     Framework is tried in the mouth and nonpassive fit
    noted
     Processing of metallic framework and stock acrylic
    resin is completed with a commercial acrylic resin
     Completed prosthesis is inserted in mouth new jaw
    relation records made ,occlusion refined on articulator
     Each patient is counseled tissue and prosthesis care

    Advantages:
    1. A cure for people with maladaptive denture
    2. Conceptually brilliant
    3. Enormous psychological and functional benefits
    Disadvantages :
    1. limited application
    2. Expensive
    3. Complex to undertake
    4.Maintanace not easy
    5.Esthetic outcome difficult and unpredictable
    6.Size of occlusal table reduced
    SUMMARY
     THE AVAILABILITY OF FIXED
    TREATMENT OPTION IS REMARKABLE
    ADVANCE.IT IS ONE OF DENTISTRYS
    MOST GRATIFYING TREATMENT
    MODALITIES BUT DEMAND SKILL
    ,JUDGEMENT AND PATIENT
    COMMITMENT AND UNDERSTANDING
    THANK YOU

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