implantology ii. - semmelweis...

IMPLANTOLOGY II.

Dr. Barbara Kispélyi

SURGICAL PROCEDURE

Two-stage placement

One-stage placement

TWO-STAGE PLACEMENT

Spiekermann: Color atlas of implantology

ONE -STAGE PLACEMENT

Fixture placement and abutment connection

in same time – immediate function

Spiekermann: Color atlas of implantology9

Time aspect of implantation:

• Immediately or only a few days after extr.

Immediate implantation

• 4-8 weeks after extraction

Delayed implantation

• 3-4 months after extraction

Early implantation

• At least 6 moths after extraction

Late implantation Prof. Divinyi

TREATMAN PLAN

Removable partial

denture Fixed

appliencies

Implant retained

fixed or removable

Edentulous patient

Patially edentulous patient

Single tooth loss

Implant retained

fixed or removable

Treatment plan

Conventional removable dentures Implant supported restorations

Completely Edentulous Patient

Decreased performance of

conventional complete dentures

Implants for complete dentures

Implant-Retained Complete Denture

Implant-Borne Bridges

Color atlasz 183/3,4

Color atlcasz 205/2,5

H. Spikermann

Implant-Retained Complete

Denture I.

H. Spikermann

Implant-Retained Complete

Denture II.

H. Spikermann

Implant-Retained Complete

Denture III.

H. Spikermann

Locator:

Implant-Retained Complete

Denture IV.

Implants for complete dentures

Implant-Retained Complete Denture

Implant-Borne Bridges

Color atlasz 183/3,4

Color atlcasz 205/2,5

H. Spikermann

Implant-Borne Bridges

H. Spikermann

Edentulous patient

Patially edentulous patient

Single tooth loss

Implant retained

fixed or removable

Patially edentulous patient

Distal (mesial) free-end situation Multiple missing teeth

Distal (mesial) free-end situation I.

Premolar occlusion:

Spiekermann: Color atlas of implantology

Distal (mesial) free-end situation

III.

Precision attachments retained RPD:

Spiekermann: Color atlas of implantology

Distal (mesial) free-end situation

II.

Conventional clasp retained RPD:

Spiekermann: Color atlas of implantology

Distal (mesial) free-end situation

IV.

Cantilever fixed bridge:

Spiekermann: Color atlas of implantology

Distal (mesial) free-end situation

V.

Distalization of premolars:

Spiekermann: Color atlas of implantology

Distal (mesial) free-end situation

VI.

Tooth- and implant supported bridge:

Spiekermann: Color atlas of implantology

Distal (mesial) free-end situation

VII.

Purely implant supported bridge:

Spiekermann: Color atlas of implantology

Edentulous patient

Patially edentulous patient

Single tooth loss

Implant retained

fixed or removable

SINGLE TOOTH LOSS

differential therapy

1. Orthodontic space closure

Advantages:

- definitive treatments results

- essentially risk-free

Disadvantages:

- limited spectrum of indication

- associated esthetic difficulties

- length of treatment

- functional difficulties

H. Spikermann

SINGLE TOOTH LOSS

differential therapy

2. Maryland bridge

Advantages:

- no surgery required

- risk-free treatment

- good esthetics can be achieved

Disadvantages:

- preparation is necessary

- not possible in dentition

- reduced retentive surface

- risk of caries

H. Spikermann

SINGLE TOOTH LOSS

differential therapy

3. Conventional bridge

Advantages:

- no surgery required

- good esthetics can be achieved

- no time-consuming

Disadvantages:

- preparation is necessary

- pulp explosure

- risk of caries

- not possible in dentition

- irreversible

SINGLE TOOTH LOSS

differential therapy

4. Single tooth implants

Advantages:

- high success rates (better than 97% for 10 years)

- decreased risk of caries

- decreased risk of endodontic problems

- improved hygiene

- psychological advantage

- decreased abutment loss

crest module ( cervical geometry )

body

apex

IMPLANT BODY REGIONS

3 parts

1. crest module ( cervical geometry )

2. body

3. apex

K. Pandya, R. Parikh, P. Pareek

IMPLANT BODY REGIONS

Body

- designed for implant bone interface

Crest module

- designed to retain the prosthetic component

- transition zone from implant body design to transosteal region at

the crest of the ridge

- has a platform on which abutment is seated

- when it is a smooth and polished metal – cervical collar

K. Pandya, R. Parikh, P. Pareek

abutment

Implant body

prosthesis

superstructure

Prosthetic Attachment

Abutment

portion of the implant that supports or retains a prosthesis

or implant superstructure

Mezostructure

metal framework that attaches to the implant abutment

and provides either retention for removable prosthesis

or framework for fixed prosthesis

K. Pandya, R. Parikh, P. Pareek

mezostructure

TYPES OF IMPLANT

ABUTMENTS

Screw retention

Cement retention Attachments

for RPD

PARTS OF IMPLANT –

SCREW RETAINED

Abutment

Abutment screw

Retaining screw

Composite resin

Implant body

PROSTHETIC RETAINED

SCREW

• can have a slot or hex head

• access is usually covered by a

combination of gutta percha (cotton

pellet or silicone) and composite.

• used to retain the prosthesis to the

abutment.

PROSTHETIC RETAINED

CEMENT

Attacments for RPD

Ball attacments

Bar

Locator

Dr. Déri Tamás

TRANSFER COPING

C BITE REGISTRATION

Dr. Déri Tamás

Dr. Déri Tamás

LABORATORY ANALOG

PATIENT EXAMINATION

1. Case history/anamnezis

- extraoral

- intraoral

- remaining teeth examination

- classification( Kennedy, Fábián

ás Fejérdy)

- bone examination (Vertical,

horizontal)

PATIENT EXAMINATION

2. X-ray analysis

- periapical radiography

- occlusal radiography

- orthopantomograph

- computed tomograph (DVT)

- magnetic resonance imaging

3. Diagnostic templates, Wax-up

4. Surgical templates