Implant supported fixed restoration

Prepared by: Byadr idrees supervised by: Taban SH. Ameen Dr.Abdulkarim Almzori

IMPLANT SUPPORTED FIXED

RESTORATION

UODSCHOOL OF DENTISTRY

Dental Implant

Introduction:Dental implant is a device inserted into the jaw bone to support a dental prostheses which penetrate oral mucosa to replace the natural tooth.

In 1952 Per-Ingvar Brånemark used a titanium implant chamber to study blood flow in rabbit bone and noted that the chambers could not be removed at the end of the experiment. He called the discovery

Indications

• Severe morphologic compromise of denture supporting areas

• Poor oral muscular coordination• Low tolerance of mucosal tissues• Parafunctional habits • Active or hyperactive gag reflexes• Psychological inability to wear removable prosthesis• Single tooth loss • Unfavorable number and location of abutments in a

residual dentition

Contraindications for Dental Implant

1.Acute illness.2.Terminal illness.3.Pregnancy.4.Uncontrolled metabolic disease.5.Tumoricidal radiation to the implant site.6.Unrealistic expectation.7.Improper motivation.8.Lake of operator experience.9.Unable to prosthodotically restore.

1. Preservation of bone2. Improved function3. Aesthetics4. Stability and support

ADVANTAGES

1. Can’t be used in medically compromised patients who can’t undergo surgery

2. Longer duration of treatment3. Need of patient cooperation4. expensive

DISADVANTAGES

Types of Dental Implants

1.Sub-periosteal implants.

2.Transosteal implants.

3.Endosteal impalnts.

A.Blade implants.

B.Cylinders.

Sub-periosteal implantsTransosteal implants

Types of Dental Implants

Blade implants.

Endosteal impalnts.

Cylinders.

Types of Dental Implants

Osteo integration

is a direct structural and functional connection between living bone

• and the surface of load carrying implant ,which mean that there is no progressive motion between the living bone and the implant under functional test for entire life of the patient providing mechanical stability with out distortion at the interface area

1. Replacement of dentition and supporting tissues to restore function and appearance

2. Alveolar bone preservation.

The aims of placing osseointgrated dental implants

1.Implant fixture.2.healing screw.3.Healing cap.4.Abutment.5.Impression post.6.Laboratory analogue.7.Waxing sleeve. 8.Prosthesis retaining

screw.

Components of Dental Implant

• The impression materials used in dental implantology should have the following criteria :

1. Accurate2. Viscosity3. Stiffness

IMPRESSION MATERIALS

Type I (Condensation reaction)

Type II(Addition reaction)

PolysulphidesSiliconesPolyethers

Types of Rubber Impression Materials

A-abutment levelWe have two types of abutment:

1-titanium 2- zirconiumAnd screwed to fixture, the abutment is prepared intraorally and the impression is taken like that of the ordinary crown and bridges techniqueB- implant(fixture level)

IMPRESSION TECHNIQUES

Impression Techniquethere are two impression techniques are used in dental implantology :

1- indirect (close-tray) technique.

2- direct (open-tray) technique.

IMPRESSION TECHNIQUES

The analogs are inserted into impression post & secured using the

sure-grip screws.

A flexible gingival mask should be fabricated for all implant work.It ensures optimal contouring of the crown.When removed , it allows unhindered view of the neck of the implant fixture.

The stone model with the flexible gingival mask & analogs for the restoration is now complete.

The stone with the gingival mask removed.

Surgical procedure

Treatment option

Dental implant-supported prosthesis (single crown, fixed bridge, full arch implant)

Dental Implantstreatment option

1-Replacing a Single Missing Tooth• A crown is used to replace one missing tooth –

each crown attaches to its own implant.

2-implant supported crown. 1- tooth supported bridge

IF YOU ARE MISSING A SINGLE TOOTH!!

This method of tooth replacement can be

very esthetic and functional for a period of time.

But??

1- tooth supported bridge

advantages to replacing a single missing tooth with an implant-supported crown:

1. It looks, feels, and functions like a natural tooth2. It is much more esthetic long term3. It does not decay4. There is no need to grind down the adjacent

natural teeth5. The bone is preserved, preventing a visible

bony defect6. It is more hygienic than a tooth-supported

bridge

2-Replacing Multiple Missing Teeth

there are three common treatment options:

1-the traditional tooth supported bridge, 2-a removable partial denture and 3-an implant supported bridge. In this situation the benefits of implant-supported teeth are even more obvious because comfort and stability are also concerns.

The advantages of replacing multiple missing teeth with implant-supported bridges include the following:

1. They look, feel, and function like natural teeth2. They are much more comfortable and stable than

partial dentures3. Natural biting and chewing capacity is restored4. They virtually stop the bone resorption (deterioration)

process5. The integrity of the facial structures is maintained6. Adjacent natural teeth are not compromised by

grinding them down into peg shapes or slowing loosening them with pressure

3-full arch Replacement

Some of the many advantages of implant supported replacement teeth include the following:

1. They are more comfortable and stable than traditional dentures

2. They virtually stop the bone resorption (deterioration) process

3. Integrity of the facial structures is maintained4. Appearance is improved5. It is not necessary to cover the roof of the mouth, so food can

be tasted6. Relines and repairs are infrequent compared to traditional

dentures7. Natural biting and chewing capacity is restored

Free-End Distal Extension

( 1 ) a single implant placed distal to the most posterior natural abutment and (2) A fixed prosthesis made to connect the implant and a natural tooth abutment.

The implant dentist has two options in treating the patientmissing terminal posterior abutments:

Esthetic Zone

• Anterior region The implant must have1- proper position,2- angulation, 3-and depth for esthetic restoration

SPECIAL SITUATIONS:-

Posterior region

problems…..1 - Presence of the inferior alveolar nerve limits implant length. 2 -increased occlusal load

is one reason for the higher implant failure rate in this region

Overview of Steps in Replacing Missing Teeth with Dental Implants:

i. Examination and preliminary X-rays and/or C.T. scan

ii. Extraction of tooth/teeth as needediii. Soft tissue grafts and/or bone grafts as

needediv. Placement of the dental implantsv. Delivery and installation of the prosthesis:

crown, fixed bridge, or removable prosthesis

Do Implants Need Special Care?!

Thank you