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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