Podcast
Questions and Answers
What is the minimum interarch distance recommended in the posterior sites for implant placement?
What is the minimum interarch distance recommended in the posterior sites for implant placement?
What is the ideal crown-to-implant ratio for sound biomechanics?
What is the ideal crown-to-implant ratio for sound biomechanics?
Why is it essential to evaluate the adjacent teeth during implant placement?
Why is it essential to evaluate the adjacent teeth during implant placement?
What is the primary purpose of analyzing wear facets during implant restoration?
What is the primary purpose of analyzing wear facets during implant restoration?
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What is the recommended mesio-distal distance for implant placement in the anterior region?
What is the recommended mesio-distal distance for implant placement in the anterior region?
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Why is buccal cantilevering of the restoration a concern during implant placement?
Why is buccal cantilevering of the restoration a concern during implant placement?
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What is the primary consideration for mandibular first molar sites during treatment planning?
What is the primary consideration for mandibular first molar sites during treatment planning?
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What is the recommended approach for implant restorations in patients with bruxism?
What is the recommended approach for implant restorations in patients with bruxism?
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What is the primary advantage of using custom abutments in implant restorations?
What is the primary advantage of using custom abutments in implant restorations?
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What is the recommended approach for establishing occlusal contact in implant restorations?
What is the recommended approach for establishing occlusal contact in implant restorations?
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What is the primary consideration for selecting between screw-retained and cement-retained implant restorations?
What is the primary consideration for selecting between screw-retained and cement-retained implant restorations?
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What is the recommended approach for managing bending moments and load magnification in implant restorations?
What is the recommended approach for managing bending moments and load magnification in implant restorations?
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What is the primary purpose of a surgical template in implant dentistry?
What is the primary purpose of a surgical template in implant dentistry?
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Why is it essential to examine the integrity of restorations on adjacent teeth?
Why is it essential to examine the integrity of restorations on adjacent teeth?
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What is the primary advantage of using a fixed restoration over a removable restoration in implant dentistry?
What is the primary advantage of using a fixed restoration over a removable restoration in implant dentistry?
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What is the purpose of analyzing the edentulous site and adjacent structures on study casts?
What is the purpose of analyzing the edentulous site and adjacent structures on study casts?
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Why is it essential to evaluate the occlusal scheme in implant dentistry?
Why is it essential to evaluate the occlusal scheme in implant dentistry?
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What is the role of barium sulfate in a surgical template?
What is the role of barium sulfate in a surgical template?
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What is the consequence of a compromised tooth opposed by a rigid implant restoration?
What is the consequence of a compromised tooth opposed by a rigid implant restoration?
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What is the purpose of creating a diagnostic prototype in the missing tooth site on a study cast?
What is the purpose of creating a diagnostic prototype in the missing tooth site on a study cast?
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Study Notes
Diagnosis - Clinical Evaluation
- Residual edentulous space:
- Minimum 2 mm interarch distance in anterior sites and 4 mm in posterior sites
- Mesio-distal distance should be about 7 mm
- Implant size and number should be carefully considered when there is over 10 mm of distance to avoid overloading
- Buccal cantilevering of the restoration might cause overloading
- Crown/implant ratio should be kept to 1:1 for sound biomechanics
Diagnosis - Adjacent Teeth
- Prognosis of the adjacent teeth is important for avoiding potential implant failure
- Soft tissue contours and levels should be reviewed to identify any defects that might have a direct impact on the esthetic outcome
- Position of the adjacent teeth (rotated, tilted, out of curve, extruded, intruded) can cause functional and esthetic problems if not addressed properly
- Wear facets should be carefully analyzed to understand the occlusal pattern
Treatment Planning - Restorative Design
- Biomechanical considerations:
- Mandibular first molar sites should be carefully studied due to the usually large mesio-distal distance
- Placement of a wide body implant (5 mm diameter instead of 4 mm) along with narrowing the occlusal plane can compensate for overloading
- Occlusal guidelines:
- Light centric contact should be established
- Shim stock should only be grasped when the musculature is fully engaged
- Eccentric contacts should be avoided
- Over-engineering and night guards are suggested for bruxors
- Mild cusp heights are preferable to avoid bending moments and load magnification
- Abutment selection guidelines:
- Screw or cement retained implant restorations can be fabricated
- Various reasons (retrievability, amount of space, esthetics, occlusion, ease of operation, etc.) can be considered in choosing one over the other option
- Decision should be made prior to the placement of the implant
Diagnosis - Clinical Evaluation
- Opposing teeth:
- Plane of occlusion and occlusion play an important role in the loads exerted on the implant restoration
- Occlusal scheme should be carefully evaluated for planning the centric and laterotrusive contacts
- Type of restoration (fixed or removable) affects the amount of forces transmitted
- Prognosis of a compromised tooth might be negatively impacted by a rigid implant restoration
Study Casts
- Edentulous site and adjacent structures can be analyzed in detail on the casts
- Diagnostic prototype in the missing tooth site helps visualize the proposed restoration
- Location and alignment of the proposed implant can be studied through the diagnostic work-up
Surgical Template
- Used for imaging and surgical purposes
- Fabricating a good template enhances the diagnostic value of imaging and guides successful placement of the implant
- Template contains barium sulfate mixed with clear acrylic at the missing tooth site for radio opaque marking during tomographic imaging
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Description
Learn about the diagnosis and evaluation process for dental implants, including residual edentulous space, interarch distance, and mesio-distal distance considerations.
