Podcast
Questions and Answers
What is a common problem when multiple adjacent natural teeth are missing?
What is a common problem when multiple adjacent natural teeth are missing?
Why is noble metal preferred over nonprecious alloys?
Why is noble metal preferred over nonprecious alloys?
What is a potential issue with using nonprecious metals in the casting process?
What is a potential issue with using nonprecious metals in the casting process?
What type of crown may be used in a single tooth FP-1 crown?
What type of crown may be used in a single tooth FP-1 crown?
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What is an FP-2 fixed prosthesis designed to restore?
What is an FP-2 fixed prosthesis designed to restore?
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What is the main concern with undercontouring the metal work in the final prosthesis?
What is the main concern with undercontouring the metal work in the final prosthesis?
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Why may the teeth in the final prosthesis appear unnatural in length?
Why may the teeth in the final prosthesis appear unnatural in length?
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What is the implication of placing the incisal edge of the teeth in proper position?
What is the implication of placing the incisal edge of the teeth in proper position?
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What happens to the available bone height at the time of implant placement?
What happens to the available bone height at the time of implant placement?
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What is a characteristic of the patient's lip line during smiling or speech?
What is a characteristic of the patient's lip line during smiling or speech?
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What is the purpose of adding a superstructure and overdenture attachments to the implant abutments?
What is the purpose of adding a superstructure and overdenture attachments to the implant abutments?
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In an RP-4 prosthesis, where should the implants be placed for the best biomechanical and hygienic situation?
In an RP-4 prosthesis, where should the implants be placed for the best biomechanical and hygienic situation?
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What is the minimum mesiodistal implant spacing required for a Hader clip?
What is the minimum mesiodistal implant spacing required for a Hader clip?
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What is the advantage of an RP-4 prosthesis over an FP-1, FP-2, or FP-3 restoration?
What is the advantage of an RP-4 prosthesis over an FP-1, FP-2, or FP-3 restoration?
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What is the similarity between an RP-4 prosthesis and traditional overdentures?
What is the similarity between an RP-4 prosthesis and traditional overdentures?
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What is the ideal distance between the implants for added retention?
What is the ideal distance between the implants for added retention?
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Why should the connecting bar not be cantilevered to the distal from the two implants?
Why should the connecting bar not be cantilevered to the distal from the two implants?
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What is the advantage of the A-C-E implant and bar position over the B-D position?
What is the advantage of the A-C-E implant and bar position over the B-D position?
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What is a feature of the four or more implant treatment options in a completely edentulous arch?
What is a feature of the four or more implant treatment options in a completely edentulous arch?
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Why are implants placed closer than the B, D position not recommended?
Why are implants placed closer than the B, D position not recommended?
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What percentage of younger patients do not show any soft tissue during smiling?
What percentage of younger patients do not show any soft tissue during smiling?
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In older patients, what percentage do not display gingival regions during smiling?
In older patients, what percentage do not display gingival regions during smiling?
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How is the low lip position of the mandibular lip during speech affected?
How is the low lip position of the mandibular lip during speech affected?
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What is the consideration if an implant is placed in an embrasure between two teeth?
What is the consideration if an implant is placed in an embrasure between two teeth?
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Study Notes
Bone Augmentation
- The width or height of the crestal bone is frequently lacking after the loss of multiple adjacent natural teeth.
- Soft tissue augmentation is required to improve the interproximal gingival contour, which is difficult to achieve when more than two adjacent teeth are missing.
- This can result in open "black" triangular spaces when the patient smiles.
Restorative Material
- Noble metal is the base metal of choice in case of a non-passive fit at the metal try-in.
- Noble metal corrodes less than non-precious alloys.
- Any history of exudate around a subgingival margin will dramatically increase the corrosion effect between the implant and the base metal.
- Porcelain to noble-metal alloy is the material of choice to improve the accuracy of the casting.
FP-1 Crown
- A single tooth FP-1 crown may use aluminum oxide cores and porcelain crowns or ceramic abutments and porcelain crowns.
- The risk of fracture may increase because impact forces are greater on implants than natural teeth.
FP-2 Fixed Prosthesis
- An FP-2 fixed prosthesis appears to restore the anatomical crown and a portion of the root of the natural tooth.
- If the high lip line during smiling or the low lip line during speech does not display the cervical regions, longer teeth are usually of no esthetic consequence.
- As the patient becomes older, the maxillary esthetic zone is altered.
- The low lip position of the mandibular lip during speech is not affected as much as the maxillary lip during the high smile line.
Hygienic Considerations
- Implant may even be placed in an embrasure between two teeth.
- If this occurs, the incisal two-thirds of the two crowns should be ideal in width, as though the implants were not present.
- Only the cervical region is compromised.
FP-3 and RP-4 Prosthetics
- The amount and contour of the metal work is different than for an FP-1 restoration.
- As with the FP-2 prosthesis, the original available bone height has decreased by natural resorption or osteoplasty at the time of implant placement.
- To place the incisal edge of the teeth in proper position for esthetics, function, lip support, and speech, the excessive vertical dimension to be restored requires teeth that are unnatural in length.
- A superstructure and overdenture attachments must often be added to the implant abutments.
- The implants in an RP-4 prosthesis should be placed in the mesiodistal position for the best biomechanical and hygienic situation.
Implant Positioning
- The position of an attachment on the superstructure or prosthesis may also affect the amount of spacing between the implants.
- For example, a Hader clip requires the mesiodistal implant spacing to be greater than 6 mm from edge to edge.
- The ideal distance between the implants is in the 14- to 16-mm range or B and D positions.
- Implants placed closer than the B, D position will result in reduced prosthesis stability during function whether they are connected or independent units.
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Description
This quiz covers bone and soft tissue augmentation in dental implant prosthetics, including the challenges of achieving interproximal gingival contour in edentulous ridges.