PROSTHETIC OPTIONS IN IMPLANT

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Questions and Answers

What is a common problem when multiple adjacent natural teeth are missing?

Improved casting accuracy

Excessive bone growth

Increased risk of corrosion between implant and base metal

Difficulty in achieving interproximal gingival contour (correct)

Why is noble metal preferred over nonprecious alloys?

It corrodes less than nonprecious alloys (correct)

It is less expensive

It is harder to separate and solder

It corrodes more easily with the implant

What is a potential issue with using nonprecious metals in the casting process?

They are less expensive

They shrink more during the casting process (correct)

They are harder to separate and solder

They corrode more easily with the implant

What type of crown may be used in a single tooth FP-1 crown?

Aluminum oxide cores and porcelain crowns Signup and view all the answers

What is an FP-2 fixed prosthesis designed to restore?

The anatomical crown and a portion of the root of the natural tooth Signup and view all the answers

What is the main concern with undercontouring the metal work in the final prosthesis?

It increases the risk of unsupported porcelain Signup and view all the answers

Why may the teeth in the final prosthesis appear unnatural in length?

To compensate for excessive vertical dimension to be restored Signup and view all the answers

What is the implication of placing the incisal edge of the teeth in proper position?

It provides adequate lip support Signup and view all the answers

What happens to the available bone height at the time of implant placement?

It decreases due to natural resorption or osteoplasty Signup and view all the answers

What is a characteristic of the patient's lip line during smiling or speech?

It is normal to high in maxilla and low in mandible Signup and view all the answers

What is the purpose of adding a superstructure and overdenture attachments to the implant abutments?

To enhance the biomechanical and hygienic situation of the implant Signup and view all the answers

In an RP-4 prosthesis, where should the implants be placed for the best biomechanical and hygienic situation?

In a mesiodistal position Signup and view all the answers

What is the minimum mesiodistal implant spacing required for a Hader clip?

Greater than 6 mm from edge to edge Signup and view all the answers

What is the advantage of an RP-4 prosthesis over an FP-1, FP-2, or FP-3 restoration?

Improved oral hygiene Signup and view all the answers

What is the similarity between an RP-4 prosthesis and traditional overdentures?

Both are supported by natural teeth Signup and view all the answers

What is the ideal distance between the implants for added retention?

14- to 16-mm range Signup and view all the answers

Why should the connecting bar not be cantilevered to the distal from the two implants?

To prevent reduced prosthesis stability during function Signup and view all the answers

What is the advantage of the A-C-E implant and bar position over the B-D position?

It is more stable for the prosthesis Signup and view all the answers

What is a feature of the four or more implant treatment options in a completely edentulous arch?

A cantilevered superstructure Signup and view all the answers

Why are implants placed closer than the B, D position not recommended?

They result in reduced prosthesis stability during function Signup and view all the answers

What percentage of younger patients do not show any soft tissue during smiling?

10% Signup and view all the answers

In older patients, what percentage do not display gingival regions during smiling?

50% Signup and view all the answers

How is the low lip position of the mandibular lip during speech affected?

It is not affected much Signup and view all the answers

What is the consideration if an implant is placed in an embrasure between two teeth?

The incisal two thirds of the two crowns should be ideal in width Signup and view all the answers

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.