Implant prosthodontics in complete edentulous cases I ...

2021.05.05.

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Faculty of DentistryDepartment of Prosthodontics

Dr. Tamás Déri

Department of Prosthodontics

Implant prosthodontics incomplete edentulous cases

I. (fixed and removableprosthodontics)

Lecture

05. 05. 21.

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Implant prosthodontics in completeedentulous cases I. (fixed and removableprosthodontics)

Dr. Tamás Dériclinical specialist

Lectures in implant prosthodontics in the

Department of Prosthetic Dentistry

� 1st year: Implant materials - 1

� 2nd year: Explanation of different kind of implant systems, Impression methods of implant cases - 1

� 3rd year: Implant prosthodontics in complete edentulous cases I. (fixed and removable prosthetics), Implant prosthodontics in complete edentulous cases II. (impression techniques, means of retention) - 2

� 4th year: Implants in prosthodontics - 1



Treatment strategies of total

edentulousness

� Complete denture

� Implantation and

complete(?) denture

(overdenture),

� Fixed partial denture

� (Combined denture)



Implant, implant system

� Implant: a prosthetic device made of alloplastic material(s)

implanted into the oral tissues beneath the mucosal and/or

periosteal layer and on or within the bone to provide

retention and support for a fixed or removable dental

prosthesis; a substance that is placed into and/or on the jaw

bone to support a fixed or removable dental prosthesis

� Implant system: dental implant components that are

designed to connect mechanically; an implant system can

represent a specific concept, inventor, or patent; it consists

of the necessary parts and instruments to complete the

implant placement and abutment components

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Implant prosthodontic

appliances�Definition: dental prosthesis, such as fixed complete denture,

fixed partial denture, removable complete overdenture, removable partial overdenture, as well as maxillofacial prostheses, which can be supported and retained in part or whole by dental implants Simon H, Yanase RT. Terminology for Implant Prostheses. Int J Oral Maxillofac Implants 2003; 18:539-543.



Implant prosthodontic appliances

�Analogies:

�Implant ≈ root

�Abutment ≈ prepared

tooth surface

�Implant superstructure

≈ denture



The aim of implantation

� To give better life quality, to avoid the

preparation of the teeth, to be able to make

FPD instead of RPD, to improve the

removable denture’s retention – depending

the patient individual situation

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Indication of implant dentures� Edentulous jaw

� Uni- or bilateral free-end

saddle (rather the

unilateral)

� Too long interdental

edentulous area

� Missing one tooth

� Maxillofacial prosthetics



Types of implant dentures – possibilities

in complete edentulousness

� Full-arch fixed denture

� Hybridprosthesis

� Overdenture



Fixing implant dentures

� Irreversible (definitively cement retained)

� Optionally reversible (screw retained)

� Reversible (removable denture)



Retention factors of complete

dentures� Clinical anatomical factors

� The size of the denture-bearing surface

� The height of the edentulous ridge

� Retentive undercuts for the proper grasp of thebaseplate

� Neuromuscular factors

� Physical factors

� Suction effect

� Capillary effect

� Occlusal pressure

� Gravitation

� Accessorial retentive factors

� Adhesives

� Engraving methods

� Suction cups

� Accessorial stabilising factors

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Retentive effect by implant borne

removable dentures

� (Classic retentive factors 4N!!!)

� Retention by implants: 6-23N!!!/pcs!!!



Conditions of making fixed implant

prosthesis in complete

edentulousness

• Number of implants:

• Different concepts

• Maxilla: 8, mandibula:6

• The ratio between theimplant length and theheight of the denture

• Interalveolarangulation of theedentulous jaws



Conditions of making removable implant

prosthesis in complete edentulousness� Can be made in case of unfavourable

clinical anatomical circumstances(even then, when a fixed denture is possible)

� The real limitating factor is thepossibility of implant placement(number and position)



Full-arch fixed implant borne denture

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Hybridprosthesis

• Alveolar bone replacement

• Lip, cheek support

• Always screw – retained!



Implant retained removable denture

� Overdenture

� These are similar to thecomplete dentures, but thebaseplate could be reduced orcould have a conventionalextension

� But: we have to take care forthe stabilising surface-form: however the retention is provided by implants, we haveto avoid weakening it! (matrix-wear?)




– ball and socket attachment• Classic solution

• Small space needed

• Simple

https://www.straumann.com/content/dam/media-center/straumann/en/documents/brochure/technical-information/152.252-en_low.pdf



Ball and socket retented lower

denture

Dr. Kádár László’s pictures

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Ball and socket retented lower

denture

Dr. Valentovics Anna’s pictures




– bar-retention

• Very stable

• Space requirements – also

orovestibular!

• Expensivehttps://www.straumann.com/content/dam/media-center/straumann/en/documents/brochure/technical-information/152.252-en_low.pdf




– bar-retention



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Implant retained removable denture -

Locator• „Cylinder in cylinder”

• „Self-aliging” retention

• Better (matrix/implant)

https://www.straumann.com/content/dam/internet/straumann_ca/resources/brochurecatalogue/brochures/en/CALIT118%20Locator%20Brochure.pdf




Locator

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Magnet• Cheap

• Simple

• Stable

Straumann Gmbh. Verankerungssysteme für implantatfixierte Hybridprothesen



Summary�Nowadays implant prosthetic appliances are

reliable and widely-used solutions

�Compared to the conventional dentures they can

provide intense improvement in life – quality for

the patients

�Very important to follow the indications and

construction rules

�In maxillofacial prosthetics they are often the

only ways to get a well – functioning prosthesis

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Thank you for your attention!



Implant prosthodontics in complete edentulous cases I ...

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