TOPIC: SURGICAL AND PROSTHETIC PHASE
🎯 KEY POINTS:
🔹In implant-retained overdenture for completely edentulous patient, balanced occlusion or lingualized occlusion is given.
🔹In full fixed arch implant-supported bridges, there should be simultaneous contact on the anterior and posterior teeth in centric relation with anterior group function and multiple contacts in eccentric jaw movements.
🔹Guided bone regeneration is used for the treatment of localized ridge defects and to regenerate bone in dehiscence and fenestrations.
🔹During osteotomy, care should be taken that the bone should not be heated above 47 Degree Celsius, as this will lead to bone cell death.
🔹Oil rig style bridge is made of standard cylindrical abutments which are joined together with a composite resin bar used mostly in the lower arch where aesthetics is not a primary concern.
🔹Misch occlusal analyser is used to evaluate the occlusal plane of the patient before the restoration of the opposing arch.
🔹Minimum crown height space needed for the fixed implant prosthesis is 8 mm.
🔹The distance from the centre of the most anterior implant to a line joining the distal aspect of the two most distal implants is called the anteroposterior distance or (A-P spread).
🔹Greater the A-P spread, more favourable is the situation of the posterior cantilever.
🔹The tip of the osteotomes is usually concave and blunt so as to
minimize the chances of tearing the Schneiderian membrane during sinus lift procedures.
🔹In group function occlusion, there is contact of all the teeth on the working side and there is no contact on the balancing side.
🔹Shim stock is the most accurate method of checking occlusion for a fixed prosthesis.
🔹Anterior mandible is the ideal location for placement of implants.
🔹The intraoral sites for harvesting bone for autogenous graft are maxillary tuberosity, mandibular symphysis, mandibular ramus or third molar region.
🔹Recently introduced zirconia abutments provide excellent aesthetics.
🔹The implant should be placed at least 2 mm longer than the tooth socket for good primary stability.
📢 SURGICAL PHASE OF IMPLANT PLACEMENT IS CATEGORIZED AS FOLLOWS:
(i) Anatomical considerations
(ii) Crestal incision and flap design
(iii) Osteotomy of the implant site
(iv) Implant placement
📌 CLASSIFICATION OF BONE:
➡️ On the Basis of Macroscopic Density:
1. Dense compact bone (D1)
2. Porous compact bone (D2)
3. Coarse trabecular bone (D3)
4. Fine trabecular bone (D4)
📌 TYPES OF IMPLANT RESTORATIONS:
1. Single-tooth implant restorations
2. Implant-supported overdentures
3. Multiple fixed implant restoration
🔍 CLASSIFICATION OF IMPLANT ABUTMENTS
👉 On the Basis of Type of Restoration
(i) Single-tooth abutment
(ii) Fixed bridgework abutment
(iii) Overdenture abutment
👉 On the Basis of Type of Retention
(i) Screw-retained abutment
(ii) Cement-retained abutment
👉 On the Basis of Fixation with Implant
(i) Single-piece implant: The abutment is attached to the implant as a single unit.
(ii) Two-piece implant: Both the abutment and the implant are separate entities.
📌 TYPES OF IMMEDIATE LOADING
- Immediate functional loading
- Immediate nonfunctional loading
🔎 CLASSIFICATION OF IMPLANT FAILURES
💡 Failures in Implants Related to Surgery and Initial
Healing Period:
(i) Mobile fixtures
(ii) Mucosal fixtures
💡 Failures in Implant Related to Abutment Connection
and Initial Loading:
(i) Abutment loosening
(ii) Occlusal factors
(iii) Screw loosening or cement failure
💡 Failures in Implants Detected During Follow-Ups:
(i) Wear or breakage of the components
(ii) Soft tissue complications
(iii) Exposed implant threads
(iv) Fracture of abutment screw
(v) Fracture of fixture
(vi) Loss of implant
💡 Failures in Implant Due to Bacterial-Induced Factors:
(i) Poor oral hygiene of the patient
(ii) Retention of cement in the subgingival area
(iii) Macroscopic gaps between the implant components subgingivally
(iv) Marked inflammation, exudation and proliferation of the soft tissues