Partially Edentulous Patients Flashcards
Cement Retained
Use of — as a final cement for implant
supported cement retained restorations
TempBond
Retrievability -
Radiographic Detection
— demonstrated the highest
grey level values for the cements tested.
TempBond (zinc oxide with eugenol)
- All cements containing zinc (TempBond, TempBond NE, Fleck’s)
could be
detected radiographical
- Undetected excess cement is a major concern of cement retained prostheses due to its strong association to —
periimplantitis
— washes away over time and the restoration will become loose. This creates some
problems and may compromise the implant as well.
- TempBond (zinc oxide with eugenol)
- The — of cements have increased radiopacity
new generation
- — Resin based cements are the most radiolucent and difficult to detect radiographically, the hardest to retrieve, most
difficult to remove excess, and the majority contain fluoride (associated to titanium corrosion), and should therefore be avoided
whenever possible
Definitive
- Implant Resin based cements are specifically made for
implant prostheses, combining radiopacity, resistance to wash-out and
secure retention, improved retrievability and non fluoride formulation (Ex: Premier Implant Cement; Telio CS CEM Implant)
- — is to use a cement that is as radiopaque as possible, take precautions to avoid any excess during cementation, and
insure retrievability of the prostheses
Bottomline
Implant Position in Partially Edentulous Patient
* only when the implants are in
native (not grafted) bone
Implant Supported Cantilevered Fixed
Dental Prosthesis(ICFDP)
When a force is applied to the cantilever by
an opposing tooth (vertical white arrow), the
approximate center of the terminal implant
acts as a —, and the approximate
center of the mesial implant acts as the
—
fulcrum (F)
resistance (R)
Technical complications associated with ICFDP
(5)
- Implant Fractures
- Veneer Fracture
- Abutment Screw Fracture
- Screw Loosening
- Loss of Retention
Recommendations for treatment with ICFDPs
(10)
- Number, diameter, length and position of implants.
- Mesiodistal length of the cantilever (premolar size).
- Dimensions of the connector.
- Preloading (tightening of the screw/torque to the manufacturers’
recommendations) - Technological improvements to implant components and design
(wider implants more bone to implant contact / stronger walls). - Occlusion and occlusal prosthesis material
(infra occlusion, low cusp height, narrow occlusal table). - Retention of abutment crowns (maximum wall length, minimum taper)
- Fit of prosthesis (passive fit).
- Precautions regarding patients with bruxism (avoid ICFDP in bruxers).
- Mesial cantilever is more favorable than distal (less force, class III lever system)
Greenstein et al. Cantilevers extending from unilateral implant-supported fixed prostheses: a review of the literature and presentation of practical guidelines. JADA 2010 Oct; 141(10): 1221-30
Implant Supported Cantilevered Fixed
Dental Prosthesis(ICFDP)
Unilateral, short-span ICFDP is a predictable and dependable
solution for the restoration of a — of the
mouth when there is a lack of bone to support an implant or there
are anatomical structures that need to be avoided.
partially edentulous area