Prosthodontist's Tips for Full Arch Fixed Hybrid

of 21

Please download to get full document.

View again

All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
PDF
21 pages
0 downs
18 views
Share
Description
Select slides from the Implant Restorative Study Club's August 2014 meeting. The lecture was provided by Dr. Douglas Weir, a Prosthodontist practicing in Bloomington, Indiana.
Transcript
  • 1. Select  Slides  from  Prosthodon1cs  of   Central  Indiana  –  Implant   Restora1ve  Study  Club   Presented  by:  Dr.  Douglas  Weir   August  28,  2014  
  • 2. •  The  Big  Picture   •  Origins  of  “All-­‐on-­‐4”   •  Pathway  to  Learning   •  The  Four  Basic  Concepts   •  Pa1ent  Factors  
  • 3. AP  spread  is  NOT  a  radiographic  metric  
  • 4. NOTE  HARD   PLASTIC  BOXING   at  least  3X  A-­‐P  spread  
  • 5. WE  CAN’T  EVEN  AGREE  ON  THE  NAME  OF  THESE   THINGS!   •  All-­‐on-­‐4  is  a  trademark  name  of  Nobel  BioCare   •  Teeth  Express      (BioHorizon)   •  RevitaliZe          (Zimmer)   •  Screw  Retained  Fixed-­‐Hybrid  Denture  or  Bridge   •  Fixed  Detachable  Removable  Denture   •  Fixed  Hybrid   •  Hybrid  Bridge   •  “Hybridge”  
  • 6. WHICH  EXPLAINS  THIS:   Add  up  the  cost,  for  one  arch    
  • 7. THREE?  
  • 8. •  Amazingly,  the  appeal  crosses  all  demographic   norms.    Once  the  concept  is  understood,  there  is   widespread  desire  on  the  part  of  these  pa1ents  to   pursue  treatment.   •  The  main  barriers  are  sa1sfactory  bone  parameters,   prosthe1c  limita1ons  and  financial  resources.   •  The  results  are  life  changing  for  pa1ents.  
  • 9. Primary  support  from  cor1cal  bone     Medullary  bone  is  secondary  support     An  angled  implant  emerges  through   cor1cal  plate  in  an  oval-­‐not  a  circle  and   has  longer  cor1cal  plate  contact  down   the  long  axis     A  longer  implant  when  angled  creates   more  surface  area  in  medullary  bone     Able  to  reach  cor1cal  bone  at  apex     Must  be  connected  by  a  precision-­‐fit   bar   ANGLED  IMPLANTS  
  • 10. – Can1levering  the  distal  implants  allows   restora1on  back  to  the  first  molar  by   angling  implants  up  to  45  degrees   –  follow  medial  wall  of  the  maxillary  sinus   –  extend  distal  to  mental  foramen   »  no  sinus  lid   »  less  risk  of  paresthesia  of  lower  anterior  
  • 11. UNDERSTANDING  THE   ALVEOLOPLASTY  
  • 12. 15  MM  OF  PROSTHETIC   SPACE   15mm  measured  from  crest  of  bone  to  proposed  incisal   edge  of  prosthe1c  design  during  surgery   12mm  from  margin  of  supra  gingival  mul1-­‐unit  abutment   to  proposed  incisal  edge  of  prosthesis   Cau1on:  angled  abutments  are  1.5mm-­‐2.0mm  taller  due   to  design  of  the  double  screw  reten1on-­‐implant  may   need  to  be  placed  deeper  when  pre-­‐planning-­‐ especially  in  anterior    
  • 13. WHY  15MM?   1-­‐2  mm  of  space  between  bone,  1ssue  and  prosthesis   Milled  1tanium  bar  is  4  mm  minimum   Prosthe1c  teeth  8-­‐10  mm  or  more  
  • 14. IMMEDIATE  CONVERSION   A  temporary  immediate  denture  is  fabricated  prior  to  surgery.     It  is  either  lined  with  a    1ssue  condi1oner  at  delivery  and  placed  over   healing  caps  and  worn  as  a  full  denture,  or  converted  into  a  fixed   hybrid  temporary  appliance  at  the  surgery  if  the  implants  achieve   35  Ncm  during  placement.   Some  doctors  prefer  to  make  a  master  impression  and  have  a  lab   perform  the  conversion  overnight  for  delivery  the  next  day.     Others  do  everything  at  the  surgical  appointment.  
  • 15.   SOMETIMES  WE  OVERESTIMATE  OUR  PREPAREDNESS     SOMETIMES  WE  UNDERESTIMATE  THE  CHALLENGE     NEVER  DO  BOTH  AT  THE  SAME  TIME        
  • 16. BASIC  ENGINEERING   PRINCIPLES   Triangula1on  of  force   vectors-­‐more  than  a   century  of  experience  
  • Related Search
    We Need Your Support
    Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

    Thanks to everyone for your continued support.

    No, Thanks