implant diagnosis n planning /fixed orthodontic courses by IDA

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats. Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics, Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call 0091-9248678078

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DIAGNOSIS AND TREATMENT PLANNING :

DIAGNOSIS AND TREATMENT PLANNING PRE PROSTHETIC EVALUATION www.indiandentalacademy.com

PowerPoint Presentation:

INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com

Pre Prosthetic Evaluation:

Pre Prosthetic Evaluation Intraoral examination Analysis of mounted study casts Bone mapping Radiographic analysis Force evaluation www.indiandentalacademy.com

Intraoral Examination:

Intraoral Examination Existing occlusion Existing occlusal plane, orientation Interarch space Existing vertical dimension of occlusion Maxillomandibular arch relations Temporomandibular joint status Existing prosthesis www.indiandentalacademy.com

Intraoral Examination:

Intraoral Examination Arch form Ideal implant permucosal position Missing teeth location Missing teeth number Lip line at rest and during speech Mandibular flexure Soft tissue support www.indiandentalacademy.com

Arch form :

Arch form www.indiandentalacademy.com

Diagnostic Casts:

Diagnostic Casts Mounted diagnostic cast are invaluable for Occlusal centric relation position including premature occlusion Edentulous ridge relations to adjacent teeth and opposing arches Position of potential natural abutments including inclination rotation extrusion spacing parallelism and esthetic considerations www.indiandentalacademy.com

Position of the replacement in relation to the residual ridge:

Position of the replacement in relation to the residual ridge www.indiandentalacademy.com

Diagnostic Casts:

Diagnostic Casts Direction of forces in future implant sites Present occlusal scheme including the presence of balancing or working contacts Edentulous soft tissue angulation, length, width, locations, permucosal esthetic position, muscle attachments and tuberosities www.indiandentalacademy.com

Study Model Analysis – Edentulous Patient:

Study Model Analysis – Edentulous Patient Pattern of resorption - can exhibit as cross bite in posterior region and as prognathism in anterior region. Mounted study models will help ascertain vertical and sagittal relationships www.indiandentalacademy.com

Mounted study models indicating minimum Interocclusal distance:

Mounted study models indicating minimum Interocclusal distance www.indiandentalacademy.com

Mounted Study models showing large interarch space:

Mounted Study models showing large interarch space www.indiandentalacademy.com

Prognathic relationship:

Prognathic relationship www.indiandentalacademy.com

Angle class II:

Angle class II www.indiandentalacademy.com

Study Model Analysis – Partially Edentulous Patients:

Study Model Analysis – Partially Edentulous Patients www.indiandentalacademy.com

Interarch Distances:

Interarch Distances www.indiandentalacademy.com

Evaluation Of Available Bone:

Evaluation Of Available Bone Evaluation of bone quantity Evaluation of bone quality www.indiandentalacademy.com

Available bone is evaluated by:

Available bone is evaluated by Digital Palpation Radiographs Study models Bone sounding www.indiandentalacademy.com

Bone sounding :

Bone sounding www.indiandentalacademy.com

OSTEOMETER:

OSTEOMETER www.indiandentalacademy.com

MAINZ MEASURING GAUGE:

MAINZ MEASURING GAUGE www.indiandentalacademy.com

EVALUATION OF BONE QUANTITY :

EVALUATION OF BONE QUANTITY www.indiandentalacademy.com

PowerPoint Presentation:

ALVEOLAR PROCESS FUNCTIONAL ADAPTATION www.indiandentalacademy.com

ATWOODS CLASSES OF RESORPTION FOR MAXILLA:

ATWOODS CLASSES OF RESORPTION FOR MAXILLA www.indiandentalacademy.com

ATWOODS CLASSES OF RESORPTION FOR MANDIBLE:

ATWOODS CLASSES OF RESORPTION FOR MANDIBLE www.indiandentalacademy.com

Classification Of Degree Of Resorption Of Edentulous Jaws By Lekholm And Zarb(1985):

Classification Of Degree Of Resorption Of Edentulous Jaws By Lekholm And Zarb(1985) www.indiandentalacademy.com

Pattern of resorption (Harle):

Pattern of resorption (Harle) Maxillary arch buccal to lingual Mandibular arch lingual to buccal www.indiandentalacademy.com

Available bone is studied under :

Available bone is studied under Height of bone Width of bone Length of bone Bone contour Crown implant ratio www.indiandentalacademy.com

Height of bone:

Height of bone Vertical extent bone available for implantation Distance between the crest of alveolar bone to the opposing anatomic structures www.indiandentalacademy.com

Width of bone:

Width of bone Distance between oral and vestibular cortical plates 1mm diameter increase = 20-30% increase in the total surface area 3mm increase in length provides more than 10% increase in surface area www.indiandentalacademy.com

Length of bone:

Length of bone Minimum distance between axis to axis between two implants is 7mm R1+R2+2mm=distance between two implants www.indiandentalacademy.com

Bone contour (Angulation):

Bone contour (Angulation) Favorable bone contour is one in which the functional and esthetic demands of the prosthesis to be borne by the implant can be fulfilled with axial loading of the prosthesis www.indiandentalacademy.com

Divisions of Available bone quantity:

Divisions of Available bone quantity Division A (abundant) Division B (barely sufficient) Division C (Compromised) Division D (Deficient) www.indiandentalacademy.com

Division A:

Division A Width > 5mm Height >10-13mm Length >7mm C/I < 1 www.indiandentalacademy.com

Division B:

Division B Width 2.5-5mm Height >10-13mm Length >12mm C/I < 1 www.indiandentalacademy.com

Options for Division B Bone:

Options for Division B Bone Modify the existing Div B ridge to another division by Osteoplasty Insert a narrow Div B root form implant Modify existing Div B bone into Div A by augmentation www.indiandentalacademy.com

PowerPoint Presentation:

www.indiandentalacademy.com

Disadvantages Division B :

Disadvantages Division B Stress at the crestal region around the implant is twice Lateral loads on the implant result in almost 3 times greater stress than Division A Fatigue fractures in the abutment are increased Crown emergence profile is less esthetic www.indiandentalacademy.com

Disadvantages Division B:

Disadvantages Division B Conditions around the cervical aspect of the crown for daily care is poor Angle of load must be reduced to less than 20 degrees to compensate for the small diameter Two implants are required for proper prosthetic support www.indiandentalacademy.com

Division C:

Division C Unfavorable Width (C-w) Unfavorable Height (C-h) Unfavorable Angulation (C-a) Unfavorable C/I = 1 www.indiandentalacademy.com

Treatment options for Division C:

Treatment options for Division C Ostoeplasty Root form implants Subperiosteal implants Augmentation procedures Ramus frame implants Transosteal implants www.indiandentalacademy.com

EVALUATION OF BONE QUALITY :

EVALUATION OF BONE QUALITY www.indiandentalacademy.com

Bone Quality Is Evaluated By:

Bone Quality Is Evaluated By Tactile Radiographic Biochemical www.indiandentalacademy.com

Bone density and success rates:

Bone density and success rates Adell et al reported 10% greater sucesss rate in the anterior mandible compared to anterior maxilla Schnitman et al reported highest success rate of 75% in the posterior maxilla Friberg et al reported 66% of the implant failures occurred in soft bone www.indiandentalacademy.com

CT determination of bone density:

CT determination of bone density D1: > 1250 Hounsfield units D2: 850 - 1250 Hounsfield units D3: 350 - 850 Hounsfield units D4: 150 - 350 Hounsfield units D5: < 150 Hounsfield units www.indiandentalacademy.com

Mechanostat theory of Frost:

Mechanostat theory of Frost The structure of bone is maintained by the micro strain environment Bone reaction to different degrees of micro strains 0-50 : acute disuse window 50-1500 : adapted window 1500-3000 : mild overload Above 3000 : pathologic overload www.indiandentalacademy.com

Bone Classification Related To Implant Dentistry By Linkow (1970) :

Bone Classification Related To Implant Dentistry By Linkow (1970) Class I Bone structure: ideal type of bone with evenly spaced trabeculae with small cancellated spaces Class II Bone structure: bone has larger cancellated spaces with less uniformity of the cancellous spaces Class III Bone structure: large marrow spaces between trabeculae www.indiandentalacademy.com

BONE DENSITY CLASSIFICATION BY MISCH:

BONE DENSITY CLASSIFICATION BY MISCH Dense cortical Porous cortical Coarse Trabecular Fine trabecular D1 D2 D3 D4 www.indiandentalacademy.com

Bone density location:

Bone density location D1 – 6% in anterior mandible 3% in posterior mandible D2 – most common in mandible D3 – most common in maxilla 65% in anterior maxilla 50% in posterior maxilla D4 – most common in posterior maxilla www.indiandentalacademy.com

Influence Of Bone Density On Treatment Planning:

Influence Of Bone Density On Treatment Planning Surgical Soft bone protocol Selection of fixture size Selection of the drilling sequence Selection of the material of the implant Auxiliary procedures Prosthetic Progressive loading www.indiandentalacademy.com

Evaluation of force:

Evaluation of force Parafunction Position of abutment in the arch Masticatory dynamics Nature of the opposing arch Direction of load forces Crown-Implant ratio www.indiandentalacademy.com

PowerPoint Presentation:

Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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