.. Uploads Lecture Implant Overdenture 200702

1Implant Prosthesis for Fully Edentulous Patients

Part I. Implant Overdenture

SAMSUNG MEDICAL CENTER

DONG HWAN LEE

Donghwan Lee

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No diagnosis, no treatment.

If you dont know where you go,you never get lost.

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Diagnosis & Treatment Planning

Implant Prosthesis

Fully Edentulous Patient

Metal Ceramic

Fixed

Complete Denture

Removable

Metal Resin (Hybrid)

Spark Erosion

Overdenture

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Proper lip support for esthetics

Evaluation of missing hard and soft tissue

Vertical dimension

Proper restorative space

Financial constraint

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Vertical dimension

Proper restoration space

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Ideal

Ridge Resorption Pattern

Evaluation of Missing Hard & Soft Tissue

Classification of residual ridge form Siebert 1983

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Horizontal Class I




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Vertical Class II




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Combined Class III




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Smile Line

Lip Support

Facial Support

Proper Lip Support for Esthetics

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Smile Line

Lip Support

Facial Support


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Smile Line

Lip Support


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Vertical dimension


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Teeth

Resin

Metal

Proper Restorative Space

Metal Ceramic Metal Resin (Hybrid)

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Teeth

Resin

Metal

Metal Ceramic Metal Resin (Hybrid)

> 16 mmTotal

> 1 mmClearance for Hygiene

> 3 mmMetal Framework

> 2 mmDenture Base Resin

> 10 mmTeeth


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Implant Overdenture Metal Resin (Hybrid)

> 4 mmAttachment

> 20 mmTotal

> 16 mmTotal

> 1 mmClearance for Hygiene

> 3 mmMetal Framework

> 2 mmDenture Base Resin

> 10 mmTeeth


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Implant Prosthesis

Fully Edentulous Patient

Metal Ceramic

Fixed

Complete Denture

Removable

Metal Resin (Hybrid)

Spark Erosion

Overdenture

Metal Ceramic

Metal Resin

Spark Erosion

Overdenture

More Restorative Space


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Vertical dimension


Financial constraint

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Types of Restorations by Number of Implants

Implant Overdenture

Conventional Complete Denture

Implant Retained & Supported OD

Implant Retained OD

Metal Ceramic Restorations

Implant Supported Fully Fixed Denture

Metal Resin Restorations

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Types of Restorations by Restorative Materials

Implant Overdenture


Implant Retained OD




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Types of Restorations by Mode of Support

Implant Overdenture


Implant Retained OD




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Implant Overdenture

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Considerations for Implant Overdenture

9 Number of implants9 Position of implants9 Selection of attachments9 Complications

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Retained vs. Supported IOD

9 Implant Retained Prosthesis Mx. > 2 - 4Mn. > 2

9 Implant Retained & Supported ProsthesisMx. > 6Mn. > 4

Number of Implants for IOD

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Implant Retained Overdenture


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Implant Retained Overdenture

Implant-retained, tissue-supported overdenture


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Tissue Supported ???


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Success Rate of Implant Overdenture


9 16% (69/430) of implant fixture failure in Mx. followed for 1 year.Jemt et al., IJOMI 1992

9 75.4% in Mx. & 100% in Mn. of 115 implants for 7yrs.Bergendal et al., IJOMI 1998

9 100% success in single implant overdenture in Mn. Of 21 implants for 7yr.Cordiloi et al., JPD 1997

9 Most Mx. Implant overdenture failure in less than 4 implants.Ekfeldt et al., IJP 1997

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Maxilla

Implant Retained Overdenture minimum 2 implants ??minimum 4 implantsimplants splinted with barsfull palatal coverage

X

?

X

O


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Maxilla

Implant Supported Overdenture minimum 4 implantsimplants splinted with barsfull palatal coverage

Implant Supported Overdenture minimum 6 implantsSpark-erosion prosthesisopen palatal coveragehigher restorative fee


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Mandible

Implant Retained Overdenture 2 implants with or without bar

Implant Supported Prosthesis 4 to 6 implants


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9 Number of implants9 Position of implants

Arch shapeBetween canine and lateral incisorVertical space for attachmentInter-Implant distanceAngulation between Implants

Position of Implants for IOD

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9 Number of implants9 Position of implants

Arch shapeBetween canine and lateral incisorVertical space for attachmentInter-Implant distanceAngulation between Implants *

Position of Implants for IOD

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9 Number of implants9 Position of implants9 Selection of attachments

Ball AttachmentsO-ring SystemLocator System

Bar & Clip AttachmentsCM Bar & Rider/Ackermann ClipsDolder Bar SystemHder Bar System/EDS System

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Various Types of Implant Overdenture

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Bar Type Implant Overdenture

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Locator

Lowest profileEasy solution for divergenceSelf aligningDual retentionLong lasting

Ball Type Implant Overdenture

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Characters of Locator

9 Lowest profile9 Easy solution for divergence9 Self aligning9 Dual retention9 Long lasting

3.17 4.85 5.82 6.14 6.22mm Locator ERA Dal-Ro O-Ring EDS

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Characterss of Locator



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9Lowest profile9Easy solution for divergence9Self aligning9Dual retention9Long lasting


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9Lowest profile9Easy solution for divergence9Self aligning9Dual retention9Long lasting


0

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Locator Stren ERA

Insertion & Extraction Test of Retention Loss

Cycl

es o

f Th

ousa

nds

( Cycles to 0.5 Pounds Retention)

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Locator


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Solving the Positioning Problems


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Gingival hyperplasiaFracture of denture base and clipsSpeech problemExtra post insertion appointmentsEtc

Jemt et al, 1996 IJOMINeart et al., 1991, 1997 JPD

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Gingival Hyperplasia in IOD

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Gingival Hyperplasia in IOD

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Speech Problems in IOD

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Speech Problems in IOD

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Retained vs. Supported

Restorative space + Vertical dimension

Implant Retained Overdenture is Complete Denture ! !

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Thanks toDr. Sung-O KimDr. Winston CheeDr. Seung Beum GyeDr. Seung Min YangDr. Jung-Han Choi

.. Uploads Lecture Implant Overdenture 200702

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