Dental Implants In The Diagnosis And Treatment Planning Of Patient Syllabus
2014-11-12
: Pdf Dental Implants In The Diagnosis And Treatment Planning Of The Dental Patient Syllabus Dental_Implants_in_the_Diagnosis_and_Treatment_Planning_of_the_Dental_Patient_Syllabus 11 2014 pdf
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Diagnosing and treatment planning the full arch implant patient Rick Ferguson DMD Clinical Assistant Professor University of Florida Diplomate ICOI Associate Fellow AAID 1 AAOMR Position Paper 2012 3 Dimensional Imaging should be used for all Dental Implant Planning 2 How we use CBCT Diagnosis Case Presentation Pre-surgical Assessment Intra-surgical Assessment Post Surgical Assessment Computer Guided Surgery Why Use Prexion CBCT • • • • • • To accurately assess volume of alveolus and implant site pre-surgically More accurate than 2D imaging Lower Radiation dosage compared to conventional CT Use of CBCT leads to a lower complication rate Used to assess the success of grafting and implant position CBCT self corrects for magnification yielding a 1:1 ratio for accurate measurements Predictability Alamri, H. M., Sadrameli, M., Alshalhoob, M. A., & Alshehri, M. A. (2012). Applications of CBCT in dental practice: A review of the literature. General dentistry, 60(5), 390. Predictability = Profitability 3 Diagnosing and treatment planning the full arch implant patient Rick Ferguson DMD Clinical Assistant Professor University of Florida Diplomate ICOI Associate Fellow AAID Full Mandibular Restoration Full Mandibular Restoration Implant retained tissue supported Does not stop bone loss in posterior and may accelerate it Reserved as a last resort for older patients Implant supported by tripod clips Prevents further bone loss Very good long term implant survival Removable appliance Higher cost Easy maintenance Fixed or removable implant borne Prevents further bone loss Fixed Appliance More difficult maintenance Higher cost 4 Case by Dr. Arthur Acker Case by Dr. Arthur Acker 5 Case by Dr. Arthur Acker 6 Case by Dr. Arthur Acker 7 Case by Dr. Arthur Acker Mandibular Bar Overdenture 8 Mandibular Implant Overdenture Prosthetics Maximum cantilever X Depends on: •AP spread •Stress Factors •Parafunction •Age X •Sex AP Spread •Opposing Dentition Misch, Carl E. Dental Implant Prosthetics Chapter 14 Cantilevers How “arch form” effects the AP Spread: X+ X- Tapered arch form Ovoid arch form Largest AP Spread Less AP Spread Distal Cantilever Possible Distal Cantilever Possible Square arch form Ø A/P Spread – No Cantilevers 9 10 Mandibular Fixed Restoration Enid 80 11 Enid 12 13 Full Maxillary Restoration Implant retained tissue supported Implant supported by tripod clips Fixed implant borne 14 Fixed Implant Borne Misch, Carl E. Dental Implant Prosthetics Chapter 18 Case without CBCT 15 16 Late Complication Periapical Implant Pathology 4 months post Implant Placement 17 6 months post graft 18 19 7 Year follow up 20 Joe - 58 3D visualization and treatment plan acceptance go hand in hand 21 Joe Tx plan for Joe • Full Arch Temporary #4-13 • Extraction and immediate placement of implants #5,6,9,12 • 4 months later Fabrication of Screw retained temps on Implants #4,6,9,12 • Extraction and immediate Placement of implants #4,8,13 with Delivery of screw retained temps on implant #4,6,9,12 • After 4 months Fabrication and delivery of definitive Prosthesis Advantages of phased treatment • No removable appliance • Keep existing VDO (if adequate) • Less traumatic surgeries for patient at each phase • Ability to evaluate patient acceptance along the way • Greater predictability • Familiar processes for most dentists 22 23 24 25 All on 4 26 David - 65 – The WOW factor 3D visualization and treatment plan acceptance go hand in hand 27 28 All on 4 $42,000 C&B on anteriors plus 9 implants $45,000 29 30 Fran 1 Year Post reconstruction without 3D imaging 31 Tx plan for Fran • • • • Extraction of all maxillary implants and teeth with bone grafting Immediate full denture 4 months later CBCT and Guided surgery for placement of 6 implants for a fixed hybrid • Fabrication of fixed hybrid 4 months later • Why not immediate fixed hybrid -- $$ 32 Tapered 3.0, Tapered Internal & Plus MLV189 REV A APR 2014 33 guide manufacturers with BioHorizons drilling protocols and master cylinders VIP Treatment Planning Software MLV189 REV A APR 2014 34 What about immediate load full arch restorations 35 Carol 36 37 38 39 The full arch implant restoration can be treatment planned with 3D imaging to be predictable for all patients and budgets 40 Contact Information Email DrFerguson@aol.com Web WWW.IMPLANTEDUCATORS.COM Phone 954-319-5606 Fax (954)206-2218 Facebook implanteducators Twitter @implantedu 41 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Siamak Abai DDS MMedSc Prosthodontics: Implant, Reconstructive, & Aesthetic Dentistry Private Practice Newport Beach, CA Director: Clinical Research & Development Glidewell International Technology Center Newport Beach, CA Lecturer: UCLA School of Dentistry Advanced Graduate Prosthodontics AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Developing a referral based practice Establishing a protocol for success Knowing your limitations Treating patients and not opportunities AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Implant Placement in Context 1 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Study of Cone Beam CT Data AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Implant Placement in Context AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Referral for Restorations 2 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Developing Perspective in Overall Treatment AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Post Implant Placement CBCT AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Addressing the System 3 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Aesthetic Evaluation AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Aesthetic Evaluation AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Aesthetic Evaluation 4 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Diagnostic Casts AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Diagnostic Casts AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Diagnostic Wax-Up 5 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Transfer of Diagnostic Information AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Transfer of Diagnostic Information AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Creating Harmony: Provisionals, Soft Tissue, Occlusion 6 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Midterm Evaluation AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Midterm Evaluation AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Finalizing Mandibular Arch 7 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Form Following Function AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Form Following Function AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Finalizing Mandibular Arch 8 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Finalizing Maxillary Arch AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Finalizing Maxillary Arch AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Finalizing Maxillary Arch 9 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Digital Treatment Planning AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Surgical Guide Fabrication AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Guided Implant Placement 10 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Finalization AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Finalization AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Occlusion 11 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Occlusion AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Occlusion AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Occlusion 12 11/11/2014 AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Aesthetics AVOIDING PROSTHETIC COMPLICATIONS IN IMPLANT DENTISTRY Radiographic Evaluation 13
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