Under the Supervision of : Prof. Samahi

King Abdulaziz University

Faculty of Dentistry

Removable Prosthodontics Division

Based Dentistry (EBD), a brief definition:-Evidence

Empowers practitioners a strong scientific basis rather than common

or expert’s opinion.practice

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Finding

information

Critically

evaluating it

Wisely

applying it

in our

practice

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AAFP Report: Review of Selected Dental Wood MR, Vermilyea SG. .1Based Treatment Planning for Dental Implants.-Literature on Evidence

J Prosthet Dent 2004; 92:447-62.

Aim:

Provide dentists with evidence-based guidelines to apply when

planning treatment with osseointegrated implants

Method:

Peer-reviewed literature published in the English language

was reviewed2003and 1969between

Based Guidelines for Implant Treatment Planning:-Evidence

Factors

Systemic Host Factors"The Cluster Phenomenon”

HabitsSmoking, Bruxing

Local Host Factors

bone quality/quantity

Prosthesis Design Factors

AAFP Report: Review of Selected Wood MR, Vermilyea SG. .1Cont.

Based Treatment Planning for Dental -Dental Literature on Evidence

62-447:92; 2004J Prosthet Dent Implants.

3 - 15

3 - 15

AAFP Report: Review of Selected Wood MR, Vermilyea SG. .1Based Treatment Planning for -Dental Literature on Evidence

Dental Implants.

J Prosthet Dent 2004; 92:447-62.

ProsthodonticStern R. -Taylor TD, Belser U, Mericske.2.107-101(Suppl.): 11 : 2000Clin Oral Impl Res Considerations.

Prosthodontic Considerations:

Aim:

Come up with a general agreement on issues related to the prosthodontic

phase of implant therapy.

Method:

to 1952Examined issues related to the prosthodontic phase of implant therapy from

.1997in a Consensus Conference held in Switzerland in 1997

Agreement on all points was reached by voting within the prosthodontic section.

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. Number, Size and Position of Implants:1

* Greater number and size stress distribution, retention [1]

* Length 7mm [2]

* Width 4mm [3]

* Ideal mesiodistal distance 3mm (implant-implant)

1.5mm (implant-tooth) [4]

* Narrow-body vs. wide-body implants [5]

[1],[2],[3] Wood et al (2004) [5],[8] Taylor et al (2000)

. Cantilever:2

* Anterior-posterior spread 11.1 mm [6]

* Maximum cantilever length 15 mm – mandible

10-12 mm – maxilla [7]

[4],[6] Carl Mish (2005) [7] Kim Y. et al (2005)

. Passivity to Fit:3

Accuracy in impression making [8]

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Cont. Prosthodontic Considerations:

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Retained Restorations:-. Cemented Vs. Screw4

Cemented Restorations:

] 1single unit restorations, short span restorations. [Indications:

] 2fit. [-loosening is not a complication, passive-screwAdvantages:

Retained Restorations:-Screw

Indications:

long span and full arch restorations

deep mucosal implant shoulder placement ( > 3mm )

extended cantilever

[3]

[1],[3] Taylor et al (2000)

[2] Wood et al (2004)

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Occlusal Ju Oh, Misch CE, Wang H. -Kim Y, Tae.3Considerations in Implant Therapy: clinical guidelines with

.35-26:16; 2005Clin. Oral Impl. Res biomechanical rationale.

Aim:

Method:

Discuss the importance of implant occlusion for implant longevity.

Provide clinical guidelines of optimal implant occlusion.

Possible solutions managing complications related to implant occlusion.

was reviewed2002and 1958Literature published between

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Occlusal Considerations in Implant Therapy

Occlusal considerations for implants do not differ from those for natural teeth

However

lack of the periodontal ligament causes osseointegrated implants to react

biomechanically in a different fashion to occlusal force.

Occlusal Overloading

Implant Failure

Kim Y. et al (2005)

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Occlusal Ju Oh, Misch CE, Wang H. -Kim Y, Tae.3Cont

Considerations in Implant Therapy: clinical guidelines with

.35-26:16; 2005Clin. Oral Impl. Res biomechanical rationale.

Overloading Factors of Implant Occlusion:

1. Overextended cactilever

> 15mm in the mandible

> 10-12mm in the maxilla

2. Parafunctional habits / Heavy bite force

3. Excessive premature contacts

4. Steep cuspal inclination

5. Large occlusal table

6. Poor bone density/quality

7. Inadequate number of implants

Kim Y. et al (2005)

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Principles of Implant Occlusion:

1. Bilateral stability in centric occlusion.

2. Evenly distributed occlusal contacts and force.

3. Wide freedom in centric occlusion.

4. Anterior or canine guidance whenever possible.

5. Smooth lateral excursive movements without working/non-working

interferences.

Kim Y. et al (2005)

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Clinical Applications:

Full-arch

Fixed

Prosthesis

Bilateral Balanced

occlusion with

opposing

complete denture

Group function

occlusion or

mutually protected

occlusion when

opposing natural

teeth

No working and

balancing

contact on

cantilever

Infraocclusion

in cantilever

segment

Freedom in

centric

(1-1.5mm)

Kim Y. et al (2005)

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Overdenture

Bilateral balanced

occlusion using

lingualized occlusion

Monoplane occlusion

on a severely resorbed

ridge

ContinuedClinical Applications…

Kim Y. et al (2005)

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Conclusion:

Review:st1

treatmentWith any prosthodontic restoration, meticulous attention must be given to

planning.

, it is no longer acceptable to apply the based” enviroment-“evidenceIn the current

principles and concepts for the treatment of natural teeth to the treatment of dental

implants.

-for evidencerandomized, controlled clinical trialsClinicians need the results of

based decision making.

Limitations:

with implants. esthetic restorationThe article has not discussed the issue of

There is lack of quantifiable evidence-supported guidelines regarding esthetics.

Future research is required to establish such guidlines.

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Cont. Conclusion:

Review:nd2

Limitation:

Many of the consensus statements were reached unanimously, while some were

reached with compromise and split vote.

Review:rd3

specific concept -, implantbased-no evidenceIt emphasized that currently there is

of occlusion. Future studies in this area are needed to clarify the relationship

between occlusion and implant success.

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AAFP Report: Review of Selected Wood MR, Vermilyea SG. .1

Based Treatment Planning for -Dental Literature on Evidence

.62-447:92; 2004. J Prosthet Dent Dental Implants

ProsthodonticStern R. -Taylor TD, Belser U, Mericske.2

.107-101(Suppl.): 11 : 2000Clin Oral Impl Res Considerations.

Occlusal Ju Oh, Misch CE, Wang H. -Kim Y, Tae.3

Considerations in Implant Therapy: clinical guidelines with

.35-26:16; 2005Clin. Oral Impl. Res biomechanical rationale.

, Elsevier 2005, Dental Implant ProstheticsCarl E. Misch: . 4

Mosby, chapter 14, 206-227.

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