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Implant Restorations: A Step-by-Step Guide, 2nd Edition

ISBN: 978-0-8138-2883-1
244 pages
January 2007, Wiley-Blackwell
Implant Restorations: A Step-by-Step Guide, 2nd Edition (081382883X) cover image
Implant Restorations: A Step-by-Step Guide offers clinicians a practical, step-by-step approach to treatment planning and restoring dental implants. This highly-illustrated, case-based book demonstrates how to treat the most commonly encountered treatment scenarios, describing the procedures, techniques, and sequences required in clear, concise language and in an easy-to-use format. The book takes the theory of implant restoration, using as its basis 3i’s implant systems, and places it directly in the operatory, concentrating in detail on each stage of the actual clinical procedures involved in treating different patients. It integrates implant treatment with the realities of running a successful restorative practice. Building on the work of the 1st edition, the 2nd edition of this successful text reflects the advances of implant prosthetics over the intervening years, providing all new cases, exploring new techniques and technology, and demonstrating updated system components and armamentarium.
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Contributors.

Foreword.

Acknowledgments.

Chapter 1. Introduction To Implant Dentistry.

1. Introduction.

2. Purpose of Textbook.

3. Economics of Implant Dentistry.

Predictability of Fixed Prosthodontics.

4. Development of Prognosis for Teeth: Extract or Maintain.

The Heavily Restored Tooth.

The Furcation-Involved Tooth.

The Periodontal Prosthesis Patient.

Difficult Esthetic Cases.

Classification of Ridge Defects.

Development of Prognosis for the Dentition.

5. Summary.

Bibliography.

Chapter 2. Implants and Implant Restorative Components.

1. Introduction.

2. Implants.

3. Implant/Abutment Connections.

External Implant/Abutment Connections.

Internal Implant/Abutment Connections.

4. Healing Abutments.

EP Healing Abutments.

Encode Healing Abutments.

5. Impression Copings.

Implant Impression Copings.

Abutment Impression Copings.

6. Abutments.

Standard Abutments.

LOCATOR Abutments.

Immediate Occlusal Loading (IOL) Abutments.

GingiHue Posts.

ZiReal Posts.

Provide Abutments.

UCLA Abutments.

CAD/CAM abutments (Encode Abutments).

7. Screws (Clinical).

8. Cylinders.

Standard Gold Cylinders.

IOL Abutment Gold Cylinders.

9. Drivers and Placement Instruments.

Large Hex Drivers.

Large Hex Driver Tips.

Square Drivers.

Square Driver Tips.

Abutment Drivers.

Abutment Driver Tips.

10. Laboratory Components.

Implant Analogs.

Abutment Analogs.

Try In Screws.

Abutment Holders.

11. Bibliography.

Chapter 3. Diagnosis and Treatment Planning in Implant Restorative Dentistry.

1. Patient Selection.

2. Medical History.

3. Diagnostic Procedures.

Radiographs.

CT scans.

Diagnostic casts.

4. Physical examination.

Extra-Oral examination.

Intra-Oral examination.

5. Diagnostic Articulator Mounting.

Diagnostic Wax Patterns.

Surgical Guides.

6. Implant Bone Volume.

7. Implant Restorative Volume.

8. Treatment Planning.

Edentulous Patients.

Partially Edentulous Patients.

9.Implant Loading Protocols.

Two-stage Surgical Protocol.

Single-stage Surgical Protocol.

Early Loading Protocol.

Immediate Occlusal Loading Protocol.

Immediate Non-Occlusal Loading Protocol.

10. Patient Consultation.

Principles.

Informed Consent.

12. Implant Coordinators.

13. Summary.

14. Bibliography.

Chapter 4. Treatment of An Edentulous Mandible With An Implant Retained Overdenture and Resilient Attachments.

1. Literature Review.

2. Clinical Case Presentation.

Appointment 1. Initial Examination.

Radiographs.

Physical Examination.

Diagnostic Cast.

Diagnosis.

Appointment 2. Consultation Restorative Dentist/Patient.

Treatment Options.

Appointment 3. Consultation Restorative Dentist/Surgeon.

Type/Number/Size of Implants.

Prosthesis Design.

Implant/Abutment Connection.

Surgical Guide.

Surgical Protocol.

Healing Abutment Selection.

Implant Restorative Wish List.

Appointment 4. Implant Placement.

Two Stage Surgical Protocol.

Post-Operative Instructions.

Appointment 5. Follow-Up Appointments.

Suture Removal.

Tissue Conditioning.

Appointment 6. Stage II Surgery.

Healing Abutments.

Tissue Conditioning.

Appointment 7. Abutment Connection and Reline Impression.

LOCATOR Abutment connection.

Torque.

Impression Copings.

Reline Impression.

Laboratory Work Order/Procedures.

Appointment 8. Insertion Relined Denture.

Appointment 9. Follow-Up Appointments.

Two weeks.

One-Year Recall Clinical and Radiographic Evaluations.

Costs/Fees/Profitability.

3. Bibliography.

Chapter 5. Treatment of A Partially Edentulous Mandible With A Pre-Machined Titanium Abutment and Single Unit Porcelain Fused to Metal Crown.

1. Literature Review.

2. Clinical Case Presentation.

Appointment 1. Initial Examination.

Diagnostic Casts.

Diagnoses.

Appointment 2. Consultation Restorative Dentist/Patient.

Treatment Options.

Appointment 3. Consultation Restorative Dentist/Surgeon.

Type/Number/Size of Implants.

Abutment/Prosthesis Design.

Implant/Abutment Connection.

Surgical Protocol.

Healing Abutment Selection.

Implant Restorative Wish List.

Appointment 4. Implant Placement.

Appointment 5. Restorative Follow-Up Appointments.

Ten Days.

Four Weeks.

Eight weeks.

Appointment 6. Re-Evaluation and Determination of Implant Impression Date.

Laboratory Procedures.

Custom Open Face Impression Tray.

Tentative Abutment Selection.

Appointment 7. Implant Level Impression.

Clinical Procedures.

Laboratory Procedures.

Master Cast.

Laboratory Work Order for Abutment Preparation and Crown Fabrication.

Appointment 8. Abutment and Crown Insertion Appointment.

Abutment Placement.

Radiographic Verification And Crown Try-In.

Torque.

Cementation.

Appointment 9. Follow-Up Appointments.

Two Weeks/Six Months.

One-Year Recall Clinical and Radiographic Evaluations.

Costs/Fees/Profitability.

3. Bibliography.

Chapter 6. Re-Treatment of A Fractured Implant-Retained Fixed Partial Denture in the Posterior Maxilla With CAD/CAM Abutments And A New Fixed Partial Denture.

1. Literature Review.

2. Clinical Case Presentation.

Appointment 1. Initial Examination.

Diagnostic Casts.

Diagnosis.

Appointment 2. Consultation Restorative Dentist/Patient.

Treatment Options.

Laboratory Procedures.

Custom Impression Tray.

Appointment 3. Removal of Existing Prosthesis/Abutments; Implant Impression.

Implant-Level Impression.

Laboratory Procedures/Work Orders.

1. Fabrication of Master Cast (Implant Analogs).

2. CAD/CAM Protocol.

3. Articulator Mounting.

4. CAD Design of Abutments.

5. CAM Milling of Abutments.

6. Fabrication of Three Unit Fixed Partial Denture.

Appointment 4. Bisque Bake Try-in.

Removal of Pre-Existing Prosthesis and Abutments.

Try-In CAD/CAM Abutments.

Verification Radiograph (Abutments).

Try-In Bisque Bake FPD.

Verification Radiograph (FPD).

Appointment 5. Insertion Appointment.

Removal of Pre-Existing FPD and Abutments.

CAD/CAM Abutment Placement.

Torque.

Fixed Partial Denture Cementation.

Appointment 6. Follow-Up Appointments.

Two weeks/Six months.

One-Year Recall Clinical and Radiographic Evaluations.

Costs/Fees/Profitability.

3. Bibliography.

Chapter 7. Treatment of an Edentulous Mandible with A CAD/CAM Titanium Framework/Fixed Hybrid Prosthesis.

1. Literature Review.

2. Clinical Case Presentation.

Appointment 1. Initial Examination.

History of the Present Illness.

Radiographic Examination.

Physical Examination.

Diagnosis.

Appointment 2. Consultation Restorative Dentist/Patient.

Treatment Options.

Appointment 3. Consultation Restorative Dentist/Surgeon.

Prosthesis Design.

Number/Size of Implants.

Implant/Abutment Connection.

Surgical Protocol.

Surgical Guides.

Anticipated Healing Time.

Appointment 4. Implant Placement.

Single-Stage Surgical Protocol.

Healing Abutment Selection.

Appointments 5-7. Prosthetic Follow-Up Appointments.

Ten Days.

Tissue Conditioning.

Four Weeks.

Eight Weeks-Tissue Conditioning.

Appointment 8. Re-Evaluation.

Diagnostic Impressions/Casts.

Tentative Abutment Selection.

Custom Impression Tray.

Appointment 9. Implant Level Impression.

Clinical Procedures.

Laboratory Procedures/Laboratory Work Orders.

Implant Analogs.

Master Cast.

Work Order.

Verification Index.

Work Order.

Appointment 10. Verification Index/Definitive Impression.

Clinical Procedures.

Laboratory Procedures/Laboratory Work Orders.

Master Cast (Definitive).

Maxillary Occlusion Rim/Mandibular Record Base.

Work Order.

Appointment 11. Jaw Relation Records, Tooth Selection.

Clinical Procedures.

Laboratory Procedures.

Articulator Mounting.

Initial Denture Set-Up.

Appointment 12. Wax Try-In.

Verification of Jaw Relation Records.

CAD/CAM Protocol.

CAM StructSURE Precision Milled Bar.

Wax Denture.

Master Cast.

Verification Index.

Completed Work Order.

Virtual Design of Framework.

Mill Framework.

Laboratory Evaluation of Framework/Master Cast Fit (Square Try In Screws).

Appointment 13. Clinical Framework Try In.

One Screw Test (Square Try-In Screws).

Clinical.

Radiographic.

Laboratory Procedures/Laboratory Work Order.

Silicoat Framework.

Denture Set Up.

Appointment 14. Wax Try In with Framework.

Verification of Jaw Relation Records, Approval of Esthetics, Vertical Dimension, Centric Relation, Lip Support, Incisal Display, and Tooth Arrangement.

Laboratory Procedures/Laboratory Work Orders.

Work Orders.

Appointment 15. Prosthesis Insertion.

Removal of Healing Abutments.

Insertion of Mandibular Prosthesis.

Abutment Screws.

Torque.

Screw Access Hole Restorations.

Final Prostheses.

Oral Hygiene Instructions/Demonstrations.

Follow-Up Appointments.

Appointment 16. Follow-Up Appointments.

Two Weeks/Six Months.

Subjective Patient Evaluations.

Clinical Evaluations.

Occlusion.

Oral hygiene.

One-Year Recall.

Subjective Patient Evaluation.

Radiographic Evaluation.

Clinical Evaluations.

Occlusion.

Oral Hygiene.

Costs/Fees/Profitability.

3. Bibliography.

Chapter 8. Treatment of The Edentulous Mandible with An Immediate Occlusal Loading Protocol (C. Garry O'Connor, Gundersen Lutheran Medical Center and Carl J. Drago, Gunderson Lutheran Medical Center).

1. Literature Review.

2. Clinical Case Presentation.

Appointment 1. Initial Examination (Surgical Office).

Radiographs.

Chief Complaint.

Physical.

Diagnosis.

Prognosis.

Appointment 2. Examination/Consultation Restorative Dentist/Patient.

Examination.

Diagnosis.

Treatment options.

Prognosis.

Appointment 3. Consultation Restorative Dentist/Surgeon.

Number/Size of Implants.

Prosthesis Design.

Implant/Abutment Connection.

Surgical Work-Up and Protocol.

Appointment 4. Surgical Re-Evaluation.

Appointment 5. Definitive Impression.

Diagnostic Casts.

Articulator Mounting.

Appointment 6. Wax Try In.

Laboratory Procedures/Work Orders for Processing Dentures.

Appointment 7. Implant/Prosthesis Placement.

Surgical Protocol.

Prosthetic Protocol.

Postoperative Instructions.

Appointment 8. Prosthetic Follow-Up Appointments.

Twenty-Four Hours.

One Week.

Four Weeks.

Eight Weeks.

Appointment 9. One-Year Recall.

Radiographs.

Clinical.

Definitive Prosthesis (CAD/CAM).

Costs/Fees/Profitability.

3. Bibliography.

Chapter 9. Immediate Non-Occlusal Loading Provisional Restoration; Definitive Restoration Maxillary Central Incisor.

1. Literature Review.

2. Clinical Case Presentation.

Appointment 1. Initial Clinical Visit.

History of the Present Illness.

Radiographs.

Physical Examination.

Diagnostic Casts.

Surgical Guide.

Diagnoses.

Prognosis.

Appointment 2. Consultation Restorative Dentist/Patient.

Diagnosis.

Treatment Options.

Appointment 3. Consultation Restorative Dentist/Surgeon.

Number/Size of Implant.

Implant/Abutment Connection.

Surgical Protocol.

Interim Abutment.

Implant Restorative Wish List.

Appointment 4. Implant and Interim Abutment Placement (Surgical Office).

Implant Placement and Insertional Torque.

Interim Abutment Placement.

Appointment 5. Restorative Appointment-INOL Provisional Restoration (Same Day).

Abutment Preparation.

Immediate Non-Occlusal Loading Provisional Crown (INOL-No Centric/Eccentric Contacts).

Dietary and Oral Hygiene Instructions.

Appointments 6-8. Re-Evaluation Appointments.

Twenty-Four Hours.

Ten Days.

Ten Weeks.

Appointment 9. Re-Evaluation (Twelve Weeks).

Appointment 10. Implant Impression.

INOL Provisional Restoration and Interim Abutment.

Implant Level Impression.

Interim Abutment Re-Preparation.

Provisional Crown with Occlusal Contacts.

Laboratory Procedures for the Master Cast.

Implant Analogs.

Master Cast.

Abutment Selection.

Protocol for Fabrication of Final Encode™ Abutment.

Laboratory Fabrication of Encode Master Cast.

Laboratory Work Orders.

Appointment 11. Abutment and Crown Insertion.

Interim Abutment and Crown Removal.

Definitive Abutment Placement.

Radiographic Verification.

Torque.

Crown Try In.

Cementation.

Postoperative Instructions.

Appointments 12-14. Follow-Up Appointments.

Two Weeks.

Six Months.

History.

Clinical Examination.

Twelve Months.

History.

Radiograph.

Clinical Examination.

Costs/Fees/Profitability.

3. Bibliography.

Chapter 10. Surgical Considerations in Implant Dentistry: Integration of Hard and Soft Tissues (Paul J. Kelly, Gundersen Lutheran Medical Center).

1. Introduction.

2. Implant Design.

3. Hard Tissue Integration.

4. Soft Tissue Integration.

5. Traditional and Early Loading Protocols for Dental Implants.

6. Quantitative Measurements of Implant Success.

7. Implant Failure.

8. Maintenance.

9. Conclusions.

Bibliography.

Index.

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Carl Drago is Clinical Science Editor of the Journal of Prosthodontics, the journal of the American College of Prosthodontists. He had a practice limited to fixed, removable, and implant prosthodontics from 1981 to 2007, and is currently the Director of Dental Research for 3i and is also an adjunct clinical professor at Nova SE School of Dental Medicine, Davie, FL. He has also held positions as Assistant Professor at the University of Texas Dental School at San Antonio. He is a diplomate of the American Board of Prosthodontics (ABP).
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  • Step-by-step format for quick and clear reference
  • Highly illustrated with full color throughout
  • Focuses on the practical aspects of actual clinical procedures
  • Profiles several common basic and more advanced cases in a simple, concise and straightforward manner
  • Advises on procedural protocols, treatment planning and sequencing
  • Includes single unit and implant supported denture prostheses
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"The author's straightforward approach to treatment planning and procedural description makes this a valuable text for practitioners and technologists of every experience level, no matter the implant system they restore. A most comprehensive review of the literature has been furnished in each chapter to impart an evidence-based understanding of the clincial procedures. The hardbound text is filled with wqulity color diagrams and images to support the vebiage. The entire text supports a tem approach to treatment palnning, thus improving the outcomes for the patients." (Journal of Prosthodontics)
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