implant occlusion final ppt

IMPLANT OCCLUSION

BY

FEBEL HUDA

2ND Yr PG

GUIDED BY Dr. R.Madhan

M.D.S

“Occlusion is a static relationship between the incising or masticating surfaces of the maxillary and mandibular teeth or tooth

analogues.”GPT-8.

QUERIES ?

WHAT IS AN IMPLANT?“A graft or insert set firmly or deeply into the

alveolar process that may be prepared for its insertion” – GPT-8

• WHAT IS AN IMPLANT?

QUERIES ?

WHAT IS SO DIFFERENT BETWEEN IMPLANT AND NATURAL TEETH?


• WHAT IS SO DIFFERENT BETWEEN IMPLANT AND NATURAL TEETH?

PDL OSSEOINTRGRATION

SHOCK ABSORBERSTRESS DISTRIBUTION

STRESS CONCENTRATED

ATCRESTAL BONE

FULCRUM TO LATERAL FORCES

LATERAL MOVEMENTS

56 -108µm 10-50µm

APICAL MOVEMENT

25-100µm3-5µm

PROPRICEPTION

OSSEOPERCEPTION

OVER LOAD

QUERIES ?• WHAT IS AN IMPLANT?


Carl. E. Mish; contemprory implant dentistry,3rd ed.

QUERIES ?

WHAT ARE THE DIFFERENT FORCES ACTING ON AN IMPLANT?

FORCES ON A IMPLANT ARE

NORMAL FORCE

SHEAR FORCE



• WHAT ARE THE DIFFERENT FORCES ACTING ON AN IMPLANT?


QUERIES ? • FORCE• WHAT IS AN IMPLANT?




QUERIES ? • MOMENT or torque is defined as a vector(M),the magnitude of which equals the product of the force magnitude multiplied by the perpendicular distance(moment arm) from the point of interest to the line of action of the force.





QUERIES ? • MOMENT• WHAT IS AN IMPLANT?




QUERIES ? • MOMENT (OCCLUSAL FORCE)

LENGTH OF THE PROSTHESIS BECOMES THE

MOMENT ARM





QUERIES ? • MOMENT (LINGUAL FORCE)

HEIGHT OF THE PROSTHESIS BECOMES THE

MOMENT ARM





QUERIES ? • MOMENT (LINGUAL FORCE)HEIGHT OF THE PROSTHESIS BECOMES THE

MOMENT ARM





QUERIES ? • MOMENT (MESIAL FORCE)HEIGHT OF THE PROSTHESIS BECOMES THE

MOMENT ARM





QUERIES ? • HOW SPLINTING HELPS REDUSE FORCE?• WHAT IS AN IMPLANT?



• HOW SPLINTING HELPS REDUSE FORCE?


QUERIES ? • WHAT IS SO IMPORTANT ABOUT OCCLUSION?

1. Masticatory efficiency

2. Comfort and stability

3. Long term success of prosthesis





•WHAT IS SO IMPORTANT ABOUT OCCLUSION?

QUERIES ? • WHAT IS AN IDEAL OCCLUSION?

• DAWSON(1974)• WHAT IS AN IMPLANT?





•WHAT IS AN IDEAL OCCLUSION?

QUERIES ? NATURAL DENTITION

• Canine protected

• Group function(unilateral balanced occlusion)

• Mutually protected(anterior disclusion, posterior disclusion, organic occlusion, anterior protected occlusion)

• Bilateral balanced occlusion

• DENTURE OCCLUSION

• Bilateral balanced occlusion

• Lingualized occlusion






•WHAT ARE THE DIFFERENT TYPE OF OCCLUSION?

WHAT ARE THE DIFFERENT TYPE OF OCCLUSION?

CANINE PROTECTED

GROUP FUNCTION

MUTUALLY PROTECTED

BILATERAL BALANCED OCCLUSION

LINGUALIZED OCCLUSION

QUERIES ? • CANINE PROTECTED OCCLUSION

• D AMICO(1958)• WHAT IS AN IMPLANT?






Dawson PE ,Evaluation ,Diagnosis and Treatment of Occlusal Problems :A textbook of Occlusion. 2 nd Edition St.Louis,C V Mosby Co. 1978. pp274-297

QUERIES ? • CANINE PROTECTED OCCLUSION

• WHY CANINE?• WHAT IS AN IMPLANT?






QUERIES ? • GROUP FUNCTION

• SCHUYLER 1959• WHAT IS AN IMPLANT?






QUERIES ? • FREEDOM OF OCCLUSION

(LONG CENTRIC)

POSSELT (1952) in study 0.5- 1.5mm








QUERIES ? • MUTUALLY PROTECTED

STUART & STALLARD (1960)• WHAT IS AN IMPLANT?







QUERIES ? • ORGANIC OCCLUSION

• Stuart & Stallard (1961)• WHAT IS AN IMPLANT?






QUERIES ? • BILATERAL BALANCED OCCLUSION

SEAR (1925)• WHAT IS AN IMPLANT?







QUERIES ? • LINGUALIZED OCCLUSION

GYSI (1927)

FRENCH (1935)







Rodney;Lingualized occlusion revisited; J Prosthet Dent 2010;104:342-46.

QUERIES ? • LINGUALIZED OCCLUSION

PAYNE (1941)

30˚ tooth

POUND (1973)

> 30˚ MAXILLA

<20 ˚ MANDIBULAR







Rodney;Lingualized occlusion revisited; J Prosthet Dent 2010;104:342-46.

QUERIES ? • LINGUALIZED OCCLUSION• WHAT IS AN IMPLANT?






Jim Collis CDT; Lingualized Occlusion Simplifying the Set-up Enhancing Function and Esthetics.

QUERIES ? • IMPLANT PROTECTED OCCLUSION

The salient features of this concept are

1. Usage of implants of greater width whenever possible

2. Anterior teeth should disclude the posterior teeth

3. Absence of lateral contacts in excursion.

4. All occlusal contacts more medial than the natural teeth

5. A reduced width of the occlusal table







Misch CE, Bides MW. Implant-protected occlusion. Int J Dent Symp, 2: 32-37, 1994.

QUERIES ? • IMPORTANCE OF THE OCCLUSAL TABLE?

1. Occlusal table width

2. Height of the prosthesis

3. Occlusal form







•IMPORTANCE OF THE OCCLUSAL TABLE?

QUERIES ? Occlusal table width• WHAT IS AN IMPLANT?








QUERIES ? • Height of the prosthesis• WHAT IS AN IMPLANT?







IDEAL HEIGHT=9 – 10mm

Every 1mm of crown height

20% increase in force

Steven Kendrick; Vertical and Horizontal Dimensions of Implant Dentistry: Numbers Every Dentist Should Know; INSIDE DENTISTRY—JULY/AUGUST 2009.

QUERIES ? • Occlusal form• WHAT IS AN IMPLANT?







JAMIE 1996- shallow cusps and flat occlusal table

WEINBERG 1995- ↑10˚ cuspal inclination↑30% load

20˚ cusp tooth is preferred over flat cusp

Jamie; The influence of occlusal design on simulated masticatory forces transferred to implant-retained prostheses and supporting bone;J Prosthet Dent 1996;76:50-5.

QUERIES ? • WHAT IS THE MATERIAL OF CHOICE FOR OCCLUSAL TABLE?• WHAT IS AN IMPLANT?







•WHAT IS THE MATERIAL OF CHOICE FOR OCCLUSAL TABLE?

QUERIES ? • HOW TO CHECK THE FINAL IMPLANT OCCLUSION?

• 16 µ : Removable implant prosthesis

• 12 µ : Removable – natural tooth

• 8 µ : fixed implant prosthesis

• Force bearable by implant to implant prosthesis is 3µ (nearly 0)









•HOW TO CHECK THE FINAL IMPLANT OCCLUSION?

Dawson PE. Functional occlusion: from TMJ to smile design. Vol.1. St. Louis (MO): Mosby and Co. 2007. p. 347. & 393- 410.

QUERIES ? • T- SCAN• WHAT IS AN IMPLANT?









Robert.B.; Artculating paper mark misconceptions and computerized occlusal analysis technology: a clinical brief.

QUERIES ? • WHAT ARE THE OTHER MEANS OF REDUCING FORCE ON A IMPLANT?

1. Angle of the implant

2. Design of the prosthesis

3. Spacing of implants (A-P spread)

4. Splinting of the implants

5. Staggering of implants

6. Number of implants











1 2

3 4

Stewart’s , Clinical Removable Partial Prosthodontics 3rd ed

QUERIES ? • CLINICAL SITUATIONS (single tooth)• WHAT IS AN IMPLANT?









GROUP FUNCTION

Shantanu Jambhekar;Occlusion and Occlusal Considerations in Implantology; INDIAN JOURNAL OF DENTAL ADVANCEMENTS 2(1), 2010.

QUERIES ? • CLINICAL SITUATIONS ( KD class 1)• WHAT IS AN IMPLANT?









MUTUALLY PROTECTEDGROUP FUNCTION (WHEN ANTERIORS ARE PERIODONTALY COMPROMISED)


QUERIES ? • CLINICAL SITUATIONS ( KD class 2) • WHAT IS AN IMPLANT?









MUTUALLY PROTECTEDCANINE PROTECTED GROUP FUNCTION (WHEN ANTERIORS ARE PERIODONTALY COMPROMISED)











GROUP FUNCTION


QUERIES ? • CLINICAL SITUATIONS

(implant supported fixed prosthesis opposing natural dentition)










GROUP FUNCTION (OR)MUTUALLY PROTECTEDWITH SHALLOW ANTERIOR GUIDANCE



(implant supported fixed prosthesis opposing complete denture)










BILATERAL BALANCED OCCLUSION



(implant supported overdenture for normal ridge)










BILATERAL BALANCED LINGUALIZED OCCLUSION



(implant supported overdenture for severely resorbed ridge)









•HOW TO CHECK THE FINAL IMPLANT OCCLUSION? MONOPLANE OCCLUSION


QUERIES ? SUMMARY• WHAT IS AN IMPLANT?• WHAT IS SO DIFFERENT BETWEEN IMPLANT

AND NATURAL TEETH?• WHAT ARE THE DIFFERENT FORCES ACTING

ON AN IMPLANT?• HOW SPLINTING HELPS REDUSE FORCE?• WHAT IS SO IMPORTANT ABOUT

OCCLUSION?• WHAT ARE THE DIFFERENT TYPE OF

OCCLUSION?• IMPORTANCE OF THE OCCLUSAL TABLE?• WHAT IS THE MATERIAL OF CHOICE FOR

OCCLUSAL TABLE?• HOW TO CHECK THE FINAL IMPLANT

OCCLUSION?










PREVENT THIS !!!

REFERENCES1. H T Shillingburg, Fundamentals of Fixed Prosthodontics, 3rd

edition; Fundamentals of occlusion, Pp 11-242. Dawson PE ,Evaluation ,Diagnosis and Treatment of

Occlusal Problems :A textbook of Occlusion. 2 nd Edition St.Louis,C V Mosby Co. 1978. pp274-297

3. Carl. E. Mish; contemprory implant dentistry,3rd ed.4. Mc Neill; science and practice of occlusion;2nd ed. 5. Stewart’s , Clinical Removable Partial Prosthodontics 3rd ed6. Shantanu Jambhekar;Occlusion and Occlusal

Considerations in Implantology; INDIAN JOURNAL OF DENTAL ADVANCEMENTS 2(1), 2010.

7. MD Gross; Occlusion in implant dentistry. A review of the literature of prosthetic determinants and current concepts; Australian Dental Journal 2008; 53:(1 Suppl): S60–S68.

REFERENCES

7. Yongsik Kim; Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale; Clin. Oral Impl. Res. 16, 2005; 26–35.

8. YU-YING CHEN; Implant occlusion: biomechanical considerations for implant-supported prostheses; J Dent Sci2008¡EVol 3¡ENo 2.

9. Misch CE, Bides MW. Implant-protected occlusion. Int J Dent Symp, 2: 32-37, 1994.

10. Torsten Jemt; Group function or canine protection; J Prosthet Dent 2004;91:403-8.

11. Michael J. Racich; Implants & Occlusion: Observations & Their Clinical Significance; The Journal of Implant & Advanced Clinical Dentistry Vol. 3, No. 2 • February 2011.

REFERENCES12. Byoung-Sup Sohn; Strain of implants depending on

occlusion types in mandibular implant-supported fixed prostheses; J Adv Prosthodont 2011;3:1-9.

13. PJ Henry; Immediate loading of dental implants; Australian Dental Journal 2008; 53:(1 Suppl): S69–S81.

14. Steven Kendrick; Vertical and Horizontal Dimensions of Implant Dentistry: Numbers Every Dentist Should Know; INSIDE DENTISTRY—JULY/AUGUST 2009.

15. James A. Ward; Immediate Loading of Dental Implants; Chapter 21; 340pg – 454pg.

16. Jim Collis CDT; Lingualized Occlusion Simplifying the Set-up Enhancing Function and Esthetics.

REFERENCES

17. Klineberg; Osseoperception: Sensory Function and Proprioception; ADR 1999 13: 120

18. H .W. Anselm Wiskott; Rationale for a simplified occlusal design in restorative dentistry; historical review and clinical guidelines; J Prosthet Dent 1995;73:169-83.

19. Thomas ; Evidence based considerations for removable prosthodontics and dental implant occlusion ; review; J Prosthet Dent 2005;94:555-60.

20. Weinberg; A comparision of imlant/prosthesis loading with four clinical variables; Int J prosthodont 1995;8;421-433.

21. Jamie; The influence of occlusal design on simulated masticatoryforces transferred to implant-retained prostheses and supporting bone; J Prosthet Dent 1996;76:50-5.

22. Rodney;Lingualized occlusion revisited; J Prosthet Dent 2010;104:342-46.

REFERENCES

23. Clark; Toward an understanding of implant occlusion and stain adaptive bone modeling and remounting; J Prosthet Dent 1999;81:553-61.

24. Mohamed Moataz; A comparison of the effect of different occlusal form in mandibular implant overdentures; J Prosthet Dent 1998;79:422-9.

25. Tong-mei; Effect of prosthesis materials and prosthesis splinting on peri-implant bone stress around implant in poor-quality bone;Int J Oral Maxillofac Implants 2002;17;231-37.

26. Deniel; Factors to consider in selecting an occlusal concept for patients with implants in the edentulous mandible; J Prosthet Dent1995;74:308-4.

REFERENCES

27. Davies; what is occlusion; 8 volumes; British dental journal,2001 vol 191;235-659.

28. Ali M. El-Sheikh; Passive tactile sensibility in edentulous subjects treated with dental implants: A pilot study; J Prosthet Dent 2004;91:26-32.

implant occlusion final ppt

Documents

contemprory implant dentistry

canine protected occlusion

mutually protected

occlusal problems

edition st

natural teeth

3rd ed

forces acting