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Clinical and technical aspects of implant-supported restorations in the edentulous maxilla: the fixed partial denture design.

PURPOSE: The aim of the present article was to describe the treatment planning for an implant-supported maxillary fixed prosthesis and the clinical procedure involved, including the laboratory fabrication sequence. MATERIALS AND METHODS: If patients request a fixed prosthesis to restore the edentulous maxilla, it is essential to decide as soon as possible whether this prosthesis design can satisfy the requirements of esthetics, phonetics, comfort, and function. Thus, the crucial clinical factors need to be checked during examination. Furthermore, the relationships between ideal implant angulation, available bone, and intended crown should be assessed using reformatted computed tomography. RESULTS: In patients with minimal bone resorption and limited intermaxillary space, implants can usually be placed in the prosthetically driven implant position for a fixed prosthesis. To evaluate and optimize esthetics, biology, and function, a fixed provisional restoration should be inserted for a 6-month diagnostic period. The ideal provisional then serves as a guide for the final restoration. CONCLUSION: If clinical and radiologic diagnostics indicate that an implant-supported fixed complete denture is feasible, meticulous presurgical planning, precise execution of implant positioning, and a progressive prosthetic treatment sequence are required. The ceramometal fixed implant-supported restoration can then be established in an ideally prepared and matured oral environment.

Dental Prosthesis, Implant-Supported↗
PubMedDate not supplied

Influence of reinforcement design on the loss of marginal seal of provisional fixed partial dentures.

Loss of marginal cement seal, initial fracture, and stiffness of three four-unit provisional restorations were tested. Loss of marginal cement seal was monitored using strain gauges located occlusogingivally at the distal of the second molar abutment and the mesial of the first premolar abutment of a four-unit posterior fixed provisional restoration with two pontics. The provisional restorations were then placed in an Instron testing machine and loaded to initial fracture. Stiffness was calculated from the Instron recordings. The provisional designs were permachrome band-reinforced, wire-reinforced, and a nonreinforced control. Analysis showed: (1) the band-reinforced design withstood a significantly greater load before loss of cement seal (P< or =.05); (2) the band-reinforced design had a significantly higher stiffness (P< or =.05); and (3) there was no difference between the three designs for load at initial fracture. Within the same sample it was found that for both band- and wire-reinforced designs the premolar abutment lost the marginal cement seal at a significantly lower load than the molar (P< or =.05). For the control there was no significant difference for load at marginal cement seal loss between abutments.

Acrylic Resins↗