Different types of implant prostheses
Different types of implant prostheses
Prosthetic restoration is the ultimate goal of implant treatment.
The aim is to restore function and an aesthetic result compatible with the patient’s expectations.
Communication between the different players in the treatment is essential to achieve the desired goal.
This is why it is essential to know what type of prosthesis the implant-supported restoration will be oriented towards.
The treating team must be able to choose the most suitable prosthetic option from those technically available. It is therefore necessary to know the advantages and disadvantages.
Connection mode
In tooth-supported prosthetics, the prosthesis fixation system is mainly represented by fixation using cement.
In implant prosthetics, the different implant systems provide us with a whole range of connections that allow us to disassemble them on the one hand, and to resolve extreme cases on the other.
Screwed prosthesis
Restoration screwed onto the intermediate elements (abutments), themselves screwed onto the implants. Single or multiple.
Benefits
Easy disassembly.
Connections using machined pillars.
Lack of sealing cement.
Disadvantages
Altered, weakened occlusal morphology.
Screw loosening and fracture.
Difficult passivity control.
Screwing accuracy (lab).
Temporary prosthesis – usual.
Sealed Prosthesis
Restoration sealed on intermediate elements (false stumps), themselves screwed onto the implants.
Benefits
Passive adaptation of the armature.
Resistance to unscrewing and fracture.
Usual lab technique.
Simple temporary prosthesis.
Disadvantages
Difficulty of removal (unit).
Risk of overflow of the sealing cement subgingivally.
Different types of prostheses
The different prostheses will be discussed according to the type of tooth loss.
Single prosthesis
Previously, the crown could be screwed directly onto the implant or cemented onto an abutment (standardized or individualized).
-Screwed: all ceramic or ceramic-metal.
-Sealed.
Later
Plural prosthesis
The problem of the posterior sectors is simpler than the anterior sector where aesthetics plays a predominant role.
– SCREW-RETAINED PROSTHESIS ON ABUTMENTS:
The most used abutment is the MUA abutment (multi-unit abutment).
The choice is made based on two criteria:
The sinking of the implant and its axis.
– PROSTHESIS SCREWED ON THE IMPLANT NECK:
To reduce the number of rooms and floors in the reconstruction.
The fewer parts there are, the less risk there is of unscrewing or breaking.
When the implant axes are compatible with the prosthetic axes, the implants are not very buried.
– SEALED PLURAL PROSTHESIS:
The cemented prosthesis on abutments is indicated when the implant axes are not compatible with occlusal emergence or for reasons specific to the practitioner’s beliefs.
– PROSTHETIC TOOTH-IMPLANT CONNECTION:
Subject of controversy because the physiological mobility of the tooth contrasts with the ankylosis of the implant.
5 and 10 year studies show more failures on mixed dento-implant-supported prostheses
After 5 years, success rate 94.1% versus 95%.
After 10 years 77.8% versus 86.7% (Lang et al 2004).
It is best not to connect natural and implant abutments.
Total prosthesis
The most recent advances in the treatment of total edentulism do not concern the prosthetic arsenal, which has increased only slightly.
On the other hand, the introduction of computers has made it possible to develop safer and more precise methods, such as CAD/CAM.
Prosthetic options are divided into 3 main families:
Implant-supported full bridge.
Hybrid prosthesis on stilts.
Complete supra-implant removable prosthesis (PACSI).
They depend mainly on the state of bone resorption of the arch considered.
Temporary prosthesis
Temporization according to the type of edentulism:
UNITARY
- Fixed by bonded bridge.
- Removable.
PLURAL
- dento or implant-supported.
- Removable.
TOTAL
- Fixed, immediate loading protocol.
- Removable
Conclusion
The implant is one solution among other prosthetic solutions with advantages and disadvantages. It is up to the practitioner, during their individual discussion with their patient, to define and propose the solution best suited to the specific case of edentulism.
The implant is one solution among other prosthetic solutions with advantages and disadvantages. It is up to the practitioner during his individual discussion with his patient to define and propose the solution best suited to the particular case of edentulism .
Different types of implant prostheses
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