implant occlusion inside periodontology.ppt

Implant quality scale and Implant Failure

1. OCCLUSION IN IMPLANTS
IMPLANT QUALITY SCALE AND
IMPLANT FAILURE

2. IDEAL POSITION OF IMPLANTS IN RELATION TO OPPOSING TEETH(1)
OCCLUSION FOR FULL ARCH IMPLANT SUPPORTED PROSTHESIS(2)
OCCLUSION FOR RP4 AND RP5(2)
IMPLANT PROTECTED OCCLUSION

3. OCCLUSION
-Long time survival of implants

4. •Increases magnitude of load
•Intensifies mechanical stresses
•Increases complications
Poor occlusal scheme

5. Consequences of Biomechanical Overload
•Early implant failure
•Early crestalbone loss
•Intermediate to late implant bone loss
•Screw loosening ( abutment and prosthesis coping )
•Uncementedrestoration
•Component fracture
•Porcelain fracture
•Prosthesis fracture
•Periimplantdisease ( from bone loss )

6. Implant Protected Occlusion ( IPO )
-LINGUALIZEDOCCLUSION:
DECREASED STRESSTOIMPLANTINTERFACE:
~ Avoid prematurities
TOOTH IMPLANT
Forcefrom crest towards
apex
X
Reversible Bone loss
28 micrometers 5 micrometers
proprioception Slow and dull
Nearlythe same Modulus of elasticity (5 –10)
times of bone

7. Timing of occlusal contacts ( No Prematurities)
Light occlusal forces –Teeth will have greater contact
Implant will have light contact
Heavy occlusal forces –Same for tooth and implants

8. Influence of I-S area
•Increase number of implants
•Splint the implants
•Para function –FP1 -3; RP4-5
•Posteriorlywider implants

9. Mutually protected articulation
•Canine
•Anterior implants –shallow IG

10. Angle to occlusal load
Same magnitude –IBS
Long axis
Increase compressive stress
Angled implant
Angled load –Biomechanical risks
( more shear stress )

11. Cusp angle of crowns
•Flat surface
•Central fossa
No sharp cusps.
Contact should
be at the central
fossa

12. Cantilever distances
No lateral loads

13. Crown Height
INCREASEHEIGHT–VERTICALCANTILEVERESPECIALLY
ANGLEDAB/ ANGLEDLOADS

14. Crown Contour
•Narrow occlusal table
•Reduced buccalcontour –Axial loading

15. Protection of the weakest component
Max CD
MandCD (REMOVABLE) -BBO
Max CD
FP1/FP2/FP3
-BBO
-Elimination of anterior contacts
Fixed –natural
FP1-FP3 ( FIXED) -Elimination of posterior contact
-MPO
Single Tooth Implant FPD -IPO
Implant –teeth

16. Occlusal material of implant crowns
Anterior –ceramic
Posterior -metal
PORCELAIN GOLD RESIN
ESTHETICS + - +
IMPACT
FORCE
- + +
STATIC LOAD + + +
CHEWING
EFFICIENCY
+ + -
FRACTURE - + -
WEAR + + -
INTERARCH
SPACE
- + -
ACCURACY - + -

17. Occlusal contact positions
•Primary contact –central fossa
•Secondary contact –marginal ridge ( splinted )

18. IMPLANT PROTECTED OCCLUSION
•No premature occlusal contacts or interferences : timing of
occlusal contacts
•Influence of surface area
•Mutually protected articulation
•Implant body angle to occlusal load
•Cusp angle of crowns ( cuspalinclination )
•Cantilever or offset distance ( horizontal offset )
•Crown height ( vertical offset )
•Occlusal contact positions
•Implant crown contour
•Protect the weakest component
•Occlusalmaterials

19. IMPLANT QUALITY SCALE
5 GROUPS
GROUP 1 AND 2
GROUP 3
GROUP 4 AND 5 ( each 1 mark)

20. IMPLANT QUALITY SCALE

21. IMPLANT QUALITY SCALE

22. IMPLANT FAILURES
DEMOGRAPHY (1)
CAUSES(2)
MANAGEMENT(2)

23. IMPLANT SUCCESS RATE --DEMOGRAPHY

24. IMPLANT FAILURE --CAUSES
TYPE TIME CAUSES
SURGICAL FAILURE STAGE I SURGERY SURGICAL COMPLICATION
OSSEOUSHEALING FAILUREHEALING PHASETO STAGE IITRAUMA(HEAT –
SURGERY),MICRO
MOTION,INFECTION
EARLY LOADING FAILURE FIRST YEAR PROSTHETIC
LOADING( TRANSITIONAL
PROSTHESIS)
OVERLOAD/ BACTERIA
INTERMEDIATE LOADING YEAR 1UNTIL YEAR 5 IN
FUNCTION
OVERLOAD/BACTERIA
LATE FAILURE YEAR 5 UNTIL YEAR 10 IN
FUNCTION

25. IMPLANT FAILURE --SIGNS
•Horizontalmobilitybeyond0.5mm
•Rapidprogressiveboneloss
•Painduringpercussionorfunction
•Continueduncontrolledexudate
•Generalizedradiolucencyaroundanimplant
•Morethanonehalfofthesurroundingbonelostaroundanimplant
.

26. AILING AND FAILING --MANAGENENT
ACTIVE INFECTION WITH BONE LOSS NO ACTIVE INFECTION WITHOUT
RESORPTION
Degranulation with curette
Ultrasonic toremove hydroxy
appetite
Detoxification withcitric acid
40%
Bone grafts
GTR
out of function 10-12 weeks
metalliccurette
Detoxify with citric acid
Irrigate with water
Grafting and GTR