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Loma Linda University Implant Dentistry USE OF DIGITAL DENTURES IN IMMEDIATE OCCLUSAL FUNCTIONAL LOADING OF DENTAL IMPLATS ANTOANELA GARBACEA, DDS, MSD.

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Presentation on theme: "Loma Linda University Implant Dentistry USE OF DIGITAL DENTURES IN IMMEDIATE OCCLUSAL FUNCTIONAL LOADING OF DENTAL IMPLATS ANTOANELA GARBACEA, DDS, MSD."— Presentation transcript:

1 Loma Linda University Implant Dentistry USE OF DIGITAL DENTURES IN IMMEDIATE OCCLUSAL FUNCTIONAL LOADING OF DENTAL IMPLATS ANTOANELA GARBACEA, DDS, MSD

2 Loma Linda University Implant Dentistry Outline DIGITAL DENTURES VS. CONVENTIONAL COMPLETE DENTURES GUIDED SURGERY FOR IMPLANT PLACEMENT IMMEDIATE LOADING AND DENTURE CONVERSION USING CAD/CAM MILLED DENTURES

3 Loma Linda University Implant Dentistry Outline 1. INTRODUCTION 2. TECHNIQUE DESCRIPTION 3. PATIENT TREATMENT SEQUENCE 4. ADVANTAGES 5. CONCLUSIONS

4 Loma Linda University Implant Dentistry Immediate Loading Consensus Immediate/early loading of dental implants: A report from the Sociedad Espanola de Implantes World Congress consensus meeting in Barcelona, Spain, Aparicio C, Rangert B, Sennerby L. Clin Implant Dent Relat Res. 2003;5(1):57-60.

5 Loma Linda University Implant Dentistry immediate ‘non-occluding’ loading Immediate ‘occlusal’ loading

6 Loma Linda University Implant Dentistry Acrylic provisional restorations comprising any sort of metal reinforcement Tarnow et al. 1997; Horiuchi et al. 2000; Chow et al. 2001; Ganeles et al. 2001; Grunder 2001; Malo´ et al. 2003a, 2003b; Nikellis et al. 2004; Testori et al. 2004; Degidi et al.2006a, 2006b

7 Loma Linda University Implant Dentistry Entirely acrylic, metal-free restorations can be considered as an alternative Schnitman et al. 1990; Cooper et al. 2002; Kammeyer et al. 2002; Becker et al. 2003; Chee & Jivraj 2003; Wolfinger et al. 2003; Misch 2004; Balshi et al. 2005; Malo´ et al. 2006

8 Loma Linda University Implant Dentistry Technique Description Goodacre et al 2011, 2012

9 Loma Linda University Implant Dentistry AvaDent™ Digital Dentures It is a system by which impressions, interocclusal records, and tooth selection can be completed in one appointment and the dentures fabricated using CAD/CAM technology.

10 Loma Linda University Implant Dentistry 1. Maxillary and mandibular impressions using Avadent system. 2.Fabrication of Avadent Digital Dentures. 3.Fiduciary markers in the Avadent already milled dentures as required by the Nobel Guide Clinician protocol. 4. Dual CBCT Scan. Avadent Digital Dentures and Patient wearing dentures. Technique Description

11 Loma Linda University Implant Dentistry 5. Virtual Implant Treatment Plan using Nobel Clinician Software. 6. Fabrication of the Nobel Clinician surgical guide. 7. Guided Surgery 8. Immediate Loading of Implants using Avadent Digital Dentures as provisional prosthesis. Technique Description

12 Loma Linda University Implant Dentistry Treatment Sequence

13 Existing Complete Dentures

14 Loma Linda University Implant Dentistry Poly (vinyl siloxane) casts made by pressing putty into existing dentures

15 Loma Linda University Implant Dentistry Immerse AvaDent tray in 160° F waterPress softened tray onto PVS cast

16 Loma Linda University Implant Dentistry Border molding with areas of tray showing through the impression material, indicating they need to be relieved before making wash impression

17 Loma Linda University Implant Dentistry Final maxillary and mandibular impressions

18 Loma Linda University Implant Dentistry Anatomical Measuring Device used to adjust and hold OVD, serve as a gothic arch tracing device, and also provide upper lip support adjustment Brass gothic arch tracing pin is adjustable using the side hex screw.

19 Loma Linda University Implant Dentistry The maxillary lip support can be adjusted using the anterior hex screw

20 Loma Linda University Implant Dentistry Three different sizes of clear plastic overlays are available to help identify the best size of the teeth

21 Loma Linda University Implant Dentistry Adhesive and registration material applied to maxillary and mandibular AMD Completion of a gothic arch tracing

22 Loma Linda University Implant Dentistry An Occlusal Plane Orientation Ruler is Provided To Align The Occlusal Plane With The Interpupillary Line

23 Loma Linda University Implant Dentistry Use the ruler to seat the maxillary AMD so it is aligned with the interpupillary line

24 Loma Linda University Implant Dentistry The mandible is moved so the brass pin engages the dimple and holds that position while the registration material is expressed between the AMDs

25 Loma Linda University Implant Dentistry Laser scanning of the AMD impression Superimposing the laser scan of the AMD on the scan of the complete arch impression

26 Loma Linda University Implant Dentistry Locating the Borders Setting the teeth and forming the bases

27 Loma Linda University Implant Dentistry Virtual tooth arrangement Denture base morphology established

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30 Loma Linda University Implant Dentistry ATI (Advanced Try-In) Wax Trial Denture

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36 Loma Linda University Implant Dentistry Nobel Clinician: virtual planning of the diameters and lengths of the implants and stabilizing pins the to be placed in the mandible.

37 Loma Linda University Implant Dentistry 35º thread shape Double lead threads Tapered TiUnite surface

38 Loma Linda University Implant Dentistry Fabrication of the Nobel Clinician surgical guide.

39 Loma Linda University Implant Dentistry Laboratory steps in fabrication of the mandibular cast

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43 Loma Linda University Implant Dentistry The digital denture conversion as mandibular implant provisional screw- retained prosthesis.

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45 Loma Linda University Implant Dentistry Prototype converted denture for immediate loading

46 Loma Linda University Implant Dentistry Advantages

47 Loma Linda University Implant Dentistry It is possible to record all the clinical information for complete dentures in one appointment (1-2 hours) and have the dentures ready for the second appointment. Less clinical chair time provides the opportunity for a more cost-effective set of appropriately accurate complete dentures.

48 Loma Linda University Implant Dentistry There is a repository of digital data that allows for more rapid fabrication of a replacement or spare denture The denture base fit is superior to that of conventionally processed bases Research indicates some favorable properties of the PRE-polymerized resin

49 Loma Linda University Implant Dentistry Conclusions

50 Loma Linda University Implant Dentistry Thank you


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