CNUH , OMFS
Medical consultation
Treatment plan
: Minimial pain, cost, treatment period
Simpler operation
Long-term successful, simpler implant prostheses
CNUH , OMFS
Radiographic Examination
Panorama, Lateral cephalo, CT taking
Pathology
Anatomical structure
: Mx. Sinus, mandibular canal, etc.
CNUH , OMFS
Diagnostic Cast
Jaw relation
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CNUH , OMFS
Anatomical conditions
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CNUH , OMFS
Jaw Relation
Cl II
Cl I
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CNUH , OMFS
CNUH , OMFS
Post-op 2 yrs
CNUH , OMFS
04.6.12.
06.9.7.
Post-op 2 yrs
CNUH , OMFS
Interarch Space
Biomechnics
Esthetics
Funtions : mastication, phonation
Prosthetic plan
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Biomechanic Considerations
Crown/implant ratio
Cantilever
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Prosthetic Plan
Function
Biomechanics
General, local condition
Cost
Surgical skill, etc.
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Overdenture
Cantilever
Leverage
Attachment,
etc.
Arch shape
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Mental Foramen
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Overdenture
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Temporary implant
2 , 4
ball type & short head for overdenture
Temporary denture ( )
Temporary fixed bridge
Soft diet (about 6wks)
If osseointegration
Temporary implant
Intraoperative photographs
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Temporary implant
Temporary implant & overdenture
Preop
Postop +1mo
CNUH , OMFS
CNUH , OMFS
Osteoporosis
Fatty marrow
Loose trabecula
#36
#36
#36
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Osseointegration
in Poor Bone Quality
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Control
RBM
HA
SLA
Mean
SD
Minimum
Maximum
16
10
8
6
75.9
87.1*
95.4**
86.0*
11.9
5.3
2.9
3.5
69.5
83.3
93.0
82.4
82.2
91.0
97.8
89.7
Control
RBM
HA
SLA
Mean
8
8
6
8
29.6
36.7
76.1**
45.1
SD
Minimum
Maximum
5.4
10.3
15.0
15.0
25.1
28.0
60.4
32.5
34.1
45.3
91.8
57.6
CNUH , OMFS
Minimal drilling
Use of osteotome
Implants
: Wide & long diameter
Rough surface
Threaded, self-tapping implant
Number of implant
Bone (PMCB) graft
Longer healing period
CNUH , OMFS
CNUH , OMFS
Nasal cavity
Maxillary sinus
Incisive foramen
Greater palatine foramen
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Radiographs progression
Pre-op
Post-op 4mo
Post-op
CNUH , OMFS
CNUH , OMFS
Split-Crest Technique
Intraoperative photographs
: Split-crest tech. with Mx tuberosity bone graft
Radiographs progression
Pre-op
Post-op
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CNUH , OMFS
Post-op 5mon
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Preop
Postoperative Radiographs
CNUH , OMFS
CNUH , OMFS
Methods
Timing of installation
> 9 mm
OSFE (0-2mm)
Simultaneous
9 ~ 7 mm
BAOSFE (2-4mm)
Simultaneous
7 ~ 3 (5) mm
Simultaneous
< 3 (5) mm
Indication
CNUH , OMFS
2005.8.5.
Implant installation on #32i-37i,42i-47i
Temporary implant (4X) installation
CNUH , OMFS
CNUH , OMFS
CNUH , OMFS
CNUH , OMFS
CNUH , OMFS
Post-op 5mo
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CNUH , OMFS
Post-op 1.5 yrs
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Mental nerve
Inferior alveolar nerve
Atrophic ridge
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#35i
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CNUH , OMFS
Osteoplasty
Pt: La 0 0 (71/F)
Imp: Full edentulous state on both jaws
HxPi: 04. 6.17. Implant on #32i,33i,42i,43i
for bar-retained overdenture
04. 11.2. 2nd Surg.
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Osteoplasty
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Osteoplasty
Post-op 2 yrs
CNUH , OMFS
CNUH , OMFS
CNUH , OMFS
CNUH , OMFS
Implant prosthesis
CNUH , OMFS
Pre-op
Post-op 1.5
yr
CNUH , OMFS
Summary
In the edentulous patients,
1. Many factors, such as jaw relation, inter-arch space, remaining bone,
anatomical structures, soft tissue and so on, should be considered.
2. In old patients, general condition is primarily considered.
The simple and safe implantation techniques are usually recommended.
3. In the anterior region, the esthetic is primarily considered.
4. In the posterior region, the biomechanics is primarily considered.
CNUH , OMFS