The Portal dedicated to Prosthodontics

by Stefano Gracis

Main Office

Via Brera, 28/A – Milano – Italia

Fixed Prosthodontics Milan Style – Module 5

Implants: from the single tooth to the full arch

  • How many implants should be inserted if all the posterior teeth are missing from a sextant?
  • Does length of the implants influence the decision? And diameter?
  • Are the internal connections really better than the external ones and can they all be considered equal?
  • How is the occlusal scheme different for an implant-supported prosthesis compared to a prosthesis supported by natural teeth?
Topics

BIOMECHANICAL AND OCCLUSAL CONSIDERATIONS IN THE FABRICATION OF IMPLANT PROSTHESES

This presentation analyzes some aspects of the planning and fabrication of an implant prostheses that may have a role in the longevity of the treatment. There are biomechanical variables, such as the number and distribution of the implants, implant length, whether adjacent implants should be splinted or not, when cantilevers are acceptable and how long can they be.

And, then, there are occlusal variables such as the width of the occlusal table, occlusal morphology, occlusal schemes for partially and for fully edentulous patients, the role of the antagonist dentition (full denture vs. natural dentition or implant “dentition”), and the response to dynamic and static forces.

These topics will be discussed from a clinical standpoint with the aim of giving the participant practical guidelines. At the same time, references to the published literature will be made in order to draw conclusions that may be also as reliable as possible.

IMPLANT POSITIONING IN THE ESTHETIC AREA: THE PROSTHETIC POINT OF VIEW 

The possibility to create an esthetic implant prosthesis depends on the availability of a sufficient volume of hard and soft tissues and on the correct positioning of the implant.

This part of the program will analyze the consequences on the appearance of the prosthesis and on soft tissue stability of the 3-dimensional implant placement.

Through the description of different clinical cases, the speaker will stress the importance of proper pre-surgical planning and, in those cases where this was not done, demonstrate the possible solutions and the limits that the prosthodontist faces when fabricating implant restorations in case of compromises in the mesio-distal, bucco-lingual and apico-coronal positioning.

IMPLANT CONNECTIONS: WHICH FEATURES FOR THE PROSTHODONTIST? 

Are internal connections better than external ones from the point of view of screw retention and stability and, if so, do all internal connections behave in the same manner?

Is there evidence that abutment or reconstruction micromovement and abutment connection/disconnection have any influence on bone and soft tissue stability?

Is there a difference in reliability (screw retention and fracture resistance) between metal and zirconia implant abutments/reconstructions?

Does abutment or reconstruction material have any influence on tissue stability?

These questions will be addressed not only from a scientific point of view, but also from a clinically relevant perspective in order to provide the participants with applicable recommendations.

REMOVABLE PROSTHETIC SOLUTIONS ON IMPLANTS

Implants have radically changed the treatment of partially and totally edentulous arches and have significantly improved the quality of life of patients who have lost many or even all of their teeth. On what basis do we decide whether the most suitable solution for these patients with extensive tooth and bone loss is fixed or removable?

How can we recognise the degree of resorption that determines the type of prosthesis even before the patient starts treatment? Too often, we focus on fixed implant solutions without thinking about the difficulties that many patients encounter in keeping these prostheses clean or about the need to support lips and cheeks when the volume of lost tissues is high.

FIXED PROSTHETIC SOLUTIONS ON IMPLANTS

It is important that the clinician has an in-depth knowledge and understanding of the components, materials and prosthetic solutions to be adopted in the complex situations that may arise.

The following topics will be discussed: cement vs screw-retention for implant prostheses; analog vs digital workflows; one abutment, one time protocol vs multiple disconnection protocols; connecting implants and teeth vs leaving them separate.

The advantages provided by the use of intraoral scanners will be illustrated.

Course Objectives

AT THE END OF THE COURSE, THE PARTECIPANTS WILL HAVE LEARNED

BIOMECHANICAL AND OCCLUSAL CONSIDERATIONS

  • The factors that influence the decision of the number of implants to be inserted in the different clinical situations
  • The criteria for determining whether adjacent implants must be joined or can be left separated
  • The occlusal concepts applied to the prosthesis on implants: the occlusal schemes, from the single tooth to the totally edentulous arch

IMPLANT POSITIONING IN THE ESTHETIC AREA: THE PROSTHETIC POINT OF VIEW

  • The importance of proper pre-surgical planning
  • The possible prosthetic solutions when an implant has been placed with a less than ideal 3-D position

IMPLANT CONNECTIONS: EXTERNAL VS INTERNAL

  • The differences in stability and retention of the various implant-abutment connections and materials employed
  • The role of micromotion and repeated disconnections on the stability of peri-implant tissues
  • The clinical significance of preloading

REMOVABLE PROSTHESES ON IMPLANTS

  • How to recognize if a patient with a fully edentulous arch is a candidate for a fixed or removable implant prostheses
  • The range of removable and fixed prosthetic solutions
  • The role of new technologies in the simplification of clinical and technical procedures
  • The choice of the transmucosal abutment for the different solutions
  • The operational protocols and the materials used

FIXED PROSTHESES ON IMPLANTS

The choice of implant abutments and protocols for their use

The indications and limits of prefabricated components and of those custom-made

The indications, advantages and disadvantages of screw and/or cement-retained prosthetic solutions

If teeth and implants can be joined and, if so, how

How intraoral digital impressions and CAD-CAM has changed the way we work

Program of this module

THURSDAY  (9:00 – 18:30)

  • 09:00 – 09:30
    Introduction and presentation of the participants
  • 09:30 – 11:00
    Clinical criteria for the selection of the implant and the importance of a stable implant-abutment connection
  • 11:00 – 11:30
    COFFEE BREAK
  • 11:30 – 13:00
    Biomechanical and occlusal considerations in planning for implant-supported restorations (Part 1)
  • 13:00 – 14:00
    LUNCH
  • 14:00 – 16:00
    Biomechanical and occlusal considerations in planning for implant-supported restorations (Part 2)
  • 16:00 – 16:30
    BREAK
  • 16:30 – 18:30
    The placement of implants in the esthetic area from the prosthodontist’s point of view
  • 19:00
    Welcome reception on the Terrace

FRIDAY (9:00-18:30)

  • 09:00 – 11:00
    The single tooth replacement: traditional and digital workflows preparations
  • 11:00 – 11:30
    COFFEE BREAK
  • 11:30 – 13:00
    Prosthetic rehabilitation on implants: fixed prosthetic solutions
    The methods of fixing the prostheses on implants: from screwing to cementing
    Splinting teeth to implants: can it be done? If so, how?
  • 13:00 – 14:00
    LUNCH
  • 14:00 – 16:00
    The restoration of multiple implants in partially edentulous arches: traditional and digital workflows (Part 1)
  • 16:00 – 16:30
    BREAK
  • 16:30 – 18:30
    The restoration of multiple implants in partially edentulous arches: traditional and digital workflows (Part 2)
  • 20:00
    GROUP DINNER

SATURDAY (9:00-17:00)

  • 09:00 – 11:00
    Prosthetic rehabilitation on implants: removable prosthetic solutions for totally edentulous and partially edentulous arches
  • 11:00 – 11:30
    COFFEE BREAK
  • 11:30 – 13:00
    Prosthetic rehabilitation on implants: fixed prosthetic solutions for totally edentulous arches
  • 13:00 – 14:00
    LUNCH
  • 14:00 – 17:00
    Discussion of clinical cases treated by participants
  • 17:00
    Concluding remarks
Costs
  THIS MODULE  PACKAGES 
Dentist  € 2,950.00 + VAT  € 14,750.00 + VAT for all 6 modules
(instead of € 17,700.00 + VAT, that is you get one module for free) 
Young professional under 30 years old  € 1,950.00 + VAT   
Dental Technician  € 1,250.00 + VAT  € 4,600.00 + VAT for modules 3-6

The fee covers all lunches and coffee breaks for the three days and a group dinner on Friday evening. Hotel accommodation and the other dinners are not covered.

Book Now

Book, without obligation, the module (or modules) of your interest. Our secretariat will contact you as soon as possible to give you all the necessary information.

    MAKE YOUR CLINICIAN-DENTAL TECHNICIAN TEAM GROW 

    In this module, the topics discussed pertain to both clinicians and dental technicians and it is therefore open to both team members.

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