RESUMO
Restorative considerations are critical to the long-term success of fixed implant-supported prostheses, especially in the posterior quadrants of the partially edentulous patient. The parafunctional habit of bruxism must be identified and addressed. The restoration should dictate implant placement. Control of forces directed upon the prosthesis and implants is critical to long-term success. Anatomic limitations to implant placement and surgical procedures to correct these deficiencies must be considered for their impact on the prosthetic restoration. Nonaxial forces or bending moments should be minimized by the use of an adequate number, position and alignment of implants; by control of the occlusion; and by design of the prosthesis. The patient must understand the risks, limitations, costs and time commitments of implant restorations prior to treatment.
Assuntos
Implantação Dentária Endóssea , Arcada Parcialmente Edêntula/reabilitação , Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais , Implantes Dentários , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Humanos , Arcada Parcialmente Edêntula/cirurgia , Nervo Mandibular/cirurgia , Planejamento de Assistência ao PacienteRESUMO
Restoration of the edentulous maxilla with implant retained and supported prosthesis is challenging because of inherent anatomic limitations present after the loss of teeth. A fixed-removable prosthesis is one treatment choice for restoration of the edentulous maxilla with implants. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favorable biomechanical stress distribution to the implants. This article presents a procedure for fabrication of a fixed-removable prosthesis with a precision milled bar, Hader clip attachments, and a superstructure prosthesis. The criteria for patient selection and the advantages and disadvantages of this prosthesis are discussed.
Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Planejamento de Dentadura , Encaixe de Precisão de Dentadura , Retenção de Dentadura , Prótese Total Superior , Arcada Edêntula/reabilitação , Maxila , Relação Central , Ligas Dentárias , Bases de Dentadura , Revestimento de Dentadura , Estética Dentária , Humanos , Arcada Edêntula/patologia , Arcada Edêntula/cirurgia , Maxila/patologia , Maxila/cirurgia , Higiene Bucal , Procedimentos Cirúrgicos Pré-Protéticos Bucais , Satisfação do Paciente , Seleção de Pacientes , Fala , Estresse Mecânico , Dimensão VerticalRESUMO
Restorative considerations are critical to the long-term success of fixed implant-supported prostheses, especially in the posterior quadrants of the partially edentulous patient. The parafunctional habit of bruxism must be identified and addressed. The restoration should dictate implant placement. Control of forces directed upon the prosthesis and implants is critical to long-term success. Anatomic limitations to implant placement and surgical procedures to correct these deficiencies must be considered for their impact on the prosthetic restoration. Nonaxial forces or bending moments should be minimized by the use of an adequate number, position and alignment of implants; by control of the occlusion; and by design of the prosthesis. The patient must understand the risks, limitations, costs and time commitments of implant restorations prior to treatment.