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1Implant Prosthesis for Fully Edentulous Patients
Part I. Implant Overdenture
SAMSUNG MEDICAL CENTER
DONG HWAN LEE
Donghwan Lee
Donghwan Lee Donghwan Lee
No diagnosis, no treatment.
If you dont know where you go,you never get lost.
Donghwan Lee
Diagnosis & Treatment Planning
Implant Prosthesis
Fully Edentulous Patient
Metal Ceramic
Fixed
Complete Denture
Removable
Metal Resin (Hybrid)
Spark Erosion
Overdenture
Donghwan Lee
Diagnosis & Treatment Planning
Proper lip support for esthetics
Evaluation of missing hard and soft tissue
Vertical dimension
Proper restorative space
Financial constraint
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Diagnosis & Treatment Planning
Proper lip support for esthetics
Evaluation of missing hard and soft tissue
Vertical dimension
Proper restoration space
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Ideal
Ridge Resorption Pattern
Evaluation of Missing Hard & Soft Tissue
Classification of residual ridge form Siebert 1983
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Horizontal Class I
Ridge Resorption Pattern
Evaluation of Missing Hard & Soft Tissue
Classification of residual ridge form Siebert 1983
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Vertical Class II
Ridge Resorption Pattern
Evaluation of Missing Hard & Soft Tissue
Classification of residual ridge form Siebert 1983
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Combined Class III
Ridge Resorption Pattern
Evaluation of Missing Hard & Soft Tissue
Classification of residual ridge form Siebert 1983
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Smile Line
Lip Support
Facial Support
Proper Lip Support for Esthetics
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Proper Lip Support for Esthetics
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Smile Line
Lip Support
Facial Support
Proper Lip Support for Esthetics
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Smile Line
Lip Support
Proper Lip Support for Esthetics
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Diagnosis & Treatment Planning
Proper lip support for esthetics
Evaluation of missing hard and soft tissue
Vertical dimension
Proper restorative space
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Teeth
Resin
Metal
Proper Restorative Space
Metal Ceramic Metal Resin (Hybrid)
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Teeth
Resin
Metal
Metal Ceramic Metal Resin (Hybrid)
> 16 mmTotal
> 1 mmClearance for Hygiene
> 3 mmMetal Framework
> 2 mmDenture Base Resin
> 10 mmTeeth
Proper Restorative Space
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Implant Overdenture Metal Resin (Hybrid)
> 4 mmAttachment
> 20 mmTotal
> 16 mmTotal
> 1 mmClearance for Hygiene
> 3 mmMetal Framework
> 2 mmDenture Base Resin
> 10 mmTeeth
Proper Restorative Space
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Implant Prosthesis
Fully Edentulous Patient
Metal Ceramic
Fixed
Complete Denture
Removable
Metal Resin (Hybrid)
Spark Erosion
Overdenture
Metal Ceramic
Metal Resin
Spark Erosion
Overdenture
More Restorative Space
Proper Restorative Space
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Diagnosis & Treatment Planning
Proper lip support for esthetics
Evaluation of missing hard and soft tissue
Vertical dimension
Proper restorative space
Financial constraint
Donghwan Lee
Types of Restorations by Number of Implants
Implant Overdenture
Conventional Complete Denture
Implant Retained & Supported OD
Implant Retained OD
Metal Ceramic Restorations
Implant Supported Fully Fixed Denture
Metal Resin Restorations
X
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Types of Restorations by Restorative Materials
Implant Overdenture
Implant Retained & Supported OD
Implant Retained OD
Metal Ceramic Restorations
Implant Supported Fully Fixed Denture
Metal Resin Restorations
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Types of Restorations by Mode of Support
Implant Overdenture
Implant Retained & Supported OD
Implant Retained OD
Metal Ceramic Restorations
Implant Supported Fully Fixed Denture
Metal Resin Restorations
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Implant Overdenture
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants9 Selection of attachments9 Complications
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants9 Selection of attachments9 Complications
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Retained vs. Supported IOD
9 Implant Retained Prosthesis Mx. > 2 - 4Mn. > 2
9 Implant Retained & Supported ProsthesisMx. > 6Mn. > 4
Number of Implants for IOD
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Implant Retained Overdenture
Retained vs. Supported IOD
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Implant Retained Overdenture
Implant-retained, tissue-supported overdenture
Retained vs. Supported IOD
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Tissue Supported ???
Retained vs. Supported IOD
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Success Rate of Implant Overdenture
Number of Implants for IOD
9 16% (69/430) of implant fixture failure in Mx. followed for 1 year.Jemt et al., IJOMI 1992
9 75.4% in Mx. & 100% in Mn. of 115 implants for 7yrs.Bergendal et al., IJOMI 1998
9 100% success in single implant overdenture in Mn. Of 21 implants for 7yr.Cordiloi et al., JPD 1997
9 Most Mx. Implant overdenture failure in less than 4 implants.Ekfeldt et al., IJP 1997
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Maxilla
Implant Retained Overdenture minimum 2 implants ??minimum 4 implantsimplants splinted with barsfull palatal coverage
X
?
X
O
Number of Implants for IOD
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Maxilla
Implant Supported Overdenture minimum 4 implantsimplants splinted with barsfull palatal coverage
Implant Supported Overdenture minimum 6 implantsSpark-erosion prosthesisopen palatal coveragehigher restorative fee
Number of Implants for IOD
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Mandible
Implant Retained Overdenture 2 implants with or without bar
Implant Supported Prosthesis 4 to 6 implants
Number of Implants for IOD
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants9 Selection of attachments9 Complications
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants
Arch shapeBetween canine and lateral incisorVertical space for attachmentInter-Implant distanceAngulation between Implants
Position of Implants for IOD
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants
Arch shapeBetween canine and lateral incisorVertical space for attachmentInter-Implant distanceAngulation between Implants *
Position of Implants for IOD
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants9 Selection of attachments
Ball AttachmentsO-ring SystemLocator System
Bar & Clip AttachmentsCM Bar & Rider/Ackermann ClipsDolder Bar SystemHder Bar System/EDS System
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Various Types of Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Bar Type Implant Overdenture
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Locator
Lowest profileEasy solution for divergenceSelf aligningDual retentionLong lasting
Ball Type Implant Overdenture
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Characters of Locator
9 Lowest profile9 Easy solution for divergence9 Self aligning9 Dual retention9 Long lasting
3.17 4.85 5.82 6.14 6.22mm Locator ERA Dal-Ro O-Ring EDS
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Characterss of Locator
9 Lowest profile9 Easy solution for divergence9 Self aligning9 Dual retention9 Long lasting
Ball Type Implant Overdenture
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Characters of Locator
9 Lowest profile9 Easy solution for divergence9 Self aligning9 Dual retention9 Long lasting
Ball Type Implant Overdenture
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Characters of Locator
9Lowest profile9Easy solution for divergence9Self aligning9Dual retention9Long lasting
Ball Type Implant Overdenture
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Characters of Locator
9Lowest profile9Easy solution for divergence9Self aligning9Dual retention9Long lasting
Ball Type Implant Overdenture
0
5
10
15
20
25
30
35
40
45
50
55
60
Locator Stren ERA
Insertion & Extraction Test of Retention Loss
Cycl
es o
f Th
ousa
nds
( Cycles to 0.5 Pounds Retention)
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Locator
Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Solving the Positioning Problems
Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Ball Type Implant Overdenture
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants9 Selection of attachments9 Complications
Gingival hyperplasiaFracture of denture base and clipsSpeech problemExtra post insertion appointmentsEtc
Jemt et al, 1996 IJOMINeart et al., 1991, 1997 JPD
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Gingival Hyperplasia in IOD
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Gingival Hyperplasia in IOD
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Speech Problems in IOD
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Speech Problems in IOD
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Considerations for Implant Overdenture
9 Number of implants9 Position of implants9 Selection of attachments9 Complications
Proper lip support for esthetics
Evaluation of missing hard and soft tissue
Retained vs. Supported
Restorative space + Vertical dimension
Implant Retained Overdenture is Complete Denture ! !
Donghwan Lee
Thanks toDr. Sung-O KimDr. Winston CheeDr. Seung Beum GyeDr. Seung Min YangDr. Jung-Han Choi
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