Classification of implant prosthetics 1 www befrest com

Classification of implant prosthetics 1 www. befrest. com

Concept Objective - To understand each type of implant prosthetic. Goal - To acquire basic knowledge of each type of implant prosthetic. - To look overall implant prosthetics. Key Point - Screw retained restoration. - Cement retained restoration. - Combination type retained restoration. 2 www. befrest. com

Contents 1. FAQ 2. Contents for education I. Classification of implant prosthetics II. Feature of each type of implant prosthetic III. Terminology IV. Quiz 3 3 www. befrest. com

1. FAQ 1. What is a difference between implant prosthetic and prosthetic for natural teeth? ü Root – Fixture ü Prepped tooth – abutment ü Nerve – can’t sense prep 4 www. befrest. com

I. Classification of implant prosthetic 1. Classification based on shape of abutment. 2. Classification based on connection type. 5 www. befrest. com

I. Classification of implant prosthetic 1. Classification Upper structure ü classify by shape of abutment: (Prosthetic) - Screw-combined abutment. Crown - Screw-separated abutment. Abutment Artificial root of tooth (fixture) ü classify by connection type of upper structure: - Screw retained restoration. - Cement retained restoration. www. befrest. com - Combination type restoration. 6

I. Classification of implant prosthetic 2. Classification by shape of abutment (1) Screw-combined Abutment: one body type abutment that body of abutment is combined with screw which connects to fixture. Body screw 7 www. befrest. com

I. Classification of implant prosthetic (2) Screw-separated Abutment: The abutment and the screw are separated in 2 pieces. Body screw 8 www. befrest. com

II. Understanding of implant prosthetic 2. Classification by connection type (1) Screw retained restoration (Screw type): : Connects crown & abutment with screw www. befrest. com Oral Crown + Screw Crown Fixture Loading prosthetic Resin Fill Screw Hole Fill + 9

II. Understanding of implant prosthetic (2) Cement retained restoration (Cement type): www. befrest. com Cement crown with cement material. Oral Crown Fixture + Abutment Crown Loading prosthetic Hole Fill Cementation + Cement 10

II. Understanding of implant prosthetic (3) Combination type restoration (ER type): Screw Cement retained restoration. Crown is cemented to abutment by cement material for fixation and connecting / disconnecting to/from fixture by screw. www. befrest. com Oral Crown Fixture Loading prosthetic Crown Resin Fill Screw Hole Fill + Cementation between ABT and Crown 11

II. Feature of each type of implant prosthetic 1. Screw retained restoration (Screw type) 2. Cement retained restoration (Cement type) 3. Combination retained restoration (Combination type) 12 www. befrest. com

II. Feature of screw-retained implant prosthetic 1. Screw retained restoration Connecting combined crown and abutment to fixture. connecting screw. Filling screw hole with resin. Resin block out. 13 www. befrest. com

II. Feature of screw-retained implant prosthetic ◆ Real Case (Gold. Cast ABT. single) One body type Abutment connects to fixture by screw. Connecting pick-Up type Imp. coping to the fixture Trimming ABT Loading a Crown onto ABT Impression Wax Up Screw tightening Put Lab analog in impression Connecting ABT to stone model Casting Completed prosthetic Screw hole fill 14 www. befrest. com

II. Feature of screw-retained implant prosthetic advantage: • Repair and maintenance are easy due to easy removal. • Inflammation from use of cement does not happen. • Easy to solve prosthetical problems. disadvantage: • Wearing down occlusal surface requires repairing and replacing. • Building aesthetic occlusal surface is complicated due to screw hole on the occlusal. • Requires high technique. • “Passive Fit” is tough in bridge case. • Non-applicable to anterior which requires aesthetic. 15 www. befrest. com

II. Feature of screw-retained implant prosthetic ◆ disadvantage of Screw-retained type prosthetic ü Exposure of Screw hole. Unaesthetic ü block out resin and Porcelain could be damaged. 16 www. befrest. com

II. Feature of each type of implant prosthetic ◆ Line-up of Screw type Abutment Gold. Cast ABT. NP-Cast ABT. Zio. Cera ABT. Convertible ABT. 17 Multi ABT. Multi angled ABT. www. befrest. com

II. Feature of each type of implant prosthetic 2. Cement retained restoration Applying cement to inner surface of crown. Connecting crown to Abutment. Removing residual Cement on the margin of crown. 18 www. befrest. com

II. Feature of cement-retained implant prosthetic ◆ Real Case (Rigid ABT. 3 bridge) www. befrest. com Crown is cemented to abutment by cement material. Connecting ABT to fixture Sticking lab analog to impression material casting Impression Capping Rigid Imp. Coping stone model Capping burn-out cylinder Cementation Completed prosthetic 19 Impression material Wax Up Cement crown onto fixture

II. Feature of cement-retained implant prosthetic advantage: • Same process with natural teeth prosthetic. • Creating functional and esthetical occlusion surface is possible. (No screw hole) • Easy to get “Passive Fit “. • It is less influenced by path. disadvantage: • Difficult to repair and do maintenance. • Hard to remove leaked cement materials. • Leaked cement material to gingiva could cause inflammation. 20 www. befrest. com

II. Feature of cement-retained implant prosthetic ◆ disadvantage of Cement-retained type prosthetic www. befrest. com Difficulty to remove leaked cement. ü ü Inflammation on gingiva Peri-implantitis 21

II. Feature of cement-retained implant prosthetic ◆ Cement-retained type abutment Line-up Rigid ABT. Transfer ABT. Free. Form ST ABT. Angled ABT. 22 Zio. Cera ABT. www. befrest. com

II. Feature of each type of implant prosthetic Fill Screw hole. 3. Combination type restoration Capping crown to abutment. Removing residual cement. disconnecting Screw. Puling out crown cemented to abutment. Removing cement around margin. Connecting cemented ABT with crown. connecting Screw. Fill screw hole. Resin block out. 23 www. befrest. com Apply cement.

II. Feature of each type of implant prosthetic ◆ Real case (ER ABT. 3 bridge) Crown is first cemented to abutment with cement material and cemented www. befrest. com prosthetic (Crown+ABT) will be connected to fixture by screw. Connecting Pick-Up type Imp. Coping to fixture Impression Sticking Lab analog to impression material stone model Trimming ABT. Wax Up Casting Completed prosthetic Connecting ABT to fixture Cementation Removing Cement Capping crown and plugging screw hole 24

II. Feature of each type of implant prosthetic advantage: • Repair and maintenance are easy due to easy removal. • Inflammation from use of cement does not happen. • Good passive fit in a bridge case. • Applicable to multiple case. disadvantage: • Wearing down occlusal surface requires repairing and replacing. • Building aesthetic occlusal surface is complicated due to screw hole on the occlusal. • Non-applicable to anterior due to path-related problem. 25 www. befrest. com

II. Feature of each type of implant prosthetic ◆ disadvantage of Combination type prosthetic ü Exposure of Screw hole. Unaesthetic ü block out resin and Porcelain could be damaged. www. befrest. com 26

II. Feature of each type of implant prosthetic ◆ Line-up of combination type abutment Transfer ABT. www. befrest. com Free. Form ST ABT. 27 Angled ABT.

II. Feature of each type of implant prosthetic Summary www. befrest. com Type Screw Retained Restoration Cement Retained Restoration Combination type Restoration Key Point Feature connecting Convenient for maintenance & repairing. Screw Exposure of screw hole is unaesthetic. Applying Cementing + Screw connecting 28 Difficult for maintenance & repairing. Residual cement could cause inflammation. Convenient for maintenance & repairing. Exposure of screw hole is unaesthetic. No chance of inflammation with residual cement.

III. Terms 29 www. befrest. com

III. Glossary Crown : Bone which natural teeth root down and are fixated. : An artificial prosthetic which serves as enamel in natural teeth to cap and protect damaged and/or remaining teeth. Abutment : A prop which bridge fixture (root of tooth) to crown. Fixture : An artificial root of tooth which serves as root of tooth in natural tooth. Restoration : A prosthetic which restores missing teeth and/or part of impaired teeth. Combination type prosthetic Bridge UCLA type abutment A type of prosthetic that crown is first cemented to abutment with cement material and cemented prosthetic ( Crown + ABT ) is connected into fixture by screw. : A type of prosthetic which restores missing tooth by use of adjacent teeth next to tooth missing part. : One of Gold-Cast abutments developed by UCLA university. Casting work to combine crown and abutment is done and a prosthetic which becomes one body as a result of casting work is connected to fixture by screw. 30 www. befrest. com Alveolar Bone

III. Glossary Passive Fit block out Occlusion Multiple case : A state of being engaged between crown and abutment when crown is capped on abutment without friction and being hampered. : To plug a screw hole wit resin in case of screw type prosthetic. : A state of contacted surface between teeth on maxilla & mandible. A relation between teeth on maxilla & mandible while they are interfacing. : A case that multiple prosthesis are joined as one body type to reinforce stability of their sustaining in patient’s ora. l 31 www. befrest. com

IV. QUIZ 32 www. befrest. com

IV. QUIZ 1. Which one is not the type of dental prosthetic? 1) Cement retained restoration. 2) Screw retained restoration. A : 4) 3) Combination type restoration. 4) internal type restoration. 2. Please, select incorrect statement about a feature of cement type prosthetic? 1) Inflammation to gingiva could happen from residual cement. A : 2) 2) Building esthetic occlusal is impossible. 3) Way of capping prosthetic is same to a prosthetic for natural teeth. 4) Easily fabricated and cost to build is inexpensive. 33 www. befrest. com

IV. QUIZ 3. Please, select incorrect statement about a feature of combination type prosthetic. A : 3) 1) advantage of Cement type & Screw type prosthetic coexists. 2) Building esthetic occlusion is tough like screw type prosthetic. 3) Maintenance and repairing is tough. 4) Applicable to Multiple case as well. 4. Please, select incorrect statement about a feature of screw type A : 4) prosthetic. 1) Gold-Cast abutment in a series of UCLA abutment is representative. 2) Crown and abutment is combined as one body. 3) Plugging screw hole with resin is required. 4) Way of capping prosthetic is same to a prosthetic for natural teeth. 34 www. befrest. com

IV. QUIZ 5. Please, select an abutment that combination type restoration is not applicable to in a series of TS abutments. 2) Transfer Abutment 3) Free. Form ST Abutment 4) Angled Abutment 6. Please, make correct sequence of overall prosthetic work of screw retained abutment. 1) To Fabricate prosthetic for implant through prosthetic work. 2) To plug screw hole on prosthetic with resin. 3) To connect screw to abutment. 4) To assemble abutment onto fixture. ( 1 ) ( ) ( ) 35 1) 4) 3) 2) www. befrest. com A : 1) 1) Rigid Abutment

IV. QUIZ 7. Please, make correct sequence of overall prosthetic work of cement retained abutment. 2) plug screw hole on abutment. 1) 3) 2) 4) 3) assemble ABT onto fixture and connect screw. 4) apply cement to crown and cap a cement-applied crown. ( 1 ) ( ) ( ) 8. Please, make correct sequence of overall prosthetic work of combination type abutment. 1) Fabricate prosthetic for implant through prosthetic work. 2) disconnect abutment to remove residual cement on the margin of crown and reconnect. 3) assemble ABT onto fixture and connect screw. 4) apply cement to crown and cap a cement-applied crown. ( 1 ) ( 4 ) ( ) 36 1) 3) 4) 2) www. befrest. com 1) Fabricate prosthetic for implant through prosthetic work.