Implant Prosthesis
SELECTION GUIDE FOR SINGLE OR MULTIPLE IMPLANT PROSTHESIS:
The selection of abutments are based on the following factors
Colour:
TOOTH COLOURED ABUTMENTS:
These abutments are preferred in the front teeth aesthetic zones, owing to their tooth coloured nature.
METAL ABUTMENTS:
These abutments are not aesthetic and are generally used in the back teeth region.
Connector:
SCREW RETAINED:
PROS:
– Easily retrievable
– Easy to tighten the screws if the prosthesis becomes loose
– Abutment removal during maintenance of implant is possible
CONS:
– Chances of composite coming out of screw access hole or getting stained over time
– Less aesthetic due to visibility of filled screw access hole on occlusal surface
CEMENT RETAINED:
PROS:
– These abutments are generally preferred in the aesthetic zones since they appear aesthetically pleasing
CONS:
– Not easily retrievable and in cases of loosening of abutment screw – new prosthesis needs to be fabricated.
– Excess cement can extrude into the sulcus and can damage the peri-implant tissues.
Fabrication
This choice is solely decided by the dentist based on the requirement.
STOCK ABUTMENTS:
Stock abutments are the ideal choice of abutments for most cases. They come in standardized sizes for bone and tissue level implants. They are user-friendly and are often an economical choice. Straight and angulated are the two kinds of stock abutments available.
One more type of stock abutment is Multi-Unit abutment which is used in specific cases. Multi-Unit abutments are designed for angle corrections and provide positive uniform seat for screw retained implant restorations.
With stock abutments, sometimes it is also not possible to control the final margin for the placement of crown.
CUSTOM ABUTMENTS:
Custom abutments are suitable for cases which are not ideal for the stock abutments. They can provide more predictable aesthetics and superior tissue management than stock abutments. They are highly efficient but more costly.
SELECTION GUIDE FOR FULL MOUTH IMPLANT PROSTHESIS:
Implant dentist will decide full mouth implant prosthesis basis on number of implants, position of implants and for long term implant health.
Overdenture:
FRAME MATERIAL: Acrylic
TEETH MATERIAL: Acrylic
PROS:
– Easy to remove for cleaning
– Can hide aesthetic problems such as severe bone loss and tissue loss
– Light weight
– Less expensive
CONS:
– Removable which some people don’t like
– Acrylic can stain if abrasives are used to clean
– Can chip overtime
– May move or rock a little bit in mouth
Hybrid Bridge:
FRAME MATERIAL: Titanium or Cobalt Chromium
TEETH MATERIAL: Acrylic
PROS:
– Fixed option: comfortable and feels like natural teeth
– Light weight: if titanium as a frame structure
CONS:
– Heavy weight: if cobalt chromium as a frame structure
– Acrylic can stain if abrasives are used to clean
– Can chip overtime
Malo Bridge
FRAME MATERIAL: Titanium/ BioHPP/ Zirconia
TEETH MATERIAL: Porcelain or Composite
PROS:
– When implants are not in ideal position
– Fixed option that looks and feels like natural teeth
– No staining – if porcelain used as a teeth material
CONS:
– Chances of staining – if composite as a teeth material
– Costly
Titanium Bridge:
FRAME MATERIAL: Titanium
TEETH MATERIAL: Porcelain or Composite
PROS:
– Good strength
– Light weight
– Biocompatible
CONS:
– Costly
Zirconia Bridge:
FRAME MATERIAL: Zirconia
TEETH MATERIAL: Porcelain
PROS:
– Good strength
– Will not stain overtime
– Tooth coloured framestructure- looks and feels like natural teeth
– Less likely to chip or break, if full contoured zirconia
CONS:
– More costly
– Full contour zirconia lacks translucency – so prosthesis can look little opaque
– Full contour zirconia with custom porcelain overlay has good aesthetics but has chances of fracture
– If zirconia is not pure, then its carcinogenic
– If cement retained crown, then has less strength
PEEK/ BioHPP Bridge:
FRAME MATERIAL: PEEK/ BioHPP
TEETH MATERIAL: Composite
PROS:
– Very light weight
– Good shock absorber
– Feels more like natural teeth
– High aesthetics
– Highly biocompatible
– Good chewing efficiency
– Minor intraoral maintenance possible
CONS:
– More Costly
– More maintenance required
– More chances of plaque accumulation
Cobalt Chromium Bridge:
FRAME MATERIAL: Cobalt Chromium
TEETH MATERIAL: Porcelain or Composite
PROS:
– Good strength
– Economical
– Good bond to ceramic
CONS:
– Very heavy weight
– Carcinogenic if contains beryllium
In any type of implant prosthesis, regular maintenance by patient is must for long term implant success.