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Chairside Live – Case of the Week Compendium 4: Clinical Techniques for Implant-Supported Restorations

Launch Course

Course Objectives (2 CE Credits)

Michael C. DiTolla, DDS, FAGD

As improved technologies and lower costs expand the practicality of treating patients with dental implants, a clinician’s ability to implement an effective long-term strategy utilizing these fixed prosthetics has become increasingly vital. In this presentation, Dr. Michael DiTolla uses a series of case examples from episodes of Chairside Live to promote best practices and techniques for achieving lasting esthetic and functional success with implant-supported restorations. Participants who view this presentation will learn valuable clinical tips on various topics related to implant treatment therapy, including:

  • Reasons for general practitioners to be involved in abutment selection
  • Advantages of custom abutments over stock abutments
  • Using positioning and bite indexes for Kennedy Class I and II bite registrations
  • Methods to avoid black triangles in final restorations
  • Contouring ideal soft-tissue emergence with custom healing abutments
  • Taking control of esthetics with the Inclusive® Tooth Replacement System (Glidewell Laboratories)
  • Recording restorative margins using impression caps
  • Components effective in communicating accurate data to the lab
  • Benefits of fixture-level impressions
  • Proper implementation of closed-tray and open-tray transfer copings
  • The “jumping the bite” articulation technique
  • Obtaining accurate bite registrations in the absence of ample dentition

Summary

The ultimate esthetic and functional success of an implant-supported fixed restoration is due in large part to the techniques employed by the clinician to shape soft tissue, provide adequate support structure, utilize impression and restorative components effectively, and communicate accurately with the lab. In this presentation, Dr. Michael DiTolla uses several case examples featured on episodes of Chairside Live to illustrate methods and practices central to implementing an implant-supported restorative treatment plan with the best chances for dependable clinical results and patient satisfaction.

CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.


References

  1. Schoenbaum TR, Chang YY, Klokkevold PR, Snowden JS. Abutment emergence modification for immediate implant provisional restorations. J Esthet Restor Dent. 2013 Apr;25(2):103-7.
  2. Kim ES, Shin SY. Influence of the implant abutment types and the dynamic loading on initial screw loosening. J Adv Prosthodont. 2013 Feb;5(1):21-8.
  3. Del’Acqua MA, Chávez AM, Compagnoni MA, Molo Fde A Jr. Accuracy of impression techniques for an implant-supported prosthesis. Int J Oral Maxillofac Implants. 2010 Jul-Aug;25(4):715-21.
  4. Rinke S, Ziebolz D. Fabrication of an implant-supported overdenture using CAD/CAM technology: a clinical report. Quintessence Int. 2013 Feb;44(2):127-34.
  5. Abduo J, Lyons K. Rationale for the use of CAD/CAM technology in implant prosthodontics. Int J Dent. 2013;2013:768121.
  6. Gallucci GO, Papaspyridakos P, Ashy LM, Kim GE, Brady NJ, Weber HP. Clinical accuracy outcomes of closed-tray and open-tray implant impression techniques for partially edentulous patients. Int J Prosthodont. 2011 Sep-Oct;24(5):469-72.
  7. Rashidan N, Alikhasi M, Samadizadeh S, Beyabanaki E, Kharazifard MJ. Accuracy of implant impressions with different impression coping types and shapes. Clin Implant Dent Relat Res. 2012 Apr;14(2):218-25.
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