Odontologa

Páginas: 38 (9380 palabras) Publicado: 16 de octubre de 2012
PRACTICE
IN BRIEF
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When restoring the edentulous maxilla with implants one of the major decisions to make is often whether the patient should be restored with a fixed or removable prosthesis. The number of implants to be placed depends on quality of bone, anticipated force and arch form. Removable restorations require more maintenance than their fixed counterparts.

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VERIFIABLE CPDPAPER

Treatment planning of the edentulous maxilla
S. Jivraj,1 W. Chee2 and P. Corrado3
The predictability of successful osseointegrated implant rehabilitation of the edentulous jaw as described by Branemark et al.,1 introduced a new era of management for the edentulous predicament. Implant rehabilitation of the edentulous maxilla remains one of the most complex restorative challenges becauseof the number of variables that affect both the aesthetic and functional aspect of the prosthesis.2 Among the prosthesis designs used to treat the edentulous maxilla are fixed or removable implant-supported restorations. Since the aesthetic requirements and preoperative situation of each patient varies, considerable time must be spent on accurate diagnosis to ensure patient desires are satisfiedand predictable outcomes are achieved. The purpose of this article is to compare the treatment options and prosthesis designs for the edentulous maxilla. Emphasis will be placed on diagnosis and treatment planning. Criteria will be given to guide the practitioner in deciding whether a fixed or removable restoration should be placed. This objective will be accomplished through the review of caseswith regard to varying design considerations and factors that influence the decision-making process.
IMPLANTS
1. Rationale for dental implants 2. Treatment planning of implants in posterior quadrants 3. Treatment planning of implants in the aesthetic zone 4. Surgical guidelines for dental implant placement 5. Immediate implant placement: treatment planning and surgical steps for successfuloutcomes 6. Treatment planning of the edentulous maxilla 7. Treatment planning of the edentulous mandible 8. Impressions techniques for implant dentistry 9. Screw versus cemented implant supported restorations 10. Designing abutments for cement retained implant supported restorations 11. Connecting implants to teeth 12. Transitioning a patient from teeth to implants 13. The role of orthodontics inimplant dentistry 14. Interdisciplinary approach to implant dentistry 15. Factors that affect individual tooth prognosis and choices in contemporary treatment planning 16. Maintenance and failures

As in all phases of dentistry diagnosis is critical in obtaining a predictable outcome. An incomplete or erroneous diagnosis can yield unsatisfactory results for both the patient and treating clinician.Historically most of the research for implant rehabilitation of edentulous patients was conducted in the mandible. Due to the reduced denture bearing surface of the mandible and the mobility of the tongue, patients often complained of instability of the denture and an inability to adapt to a removable prosthesis. Many prostheses designs were evaluated ranging from subperiosteal implants to implantssupported complete dentures. Patients are more likely to wear and accommodate to a maxillary denture compared to its mandibular counterpart. Aesthetics are satisfactory and the greater retention, support and
1*Chairman, Section of Fixed Prosthodontics and Operative

Dentistry, University of Southern California School of Dentistry / Private Prosthodontics Practitioner, Burbank, California;2Ralph W. and Jean L. Bleak Professor of Restorative Dentistry, Director of Implant Dentistry at the University of Southern California School of Dentistry / Private Prosthodontics Practitioner, Pasadena, California; 3Private Practice, Verona, Italy *Correspondence to: Dr Sajid Jivraj, School of Dentistry, Rm. 4375 University Park, University of Southern California, Los Angeles, CA 90089-0641, USA...
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