mda session handouts
TRANSCRIPT
![Page 1: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/1.jpg)
MDA Annual SessionGrand Rapids, MI
Implant Dentistry for the Everyday Dental Practice
Saturday April 19, 2008
Timothy Kosinski, DDS, MAGD, Adjunct Assistant Professor,
Department of Restorative DentistryUniversity of Detroit Mercy
School of Dentistry
![Page 2: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/2.jpg)
Visit www.drkosinki.com
![Page 3: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/3.jpg)
Standard of Care in dentistry
The standard of care is continually evolving with the advent of new materials, new procedures and new court rulings. Before applying the standard of care, dentists should consider new available treatments, as well as their state’s current interpretation of the standard of care.
Joseph Graskemper, DDS, JD
![Page 4: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/4.jpg)
Study reported in the Journal of Periodontology that removable partial dentures have a negative impact on the gingiva. Supporting teeth had more signs of periodontal disease. After 10 years only 56% of teeth that hold a removable partial denture remain intact.
![Page 5: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/5.jpg)
Advantages to dental implants as support for removable dentures:
• Less movement
• No mobility of abutment teeth over time
• No decay
• Can replace full or partial dentures in the maxilla and mandible
• Increase retention and increased stability
![Page 6: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/6.jpg)
Candidates for implants
According to the World Health Organization, 6-10% of the world’s population is missing some or all of
its teeth
![Page 7: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/7.jpg)
Attachments developed as esthetic, completely invisible,
alternative to traditional prosthetic retention systems such as clasps. These ensure stable retention of
partials and dentures.
![Page 8: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/8.jpg)
TYPE OF PROSTHESES
• Implant supported fixed prostheses
• Implant supported removable prostheses
• Implant retained removable overdentures
![Page 9: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/9.jpg)
Advantages of freestanding implants over splinted implants
• Reduced number of fabrication steps
• Reduced treatment costs
• Fewer implants required
• Less vertical space required
• Prefabricated stock retention devices can be used
![Page 10: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/10.jpg)
Disadvantages
• Implants need to be relatively parallel
• Correct angulation needed
![Page 11: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/11.jpg)
Unique challenges to fabricating maxillary implant retained
overdentures:
• Anatomic shape of the bone
• Implants often tipped facially
• Creates angulation problems in restoration
![Page 12: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/12.jpg)
FREQUENTLY ASKED QUESTIONS CONCERNING
DENTAL IMPLANTS
![Page 13: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/13.jpg)
Q: How do I know if I am a candidate for dental implants?
A: There are two basic criteria for people who desire dental implants.
– You must be relatively healthy, meaning no uncontrolled medical problems, such as uncontrolled diabetes, uncontrolled hypertension, or immunosuppressive diseases.
– You must have enough bone to be able to place something in to it.
![Page 14: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/14.jpg)
Q: What are dental implants?
A: Dental implants are titanium fixtures that are surgically embedded into the jaw bone and simulate the root of a tooth. They are used to attach a single tooth, multiple teeth or even to stabilize a denture so it does not move around.
![Page 15: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/15.jpg)
Q: Are the procedures painful?
A: Most people relate that the implant placement procedure is similar to a simple or easier extraction. You are slightly sore, but not debilitated. Many state that following the procedure that if they knew what the surgery was going to be like, they would have done it a long time ago. Everyone is different, however, so our patients are provided the proper pain medications, as necessary.
![Page 16: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/16.jpg)
• Q: How long do implants last?
• A: Modern dental implants have been successful for over 30 years. Dental implants are intended to be permanent, however, many things contribute to their long term success including home care and regular maintenance. Cigarette smoking can cause problems with implant healing. Engineering is an important part of the success of the dental implant reconstruction. Placing the correct type and number of implants is important.
![Page 17: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/17.jpg)
• Q: What is the cost of dental implant therapy?
• A: The investment made in proper and comprehensive implant therapy is an investment in your overall health and quality of life. Appearance is improved and facial structures are preserved. There are many factors involved in cost including the number of implants and the type of teeth placed over them. A thorough consultation is required to determine final cost, but all fees are presented prior to any commitment for treatment.
![Page 18: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/18.jpg)
• Q: Will my insurance cover implants?
• A: The type of coverage you have determines whether implants are a benefit. Some insurance companies cover the cost of implants.
![Page 19: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/19.jpg)
Q: Do implants require special care?
A: No, regular maintenance visits are important as is daily home care.
![Page 20: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/20.jpg)
Q: How long does the entire process take?
A: This depends on the position that the implants are placed and what we are intending to do with our restoration. The implants are placed and sutures are usually removed in about one week. Following a proper healing time (usually 4-5 months), the implants are uncovered and impressions are made for the final teeth. This may take a month or so depending on the complexity of the situation.
![Page 21: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/21.jpg)
Q: Will I leave your office without teeth?
A: We will always try to provide you with some type of transitional or temporary tooth.
![Page 22: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/22.jpg)
Q: Are dental implants experimental?
A: Absolutely not. Implants have been thoroughly researched and the current technology results in an outstanding success rate in the hands of the well trained and experienced clinician.
![Page 23: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/23.jpg)
Q: Can implants be placed the same day as an extraction?
A: Whether an implant can be placed on the same day as an extraction depends on the amount of bone that is available and whether there is any infection around the existing tooth. When teeth are lost, bone will shrink in several dimensions. Placing an implant immediately can reduce this bone loss and provide a better esthetic result.
![Page 24: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/24.jpg)
Q: What are some of the benefits to dental implants?
A: Increased confidence when smiling, speaking and eating, especially if dentures or partials are replaced or retained with dental implants.– Elimination of denture adhesives– Improved comfort, speech and appearance.– Preservation of the integrity of facial structures.– Adjacent teeth are not ground down for a bridge.– Implants can be easier and maintain since they are cleaned like
natural teeth– Improved ability to taste food– Looking and feeling younger– Restored self esteem– Improved Quality of life
![Page 25: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/25.jpg)
What dictates type of prosthesis:
• Number of implants to be placed• Location of implants• Amount of implant/soft tissue support
needed• Quality and quantity of bone• Size of the implants (length vs width)• Medical considerations• Psychological considerations
![Page 26: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/26.jpg)
“The vast majority of complications in implant dentistry are related to biomechanics. The
complications include early loading implant failure, crestal
bone loss, abutment screw loosening, porcelain or acrylic
veneer fracture, and uncemented restorations.”
Misch, 2007
![Page 27: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/27.jpg)
The percentage of completely edentulous patients is
decreasing, but the actual number of completely edentulous patients is
increasing.
![Page 28: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/28.jpg)
• Ceka attachments 800.232.7732(preat)
• Locator attachments 760.743.7744(Zest Anchors)
• ERA attachments 800.243.9942(Sterngold)
• Bredent attachments 877.328.3965(xpdent)
• Hader attachments 800.243.9942(Sterngold)
![Page 29: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/29.jpg)
Approximate cost of attachment
Type of attachment Abutment SetReplacement
ERA $ 58.00 $ 5.00Locator $160.00 $28.00Hader $170.00 $ 7.00Bredent $119.00 $ 7.00
![Page 30: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/30.jpg)
Locator attachments (Zest Anchors, Escondido, CA) act as retentive devices for overdentures. The patient is able to easily align and seat the overdentures.
Implants should be placed in a parallel position.
The attachment resists wear and maintain satisfactory retention for up to 56,000 cycles of function. Nice to use when there is an occlusal clearance problem since it is only 3.17mm in total height. Male portions are easily changed chairside.
![Page 31: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/31.jpg)
LOCATOR IMPLANT ANCHORS (Zest Anchors, Inc.)
• Supragingival attachment• Available as a straight abutment or at 10 or 20 degreees• Permits divergence between implants up to 20 degrees
(40 degrees with extended range)• Self aligning to the top of the implants• Torque into place to 20Ncm• Low profile• Saves interocclusal space• Guides the overdenture into proper alignment similar to a
milled bar• Cost minimal when compared to a milled bar• Can be set on supporting bars
![Page 32: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/32.jpg)
Bredent attachments can be used on implants that are up to 15 degrees divergent from the path of insertion. They are available in 3 diameters with 3 different tissue heights
![Page 33: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/33.jpg)
HOW TO TAKE CARE OF DENTAL IMPLANTS
![Page 34: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/34.jpg)
• Daily care is similar to the care of natural teeth.
• Restored dental implants need to be kept clean and plaque free
• Cleaning after meals is important
![Page 35: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/35.jpg)
Access Oral Care
1-877-94-ACCESS
![Page 36: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/36.jpg)
• Gentle brushing with small soft manual or electric brush
• Low abrasive, tartar control toothpaste
• Dental floss for cleaning around the abutments
![Page 37: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/37.jpg)
• Other adjuncts:
• Antimicrobial mouth rinses
• Interdental brushes or other aids to remove plaque on either side of the implants
• Disclosing tablets to stain the locations of plaque accumulation
![Page 38: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/38.jpg)
TEAM DENTISTRY
• DENTIST• DENTAL HYGIENISTS• ASSISTANTS• TREATMENT COORDINATORS• FRONT DESK PERSONNEL• DENTAL SPECIALISTS• DENTAL TECHNICIANS• MANUFACTURERS• EDUCATORS• DIAGNOSTIC SERVICES
![Page 39: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/39.jpg)
• DIAGNOSTIC METHODS
• HIGH TECH EQUIPMENT
• DURABLE RESTORATIVE MATERIALS
• ENDOSSEOUS DENTAL IMPLANTS
• HIGH STRENGTH CERAMICS
• CAD/CAM
HIGH TECHNOLOGY IN THE 21ST CENTURY
![Page 40: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/40.jpg)
THE MOST CRITICAL CRITEREA IN DENTAL IMPLANTOLOGY
• PROSTHETIC CRITERIA
• SOFT TISSUE MANAGEMENT
• BONE PREPARATION
![Page 41: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/41.jpg)
PROSTHETIC BIOMECHANICS
• ANATOMIC FACTORS
• PROPER FUNCTION
• ESTABLISH POSITION, NUMBER AND DIAMETER OF THE IMPLANTS NEEDED
• FACILITATE HYGIENE
![Page 42: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/42.jpg)
AN AGING POPULATION
• THE GROUP OLDER THAN 65 IS PROJECTED TO INCREASE FROM 12% OF THE POPULATION IN 2000 TO MORE THAN 20% IN THE NEXT 25 YEARS
![Page 43: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/43.jpg)
POTENTIAL IMPLANT PATIENT POPULATION IS EVER INCREASINGBY 2025 NEARLY 70 MILLION PEOPLE WILL BE 65 AND OLDER
![Page 44: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/44.jpg)
POTENTIAL IMPLANT PATIENT POPULATION IS EVER INCREASINGBY 2025 NEARLY 70 MILLION PEOPLE WILL BE 65 AND OLDER
![Page 45: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/45.jpg)
ACCORDING TO MISCH THE LIFE SPAN AT FAILURE OF
CROWNS IS 10.3 YEARS
• REASON FOR FAILURE: DECAY, ENDODONTIC THERAPY
• IT HAS BEEN ESTIMATED THAT A $425 CROWN FOR A 22 YEAR OLD PATIENT WILL COST $12,000 DURING THE PATIENT’S LIFETIME TO REPLACE OR REPAIR IT.
![Page 46: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/46.jpg)
• 70% OF THE US POPULATION IS MISSING AT LEAST ONE TOOTH
• IN 1990 MORE THAN 4 MILLION BRIDGES WERE PLACED
• BRIDGES ACCOUNT FOR 7% OF THE ANNUAL DENTAL REIMBURSEMENT FROM INSURANCE COMPANIES AND MORE THAN $3 BILLION/YEAR
![Page 47: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/47.jpg)
• STUDIES SHOW THAT THERE IS A 74% 15 YEAR SURVIVAL RATE ON BRIDGES.
• MEAN LIFE SPAN OF 9.6 -10.3 YEARS
![Page 48: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/48.jpg)
ADVANTAGES OF SINGLE TOOTH DENTAL IMPLANTS
• HIGH SUCCESS RATES• DECREASED RISK OF CARIES OF ADJACENT
TEETH• DECREASED RISK OF ENDODONTIC
PROBLEMS• BETTER HYGIENE• IMPROVED ESTHETICS• BONE MAINTENANCE• ELIMINATE COLD SENSITIVITY• ELIMINATE NEED TO GRIND DOWN
ADJACENT TEETH
![Page 49: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/49.jpg)
AVERAGE EDENTUALISM IS 20% WORLDWIDE BY AGE 60
![Page 50: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/50.jpg)
1999-2002 TOTAL US EDENTUALISM OF BOTH ARCHES WAS 7.7% (20
MILLION PEOPLE)
![Page 51: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/51.jpg)
ONE OR TWO ARCH EDENTUALISM 17% OF THE
US POPULATION OR 30 MILLION PEOPLE
![Page 52: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/52.jpg)
REDUCED OCCLUSAL FORCES IN EDENTULOUS
• CHEWING FORCES DECREASED TO 20-30% OF THOSE WITH NATURAL TEETH
• NOT CHEWING PROPERLY INCREASES NEED TO MEDICATION FOR GASTROINTESTINAL PROBLEMS
• DECREASE YOUR LIFE SPAN
![Page 53: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/53.jpg)
• 5 YEAR SURVIVAL RATE FOR RPDS IS 60%
• 44% ABUTMENT TOOTH LOSS IN 10 YEARS
• ACCELERATED BONE LOSS
![Page 54: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/54.jpg)
PSYCHOLOGICAL EFFECTS
• LOW SELF ESTEEM
• SPEECH AFFECTED
• AVOID SOCIALIZING
![Page 55: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/55.jpg)
MISCH BONE DENSITY CLASSIFICATION
• D1 DENSE CORTICAL BONE IN THE ANTERIOR MANDIBLE
• D2 POROUS CORTICAL AND COARSE TRABECULAR IN THE ANTERIOR AND POSTERIOR
• D3 POROUS CORTICAL (THIN) AND FINE TRABECULAR IN THE ANTERIOR AND POSTERIOR MAXILLA
• D4 FINE TRABECULAR IN THE POSTERIOR MAXILLA
![Page 56: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/56.jpg)
CRITERIA FOR IMPLANT SUCCESS
• NOT MOBILE• NO EVIDENCE OF PERIIMPLANT
RADIOLUCENCY• VERTICAL BONE LOSS OF LESS THAN 0.2
MM ANNUALLY AFTER THE 1ST YEAR• NO PAIN, INFECTION, PARESTHESIA• SUCCESS RATES OF 85% AT THE END OF A
5 YEAR OBSERVATION AND 80% AFTER A 10 YEAR PERIOD
![Page 57: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/57.jpg)
A PROBE PENETRATES DEEPER NEXT TO AN IMPLANT COMPARED TO A TOOTH
TAKE CARE NOT TO CONTAMINATE THE IMPLANT SULCUS WITH BACTERIA FROM A DISEASED PERIODONTAL SITE
![Page 58: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/58.jpg)
TOOTH HAS CEMENTUM, BONE AND PERIODONTIUM IMPLANT IS OSSEOINTEGRATED WITH AKLYLOSIS ON IMPLANT TO BONE
![Page 59: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/59.jpg)
TOOTH AND IMPLANT HAVE HEMIDESMOSOMES AND
BASAL LAMINA AS ITS JUNCTIONAL EPITHELIUM
![Page 60: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/60.jpg)
TOOTH HAS PERPENDICULAR CONNECTIVE TISSUE FIBERS WITH INCREASED FIBROBLASTS AND DECREASED COLLAGEN
IMPLANT HAS PARALLEL AND CIRCULAR FIBERS WITH NO ATTACHMENT TO THE IMPLANT SURFACE AND BONE AND HAS INCREASED COLLAGEN AND DECREASED FIBROBLASTS
![Page 61: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/61.jpg)
TOOTH HAS GREATER VASCULARITY FROM THE PERIODONTAL LIGAMENT
![Page 62: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/62.jpg)
NORMAL PROBING IS 3MM IN A HEALTHY TOOTH BUT 2.5-
5MM IN AN IMPLANT DEPENDING ON THE SOFT
TISSUE DEPTH
![Page 63: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/63.jpg)
INSTRUMENTS TO MAINTAIN IMPLANTS MUST BE EFFECTIVE IN REMOVING BIOFILMS AND ACCRETIONS AND NOT DAMAGE THE IMPLANT BODY
![Page 64: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/64.jpg)
DON’T GOUGE TITANIUM WITH ULTRASONIC AND SONIC SCALERS.USE PLASTIC OR RUBBER SLEEVES
![Page 65: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/65.jpg)
NO STAINLESS STEEL TIPPED INSTRUMENTS
USE PLASTIC, GRAPHITE, NYLON OR TEFLON COATED INSTRUMENTS
![Page 66: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/66.jpg)
USE RUBBER CAP WHEN POLISHING WITH FINE PROPHY PASTE OR TIN OXIDE
![Page 67: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/67.jpg)
SIMPLY REMOVE THE PLAQUE AND CALCULUS
CHLORHEXIDINE GLUCONATE EFFECTIVE IN REDUCING PLAQUE.
USE WITH A BRUSH OR FLOSS
![Page 68: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/68.jpg)
CONVENTIONAL DENTAL IMPLANT APPROACHES
• PLANNING• SURGERY• REMOVE SUTURES• RELINE PROSTHESIS• ABUTMENT SELECTION AND PLACEMENT• TRANSITIONAL PROVISIONAL• SOFT TISSUE MONITORING• FINAL IMPRESSION• TRY IN • FINAL PROSTHESIS
![Page 69: MDA Session Handouts](https://reader036.vdocuments.mx/reader036/viewer/2022062307/55624a74d8b42aa52d8b496d/html5/thumbnails/69.jpg)
CAD/CAM GUIDED APPROACH
• PLANNING
• SURGERY
• TRANSITIONAL PLACMENT
• FINAL PROSTHESIS