American Dental Implant Association
The Miami Implant Update
A. Burton Melton – April 24, 2009
Prosthodontic and Surgical Considerations for the Edentuous Maxilla
· Talked about NeoOss system
· “If you don’t take a look at this system, you’re doing yourself an injustice”
· Begin with the end in mind
· GET DIAGNOSTIC CASTS
· Well made overextended impressions
· You want as much of the anatomic detail
10 Questions that demand answers
1. What are the pt’s wants, needs, expectations?
a. ASK!
2. What type of restoration fulfills these requirements?
a. Offer multiple options
b. Do nothing à High end dentistry
3. What are its support needs?
a. Supported by alveolar ridges & soft tissues
b. Bone?
4. How much interarch space is available?
5. What are the soft tissue needs?
a. Big issue in the aesthetic zone
6. What are the esthetic, phonetic, and functional requirements specific to the restoration?
7. What are the surgical solutions required for periodontal success?
8. How will the prosthesis be retained?
a. Screw retained? Cemented?
9. What is the cost to fabricate the restoration?
10. How much do I have to charge to be profitable?
· The problem with edentulism
· Loss of teeth, bone, vertical height, lip support
· Bone
· Must evaluate maxilla with ct scan
· Why am I lisping?
· You have encroached the lateral border of the tongue
· If we graft after ext, it’s a good day
· You can recreate self-cleansing
· Stage I: Minor ridge remodeling
· Can do anything you want
· Stage IV: Major ridge remodeling
· Limited choices
· The more divergent implants are, CONNECT them with a bar
· Lower jaw: At LEAST 3 implants to create a tripod
· 4 on the floor is better
· Upper jaw: 6 implants ideal, 8 at most
· If you are putting things together with duralay, index it with bite registration for 30 sec just so lab doesn’t need redo
· Cantilever section in a Haider should not exceed 1.5x the distance between the front 2 and back 2 implants
· Bredent C-Attachements allow you to connect F/ without compensating vertical attachments
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