Prosthodontics I

Implantology has increased the variety of prosthetic treatment concepts considerably. This tutorial summarizes the principles of implant-borne prosthetic reconstructions, including the implant–abutment connection, impression techniques, fabrication of the master cast, and special aspects of bite registration. Furthermore, treatment concepts for a single-tooth gap, multiple missing teeth, severely reduced dentition, and the edentulous dental arch are discussed. Treatment recommendations are discussed according to their evidence level in the current literature as well as under consideration of clinical aspects. Special aspects for the anterior esthetic zone and posterior tooth regions are highlighted.

The connection between implant and superstructure (connecting elements) is of upmost importance. For fixed dental prostheses, these attachments comprise abutments, which enable screw retention or cementation of the restoration. In general, screw-retained superstructures on multiple implants have a tendency toward more technical complications, such as screw loosening, whereas cemented superstructures bear the risk of biological complications such as periimplant mucositis. Aspects influencing selection of the appropriate abutment in the anterior and posterior region as well as aspects of treatment with single crowns or fixed dental prostheses are discussed. Treatment concepts for removable dental protheses differ in terms of primary or secondary splinting as well as static or dynamic transmission of mastication forces from the superstructure to the implant. Correlated to the number and distribution of implants, various attachments such as double crowns, bar retainers, magnets, ball attachments, or Locator™ attachments are discussed.