Immediate loading meets digital treatment planning in this latest implant title. The authors emphasize that the preservation of alveolar hard and soft tissues using the immediacy concept is more predictable than is the reconstruction of the hard and soft tissues using the traditional delayed approach once resorption has occurred. Immediate loading has also shown to be very predictable in cases of full-arch reconstructions and has become the treatment of choice in cases where appropriate criteria are met. Because a thorough understanding of analog protocols is necessary before attempting a digital case, the authors review these fundamental concepts to provide context for the transition to the digital realm. The book begins by outlining the principles of immediate loading and those of digital workflows before delving into individual clinical situations ranging from single teeth to full arches, both with and without bone resorption. Information on prosthetics is included as well as surgical treatment planning. The book concludes with a chapter entirely devoted to case presentations of all the treatment types covered throughout. If you are ready to step into the future of dental implant treatment, this book is for you! 1,153 illustrations. Contents: Osseointegration • Biologic and biomechanical principles • Implant design • Immediate loading • Tissue-level implants • Digital workflow • Full-arch rehabilitation • Systematic treatment planning protocols • Tilted implants • Prosthetics • Zygomatic implants • Case presentations
Author(s): Edmond Bedrossian, E, Armand Bedrossian, Lawrence Brecht
Publisher: Quintessence Publishing
Year: 2022
Language: English
Pages: 408
City: Batavia
THE IMMEDIACY CONCEPT: Treatment Planning from Analog to Digital
Frontmatter
Library of Congress Cataloging-in-Publication Data
Contents
Foreword
Preface
Contributors
SECTION I: THE IMMEDIACY CONCEPT
Chapter 1: Osseointegration Demystified
Tooth-Supporting Tissues
Wound Healing Cascade and Bone Healing Mechanism
The Event of Osseointegration
Different Patterns of Bone Healing Around Implants
Implants Placed in a Healed Site
Immediate Implant Placement
Implant Macro Design and Surface: Impact on Early Bone Healing
Changes in Implant Anchorage During the Early Healing Phase
Conclusions
References
Chapter 2: Biologic Principles and the Immediacy Concept
Osseointegration: Primary and Secondary Stability
Biologic Principles
Principles of Immediacy
References
Chapter 3: Implant Design for the Immediacy Concept
The Effects of Implant Design on Osseointegration
Implant Design Characteristics
Primary Stability
Prosthetic Considerations
References
Chapter 4: Biomechanical Principles for Immediate Loading
Site Preparation: Undersizing the Osteotomy
Bone Density, IT, and ISQ Value
Influence of Implant Geometry
Implant Surface Enhancement
Conclusion
References
Chapter 5: The Tissue-Level Implant
The Gold Standard
Peri-Implant Soft Tissue Topography
One-Piece Implant: The TLX
Clinical Applications
Conclusion
References
SECTION II: THE DIGITAL WORKFLOW
Chapter 6: Digital Workflow and the Immediacy Concept
Advantages of 3D Scanning and Guided Surgery
Managing the Small Edentulous Site
Surgical Guide Designs and Manufacturing
References
Chapter 7: Digital Workflow Step by Step
Acquiring Data
Superimposition of DICOM and STL
Digital Workflow Summary
Digital Workflow Utilizing SIAB for Complete-Arch Implant Therapy
Conclusion
References
Chapter 8: Complete Digital Workflow for Full-Arch Rehabilitation
Components of Digital Workflow
Challenges Encountered in Complete Digital Workflow
Complete Digital Workflow in Edentulous Arches
Discussion
Conclusion
References
Chapter 9: Analog to Digital Workflow in Immediacy
Influence of Medical Conditions and Medications on Osseointegration
Factors Influencing Osseointegration
The Immediacy Concept with Analog and Digital Workflows
Conclusion
References
SECTION III: TREATING FULLY EDENTULOUS ARCHES
Chapter 10: Loading Protocols for Full-Arch Rehabilitation
History and Evolution
Technical Aspects of Immediacy
Number of Implants
Digital Workflow
Case Example
Conclusions
References
Chapter 11: Systematic Treatment Planning Protocol for the Maxilla
Presence or Absence of a Composite Defect
The Transition Line: Visibility of the Residual Ridge Crest
Radiographic Evaluation: Zones of the Maxilla
Application of Bedrossian Screening
References
Chapter 12: The Tilted Implant Concept in the Maxilla
Challenges with Edentulous Arches
Prosthetic and Surgical Evaluation
Number and Distribution of Implants
Consequence of Prosthetic Cantilevers
Achieving Initial Stability
Challenges and Complications
Long-Term Maintenance Protocol
Conclusion
References
Chapter 13: Systematic Treatment Planning Protocol for the Mandible
Effects of Edentulism on Patients
Treatment Alternatives
Prosthetic Design: Begin with the End in Mind
Interarch Space Requirements
Biomechanical Considerations: Number and Distribution of Implants
Radiographic Evaluation
Digital Planning Software
Conclusion
References
SECTION IV: PROSTHETICS FORFULL-ARCH REHABILITATION
Chapter 14: Chairside Analog Conversionfor a Fixed Provisional Prosthesis
Using BLX Implants and Screw-Retained Abutments
Registration of the SRA Position
Seating the Prosthesis with Temporary Cylinders
Finishing the Prosthesis
References
Chapter 15: Workflow and Material Choice for the Full-Arch Prosthesis
Material Properties
Framework Passivity
Cast Noble Alloy Framework for a Metal-Acrylic Prosthesis
Milled Titanium Framework for a Metal-Acrylic Prosthesis
Milled Monolithic Zirconia Prosthesis
Maintenance Protocols for the Full-Arch Implant Prosthesis
References
Chapter 16: Managing Structural Complications of Full-Arch Restorations
Management of Complications for the Conversion Prostheses
Delamination of the Denture Tooth of a Fixed Hybrid
Chipping of Overlying Ceramics
Fracturing of Zirconia Framework
Patient Education on Complication Risk
References
SECTION V: ZYGOMATIC IMPLANTS
Chapter 17: Biomechanical Principlesfor Zygomatic Implants
The Zygomatic Implant Under Function
Zygomatic Implant Trajectory
Zones of the Maxilla
ZAGA Classification
Patient Selection
Preoperative Considerations
Surgical Protocol for ZAGA 0 to 3 with Round Zygomatic Implants
Surgical Protocol for ZAGA 4 with Flat Zygomatic Implants
Prosthetic Conversion Technique
Postoperative Care
Final Prosthetic Reconstruction
Discussion
References
Chapter 18: New Zygomatic Implant Design
Thread Design and Pitch
Surface Enhancement
Apical Geometry
Implant Diameter
A 55-Degree Platform, SRA, and Prosthetic Versatility
Modifications to the Middle Portion of the Implant
Two Different Designs
Zygomatic Screw-Retained Abutments
References
Chapter 19: Prevention and Management of Zygomatic Implant Complications
Orbital Involvement
Intracranial Placement
Infraorbital Nerve Paresthesia
Subperiosteal Infections
Overextension of the Zygomatic Implant Apex
Encountering Other Implants in the Zygoma
Vestibular Dehiscence
Failed Zygomatic Implant
Fractured Implant
Sinus Infections
Conclusion
References
SECTION VI: CASE PRESENTATIONS
Chapter 20: Case Presentations
Single Implant in the Esthetic Zone
Two Adjacent Implants in the Esthetic Zone
Immediate Mandibular Molar Implant
Immediate Maxillary Molar Implant
Partially Edentulous Cases
Full-Arch Tilted Concept
Zygomatic Implants
Quad-Zygoma Concept
References
Index
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