iCliniq logo

Ask a Doctor Online Now

HomeHealth articlesdental implantWhat Are the Phases of Prosthetic Planning in Implant Dentistry?

Phases of Prosthetic Planning in Implant Dentistry

Verified dataVerified data
0

4 min read

Share

Clinicians must focus on successful osseointegration and prosthetic rehabilitation after a dental implant. Read the article to learn more.

Medically reviewed by

Dr. Sowmiya D

Published At July 22, 2022
Reviewed AtMay 15, 2024

Introduction:

Repeated case studies show a considerable difference in esthetic expectations between professionals and what the patient expects. The patient's expectations of the final prosthetic result are often centered upon a higher degree of satisfaction than professionals who judge the prosthetic rehabilitation clinically or technically concerning aspects crucial to form and function like smile line, bite, masticatory potential, stress force assessment, etc. Hence, the operator or dental implantologist should focus on patient expectations and needs, especially regarding esthetics. This is because the satisfaction of the patient with appealing esthetics is that they have been nearly ideally restored to proper form, contour, and function regarding the missing tooth or teeth, which enhances self-confidence and boosts their idea of successful treatment with the doctor. This article discusses the challenges of prosthetic rehabilitation and the phases in treatment planning in patients with multiple dental implants.

What Is Facial Analysis?

However, it is also true that clinicians should focus not just on the patient esthetics primarily but also work on a guide to achieve long-term success rates with prosthetic rehabilitation for dental implants. This can be done by thoroughly studying the facial form analysis and considering different elements of the patient's facial profile, their needs, and the expectations desired to attain post-prosthetic fabrication.

1. Static analysis, i.e., execution of facial profile analysis anatomically.

2. Dynamic analysis, i.e., execution of functional evaluation through facial analysis.

These two components contribute a vital parameter or foundation for producing the ideal fixed restoration that the patient can deem esthetic. Various esthetic parameters that are also equally considered to be of clinical significance in dental implant prosthetic rehabilitation are

A. Facial form and soft tissue profile.

B. Lip support.

C. Smile line.

D. Facial midline.

E. Teeth dimension or vertical dimensions at rest and occlusion.

F. Gingival display.

G. An accurate centric or occlusal relationship should be ideally established after extraction or loss of the natural tooth.

What Is the Goal of Prosthetic Rehabilitation?

The goal of prosthetic rehabilitation through dental implants involves several phases of treatment planning through a unified system of surgical and prosthetic approaches that should be done pre- and post-dental implant procedures on the patient, i.e., preoperative and postoperative assessments. Complex dental implant placement procedures include ridge preservation and atraumatic extraction to bone augmentation techniques, sinus floor elevation if needed, surgical augmentation procedures, and functional concepts used for prosthetic replacement.

After dental implantation, the patient is ideally given a provisional restoration for three to six months. This is the period during which osseointegration occurs that determines the success of dental implants. Next, after the complete fusion of the dental implant to the jaw bone, the provisional restorations are replaced by permanent restoration based on functional concepts of prosthetic implant therapy. This prosthesis should ideally establish proper centric occlusal form and function. Patient evaluation can also be done using visual analog scores (VAS) based on preoperative and postoperative assessments.

What Are the Stages Involved in Dental Implant Treatment?

Losing a tooth due to an accident, trauma, or extraction can change the facial shape and affect the alignment of the remaining teeth, impacting the confidence in smiling. However, with dental implant surgery, also known as a dental implant procedure, the person can restore their smile and replace their missing tooth. Dental implant-supported teeth are often regarded as the closest alternative to natural teeth. Dental implants can effectively replace missing teeth in the mouth, whether for a single tooth or multiple teeth.

What Are the Phases of Treatment Planning?

The Phase of Esthetic Analysis

In this phase, the dental surgeon or implantologist assesses the facial analysis using different expressions. For example, the patient's stern and smiling expression can be captured, and by obtaining photographs of the patient's profile, the standards of a smile with a gingival display, usually standardized as 2 mm for prosthesis, are set. The ideal tooth position is also assessed to achieve an ideal outcome that is aesthetically pleasing.

Cephalometric and Occlusal Phase

This is considered the planning phase of treatment by the implant surgeon, wherein the facial growth and the biotype are of primary importance. First, the sagittal positions at the mandibular symphysis are assessed correctly. Next, the facial height ratio is thoroughly studied because the craniofacial morphology varies from individual to individual based on this ratio. After cephalometric assessment of the jaws, impressions are usually recorded in a hydrocolloid material, and consequently, the occlusal positions of the patient are determined by using dental wax. The casts are then mounted on the patient, and prosthetic designs can be suggested or proposed for any modifications before prosthetic fabrication. Based on this workflow, a surgical guide can be manufactured, usually from transparent acrylic resins.

Surgical Phase

Hopeless teeth or teeth indicated for replacement by atraumatic extraction procedures and ridge preservation modalities can be employed by the surgeon before the surgical osteotomy preparation for the implant. The teeth can be immediately implanted post-extraction (immediate implants), or the bone graft material or sinus lift and bone augmentation procedures, if needed, can be carried out if the bone volume is low or in resorbed ridge anatomy post the healing phase. After dental implantation is complete surgically, the manual torque wrench is used to set the implant into the bone with forces ranging from a minimal 25 Ncm to a maximum of 40 Ncm. Facebow transfer and articulation records are completed with the implant abutments bonded to the surgical guides.

The Phase of Provisionalisation

In this phase, the prosthetic fabrication work, or in simpler terms, the framework, is evaluated more so, especially in completely edentulous patients. Occlusal adjustments are made in this phase depending on whether the patient is entirely or partially edentulous and the number of teeth implanted and given a prosthesis. The predetermined records are matched for facial profile analysis, and the implant dentist can do a radiographic evaluation through lateral skull views. The prosthesis is delivered successfully in this phase through ceramic or zirconia crowns and implant abutment that can be screwed or cemented.

The Phase of Definitive Prosthesis Evaluation

This is the final phase, wherein there is a thorough reevaluation after treatment within 12 weeks of prosthetic delivery and fabrication. Then, after adjustment of the provisional restoration evaluation in six months, the definitive prosthesis is delivered to meet the patient's long-term functional and esthetic requirements.

Conclusion

In implant dentistry, prosthetic planning is a crucial phase involving various steps. Initially, thorough assessment and diagnosis are conducted, followed by treatment planning and implant placement. The prosthetic phase begins with the design and fabrication of prosthetic components tailored to the patient's needs and implant position. Finally, prosthetic delivery and maintenance ensure long-term success and patient satisfaction with the implant-supported restoration. Effective prosthetic planning is essential for achieving optimal functional and aesthetic outcomes in implant dentistry.

Frequently Asked Questions

1.

What Are the Phases of Dental Implants?

Usually, there are three phases to getting a dental implant. 
Phase 1 - Implant.
Phase 2 - Abutment.
Phase 3 - Crown.
- Phase 1 begins by placing an implant in the jaw bone and leaving it for nearly four to six months, depending on the quality and location of the bone.
- Phase 2 is marked by the placement of the implant after four to six months of the healing period. The abutment is part of an implant to which the crown can be attached.
- Phase 3 is the final stage in which the placement of the crown is done.

2.

Explain the Phases of Prosthetic Training.

There are three main phases of prosthetic training, including the following.
- Controls training.
- Repetitive drills.
- Bimanual functional skill training.
- Prosthetic training is given for an individual to make the best use of and to adapt to the prosthetic in their daily life.

3.

What Is the Concept of All-On-4 Dental Implants?

Paulo Malo developed the treatment concept of all-on-4 dental implants. It is the placement of four dental implants in a completely edentulous area that can support all the crowns. It has the major advantage of placing longer, titled implants supporting all the teeth along with multi-angled or straight implants.

4.

What Are One or Two-Stage Dental Implants?

Replacing missing teeth with dental implants can require a one-stage dental implant procedure or a two-stage dental implant procedure.
- One-Stage Dental Implant: When the quality of the bone is good, a staged procedure is employed. The abutment (connecting link for the implant and final crown) is placed during the placement of the implant, and the crown is placed.
- Two-Stage Dental Implant: This process is followed when there is no need for immediate restoration of aesthetics. The abutments are not placed during the placement of the dental implant, and only the implant is placed at first. After four months, the abutment is placed, followed by the placement of the crown.

5.

How Long Can a Prosthetic Last?

The time period for which a prosthetic can last is termed the life cycle of a prosthetic. It is also called fatigue life. This time period can depend on the quality of the prosthetics and the maintenance of the same. The time until which a prosthetic can be replaced is the life cycle of the prosthetics.

6.

What Is the Golden Period of Prothetic Rehabilitation?

Replacing the missing structure with a prosthetic within four weeks increases the chance of the individual accepting the prosthesis. This is the most vital factor of prosthetic rehabilitation and is known as the golden period of prosthetic rehabilitation.

7.

What Are the Stages Included in Life Cycle Design?

Three stages are included in the life cycle design.
Stage 1- Design.
Stage 2 - Validation.
Stage 3 - Manufacturing.
Computer-aided tools are used to design the prosthesis, and numerical simulation is done to check on the mechanical features and to validate the design. Further on approval, the design is manufactured.

8.

What Is the Meaning of the Prosthetic Process?

The prosthetic process is fitting the manufactured prosthetic and delivering it to the individual.
It starts with primary prosthetic fitting, in which the prosthetic fittings are taken. And a test socket is prepared in case of a prosthetic limb. After a test socket is prepared, a temporary or preparatory prosthesis is given, followed by a definitive therapy and training to adapt to the prosthesis.

9.

Are Prostheses and Prosthetics the Same?

Both prostheses and prosthetics denote the man-made or artificial body structures that replace the missing part in a human body. They can be made of many types of materials. Types of prostheses include eye implants, breast implants, dental implants, dentures, limb implants, and so on.

10.

What Are the Types of Dental Prostheses?

There are five types of dental prostheses, including the following.
- Dental Crowns - Crowns can be placed to regain the function of the teeth and can be made of stainless steel, zirconia, ceramic, and metal-ceramic.
- Dental Bridges - Replacing two or more teeth is done by placing a dental bridge consisting of attached crowns.
- Dental Implants - Replacement of missing teeth with a permanent prosthesis involves a dental implant which consists of a screw placed into the jawbone.
- Dentures - Dentures can replace all the teeth or a few teeth and can be removable or fixed.
- Dental Veneers - Sheet or plate-like structures that can be placed on teeth. Often used for aesthetic purposes.

11.

Are Dental Implants Prosthetics?

Dental implants are prosthetics as they are artificially made and replace the missing body structure that is the teeth. They are made of zirconium oxide or titanium.

12.

What Is the Aim of Prosthetics?

- Prosthetics aims at replacing the missing body structure, which helps in restoring not only the aesthetics but also the functional ability of the structure. 
- Regaining a missed body part boosts the individual mentally and also helps in improving the lifestyle of the individual.
- Having a prosthetic makes an individual less dependent on the caretaker than earlier.

13.

What Does Prosthetic Rehabilitation Mean?

Prosthetic rehabilitation involves restoring the individual's ability to live a normal life. It also involves training an individual on how to get adapted to the prosthetic device and how to use it. The rehabilitation phase begins right from the time the defective part is removed. Continuing with the manufacturing of the prosthesis and delivering it and daily using the prosthesis.
Source Article IclonSourcesSource Article Arrow
Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

Tags:

dental implant
Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Source Article ArrowMost popular articles

Ask your health query to a doctor online

Dentistry

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy