How Are Fixed Prosthodontic Restorations Held In Place

How Are Fixed Prosthodontic Restorations Held In Place – Open Access Article This open access article is licensed under the Creative Commons Attribution-NonCommercial 3.0 Unported License.

Anatomically, human teeth are structures that are part of the outer surface of the human body. When teeth are lost, they are often replaced with dental implants to facilitate chewing food and for aesthetic purposes. Successful replacement of missing teeth requires hard tissue integration with the implant surface. The microtopography and chemical properties of the implant surface were investigated to improve osseointegration. In addition, the clinical success of the implant depends on strong gingival anchorage to the abutment, preventing oral bacteria from penetrating the osseointegrated surface. Epithelial and connective tissue cells respond to the support surface depending on the characteristics of the surface and the material from which it is made. In particular, the structural biomechanics of the implant-abutment interface (ie, the biomechanics of the interface between the implant and the abutment surface and the screw mechanics of the implant-abutment assembly) play an important role in soft tissue sealing and hard tissue integration. . Here, we discuss the clinical significance of these three interfaces: bone-implant, gingival support, and implant-support.

How Are Fixed Prosthodontic Restorations Held In Place

How Are Fixed Prosthodontic Restorations Held In Place

Jeong Chang Kim currently works as a senior technical director at Deep Implant System, an implant manufacturing company in Seongnam, Korea. He graduated from Seoul National University, Seoul, South Korea, where he received his master’s degree in periodontics. He is a periodontist and clinical assistant professor in the Department of Periodontology at Seoul National University. He is currently working on creating a modified surface for the implant.

A Systematic Review Of Screw Versus Cement Retained Fixed Implant Supp

Min Li is a professor in the School of Dentistry and an adjunct faculty member in the Department of Bioengineering at the University of California, Los Angeles. He received his PhD in biomedical engineering from UCLA and joined the UCLA faculty in 2007. Dr. Lee’s research focuses on the design and development of novel biomaterial systems that provide fundamental and translational approaches to tissue engineering and regenerative medicine. Specific areas of interest include orthobiology, material-based therapy for cranial and orthopedic skeletal defects, novel liposome platforms for drug and gene delivery, and injectable hydrogel systems.

In-Sung Luke Yeo is currently a professor at Seoul National University, Seoul, South Korea. From 2003 to 2006, he served as a dentist in the Special Forces Commands of the Korean Army. He received his PhD in Prosthodontics from the Department of Dentistry, Seoul National University, where his topic was implant surface modification and bone-implant interface. . He is currently treating patients as a prosthetist at Seoul National University Dental Hospital and studying the characteristics of hard and soft tissue responses to implant surfaces.

1. Introduction A dental implant is an artificial biomedical device that is surgically installed and fixed in the jawbone to replace missing teeth.1 Teeth perform three main functions: swallowing. , speech, aesthetics (beauty) and tooth loss can affect them. Traditionally, dentists have treated tooth loss using fixed or removable dentures bonded to the remaining teeth; however, during this type of prosthesis, the remaining teeth may be damaged by various forces exerted on the artificial organ.2-4 Therefore, restoration with dental implants is preferred as the first choice of artificial prosthesis, and dental implants have priority in the modern environment. clinical practice. dentist.

A tooth protrudes through the gums (gums) into the mouth and consists of a crown visible in the mouth and a root embedded in the jawbone. The structure of the dental implant system is similar to that of the tooth, the implant is similar to the root, and the artificial crown is equivalent to the natural crown; However, the root and crown of the tooth form a continuous structure, while the implant and the artificial crown in the implant system are separate parts connected to each other by abutments (Figure 1).

Implant Abutment Selection In Fixed Prosthodontics

Figure 1 Basic structure of the dental implant system. The abutment is connected to the implant by an abutment screw. In this example, the artificial crown is cemented onto the abutment. The cross-sectional diagram on the right shows the implant-abutment interface consisting of a frictional interface between two inclined planes (red rectangle) and a screw interface (blue rectangle).

Implants, abutments and artificial crowns are the three main components of a dental implant system. Because implants are inserted into the jawbone and abutments are placed in the soft tissue (gum) area between the jawbone and the mouth, the dental implant system has two biological interfaces: the hard tissue-implant interface and the soft tissue-support interface. . To restore a missing tooth, the bone must integrate with the implant surface and the gingiva must adhere tightly to the abutment surface to inhibit the inflammatory response around the implant system.5-7 The implant-key interface (Figure 1) must also , to be present. Its biomechanical properties strongly influence bone and gum physiology.

This review examines the interactive effects of hard tissue–implant, soft tissue–abutment, and implant–abutment interfaces from a clinical perspective that have not been addressed in previous reviews. In the first part, we discuss topographically and chemically modified implant surfaces that affect bone healing at the hard tissue-implant interface. In the second part, we examine the clinical significance of the soft tissue seal around the abutment and discuss the design factors affecting the abutment material and the soft tissue–abutment bond. In the third section, we review some biomechanical formulas that analyze two typical structures of implant abutment connections and explain the characteristics and material limitations contained in these formulas from a clinical point of view.

How Are Fixed Prosthodontic Restorations Held In Place

2. Bone-implant interface (solid tissue union) 2.1. Hard tissue integration (osseous integration) Chewing uses teeth, jawbones and masticatory muscles, and dental implants replace the function of teeth. Therefore, the implant must be firmly anchored to the jawbone to perform its chewing function; This is called hard tissue integral.6, 7 When the implant is inserted into the bone, the initial stability of the implant depends on the mechanical contact of the surface between the bone and the implant, which is called “primary stability”. using the well-known mass-spray vibration damping model, where m is the mass of the system, c is the damping constant, and k is the spring constant. , x is displacement, and t is time.9 As the bone healing process progresses, hard tissue integration occurs at the bone-implant interface, providing secondary stability to the implant and increasing fixation of the implant to bone; this biological phenomenon complicates the mechanistic interpretation of implant stability.8, 10

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Hard tissue integration, often referred to as osseointegration, is defined as “direct contact between the loaded implant surface and bone at the level of light microscopic resolution” (Figure 2); however, by this definition, fusion of solid tissues can only be observed and described using histological methods; Therefore, this definition has been modified to be more clinically relevant. An example of a modified definition is “clinically asymptomatic rigid fixation of retained alplastic material in bone during functional loading”.11 Recently, Albrektsson et al. Commercially pure Ti has been suggested to act as a foreign body when placed in living tissue; therefore, hard tissue integration can be considered an immune-mediated inflammatory process.12 In contrast, previous in vivo studies hypothesized the possibility of a non-physical bioaffinity bond between Ti and bone.13 The nature of biocompatible interactions between Ti and bone. Zirconium dioxide (implant surfaces such as zircon, ZrO2) are not yet fully understood.

Fig. 2 Solid tissue integration (non-calcified section, stained with hematoxylin and eosin). Bone in direct contact with the implant surface (white arrowhead) is shown on the histological image. Scale bar = 100 µm.

During implant surgery, water and ions reach the surface of the implant when bleeding occurs when the implant is inserted into the bone hole. As hemorrhage and stasis continue, extracellular matrix (ECM) proteins mediate cell attachment to cover the surface. 14 Inflammation develops and subsides, leading to granulation tissue formation and angiogenesis. 15 Osteoprogenitor cells adhere to the implant surface via ECM proteins and differentiate into osteoblasts. . , forms new bone at the bone-implant interface.14 Initially, the new bone is woven bone, which is replaced by layered bone due to the distribution of load and bone stress at the bone-implant interface.15, 16 Osteoclasts resorb. the woven bone forms resorbed cavities known as Howship’s lacunae. Osteoblast progenitor cells use pseudopodia to sense the surface structure of this resorbed bone and to receive information about the amount of bone needed to fill the hole.17 Topographical changes to the implant surface to form a gap-like structure are thought to enhance bone formation. osteoblastic. .18, 19

Ti dental implants, especially those made of pure Ti, are widely used to replace missing teeth. Successful long-term clinical results (ie >10 years) have been achieved with Ti dental implants.6 Ti is a biologically stable, inert, persistent metal that does not induce biocompatible reactions or foreign body reactions when implanted in the human body . body.20, 21 Hard tissue integration is the implant

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