Prosthetic phase - Implantology
The follow-up treatment depends on the planned superstructure.
When it comes to the manufacture of crown and bridge work or a dental prosthesis, reference is made to the chapters that deal with this. In the core there is no substantial difference with the manufacture of a structure on implants. An extensive treatise on this is therefore not an issue here. A few points for attention.
Implants are stuck rigid (immobile) in the jaw bone. They do not have a periodontal ligament. The bone lies directly against the implants. So there is no question of resilience (compressibility). Its own elements have fibers in the paronal ligament that provide some suspension. In view of this difference, it is important that the crowns or bridges on implants at close range only participate in occlusion at maximum close range. The technician and the dentist must take this into account in the manufacture of the superstructure, by making the crowns a little too low in relaxed occlusion (see image below).
The difference between osseointegration in an implant and the periodontal ligament in a natural element.
When setting up the dental elements in the dental prosthesis, it is important that there is sufficient freedom in the movement of the prosthesis forward (proal) and to the sides (lateral). This is called freedom of articulation. Certainly in case the lower prosthesis is attached to implants and the upper prosthesis rests on an edentate jaw, there is a risk that people with their lower prosthesis will bite their upper prosthesis loose.
The design of any construction on implants must at all times be such that thorough and careful cleaning of the implants with the supra or mesostructure is possible. The technician and the dentist must take this into account when designing and shaping the definitive provision (see image below).
The manufacture of a bar. a Covering screws in the mouth. b Imprints are screwed into the implants that remain in the final impression. c The dental technician has cast implant analogues in plaster. d The bar construction on the model; e and in the mouth.