Teeth in a DAY
- 1. TEETH IN A DAY Immediately loaded implant supported fixed provisional denture Ting-Wey Yen, DDS, MS 4300 Long Beach Blvd Ste 320 Long Beach, CA 90807 www.drdreamsmile.com
- 2. TWYen Immediate Loading Balshi TJ, Wolfinger GJ. Immediate loading of Branemark implants in edentulous mandibles: a preliminary report. Implant Dent. 1997 Summer;6(2):838. Schnitman PA, Wohrle PS, Rubenstein JE, DaSilva JD, Wang NH. Ten-year results for Branemark implants immediately loaded with fixed prostheses at implant placement. Int J Oral Maxillofac Implants. 1997 Jul-Aug;12(4):495-503. Tarnow DP, Emtiaz S, Classi A. Immediate loading of threaded implants at stage 1 surgery in edentulous arches: ten consecutive case reports with 1- to 5-year data. Int J Oral Maxillofac Implants. 1997 May- Jun;12(3):319-24. Cooper LF, Rahman A, Moriarty J, Chaffee N, Sacco D. Immediate mandibular rehabilitation with endosseous implants: simultaneous extraction, implant placement, and loading. Int J Oral Maxillofac Implants. 2002 Jul-Aug;17(4):517-25.
- 3. TWYen Advantages Time Minimal overall discomfort Eliminate removable provisionals Cost Use existing impression/denture repair techniques—minimal new instrumentation
- 4. TWYen Disadvantages Learning curve Lab support Requires coordinated visits between two offices
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- 6. TWYen PROCEDURE (before surgery) Develop Tx plan with surgeon— make sure bone adequate Establish OVD Duplicate lower prosthesis or Fabricate new prosthesis Fabricate surgical guide Modify existing tx denture (24 hr prior)
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- 8. TWYen PROCEDURE (day of surgery)—Surgeon: Extraction of hopeless teeth Alveolectomy (to level the bone and create restorative space) Place implants Place abutments Place closed tray impression copings Close up soft tissue--place sutures Call Dr. Yen 30 min prior to end
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- 10. TWYen PROCEDURE (day of surgery)—Restorative: Verify tightness of closed tray impression copings Try in modified tx denture—adjust as necessary for clearance Full arch PVS impression—capture pear shaped pads CJR using the tx denture or surgical guide
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- 15. TWYen LABWORK Pour up impression Mount using tx denture Place metal temporary cylinders Modify denture to fit Check occlusion, connect Reinforce with Ribbond Fill in the remainder with resin Check embrasure, polish
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- 21. TWYen DELIVERY (24-48 hr): Remove closed tray impression copings—return to OS Deliver fixed implant provisional Adjust occlusion Check embrasures Seal with cotton/Fermit POD instructions
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- 24. TWYen FOLLOW-UP One week check Adjust occlusion -- avoid breakage Check embrasure OHI: initially-- rinse only; after 3 weeks-start brushing, implant floss Fabricate definitive restoration in 2- 3 months
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- 26. TWYen Precautions Keep maximum interocclusal space Alveolectomy to lower ridge height Use shortest abutment heights Fixture level impressions if necessary Avoid high water design
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- 41. TWYen Immediately loaded implant supported fixed provisional denture Time Eliminate removable provisionals Cost Use existing impression/denture repair techniques—less inventory Chee W, Jivraj S. Efficiency of immediately loaded mandibular full-arch implant restorations. Clin Implant Dent Relat Res. 2003;5(1):52-6.
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