Vilas Patel

Success in implantology depends on the profound knowledge of the concept of osseointegration, a meticulous surgical technique and a sound application of restorative principles, all governed by a thoughtful treatment plan. Evolution of dental implants has been progressing at an enthusiastic pace. From the Branemark era in the 60s of the machined titanium root form implants, the blades popularized by Linkow, to the present day of highly characterized root forms, implants have undergone tremendous modifications. Such Enhancements have been in all the aspects of implant like the biomaterial, the basic shapes, sizes, design characteristics like thread, configurations, surface coatings, abutment profiles etc. the market is flooded with an array of implants sytems, each having some feature unique to them and each claiming superiority over the others. In the 1960s dental implantology as a clinical discipline was judged by some to be rather disorganized, and treatments provided were often said to be not as successful as hospital-based orthopedic and cardiovascular surgery pro¬cedures, One part of this opinion related to the use of standard intraoral dental materials.

For many patients, being edentulous would be regarded as a handicap with respect to oral function and psychosocial impact on quality of life. As a result, restoration of oral function through oral surgery and placement of implants is often welcome. Long-term studies have demonstrated that the edentulous jaw can be restored successfully with implant-supported fixed prostheses. Nowadays, the use of implants has a great impact on the prosthodontic treatment of the edentulous patient. A variety of prosthetic designs associated with implant prostheses can be observed, and some new designs have emerged in response to the specific clinical conditions of the edentulous jaw provided with implants. Valid clinical methods and treatment strategies -involving the implant technology - exist to ensure the quality of prosthetic reconstruction. Hence, with regard to some special implant indications, specific prosthodontic principles are needed.

The implant overdenture is an especially attractive treatment because of its relative simplicity, minimal invasiveness, and economy. Existing complete dentures can be converted for many patients and maintain facial support with the denture flange when moderate to extreme alveolar ridge resorption is present. The implant overdenture is supported by both implant and mucosa and therefore fewer implants are necessary than for the prosthesis supported only by implant. The overdenture usually consists of two or more implants placed within alveolar bone on opposite side of the arch. Connected to the implants is an attachment device that has a corresponding coupling unit processed to the tissue surface of the complete denture. When the attachment components are appropriately connected, the complete denture is held in position on the mucosa and both mucosa and implants provide support, retention and stability. The overdenture is easily removed for hygiene.

La professione odontoiatrica sempre stata alla ricerca di restauri che abbiano un aspetto "naturale" ma che siano, allo stesso tempo, duraturi. In passato, la mancanza di materiali dentali appropriati ha reso tutto ci impossibile. Tuttavia, i progressi nel campo delle faccette in porcellana e dei materiali adesivi offrono oggi una variet di selezioni nel trattamento, con restauri di lunga durata e una migliore qualit dei risultati estetici. Le faccette in porcellana sono da considerarsi lo "stato dell'arte" dell'odontoiatria estetica, fornendo abbondanti vantaggi rispetto a qualsiasi sistema di faccette precedente. Sono eccellenti in termini di aspetto e durata, e la procedura vera e propria non disturba i tessuti molli o il parodonto adiacente. Dalla loro introduzione quasi 20 anni fa, le faccette in porcellana sono diventate il fiore all'occhiello della maggior parte delle pratiche basate sull'estetica.

Full mouth rehabilitation seeks to convert all unfavorable forces on teeth which invariably lead to periodontal conditions, into favorable forces which permit normal function and therefore induce healthy condition. Thus it entails the performance of all the procedures necessary to produce a healthy, esthetic, well-functioning, self-maintaining masticatory function. It implies the restoration of impaired occlusion, enhancement of esthetics, preservation of the remaining teeth and maintenance of a healthy periodontium. Treatment plan must result in healthy maintainability of the teeth and their respective supporting structures in harmony with the muscles, bones, joints and ligaments of the mouth and jaws.