Implant-supported restorations

Restoration first, then the implant

An implant is the foundation; the crown, bridge or denture on top of it is what you see, chew with and clean around. A prosthodontist plans the visible result first and then decides where the implants must go to support it. Dr. Lal’s interest in this approach goes back to his master’s research at Columbia on stereolithographic surgical guides for implant placement, and to his first-author 2006 papers on the subject in the Journal of Prosthodontics.

Options

• Single implant crown to replace one tooth without cutting the neighboring teeth.
• Implant bridge to replace several adjacent teeth on fewer implants.
• Full-arch fixed restoration: a fixed set of teeth on several implants for a whole jaw.
• Implant overdenture: a removable denture that clips onto implants so it does not move.

How planning works

A cone beam CT shows the bone in three dimensions. Combined with an intraoral scan and a digital design of the final teeth, it allows implant positions to be planned on screen. Where appropriate, the plan is transferred to surgery with a guide (computer-guided implant surgery), and the final restorations are designed in exocad.

Already have implants that are failing?

Loose crowns, broken screws, food traps or bone loss around implants are reasons for a specialist assessment. The first step is finding the cause, whether that is the bite, the design, the hygiene access or the implant position.