![]() Stud attachments and especially the ball type are more frequently used as they are considered simple and economical options. Surveyed crowns resemble conventional designs and constitute a reliable solution but they are demanding in terms of technical difficulty and costs. The use of different attachment systems does not seem to significantly influence implant survival rate and patient satisfaction. However, reduced frequency of rebasing procedures has been reported due to less bone resorption, which is attributed to relieved pressure applied upon soft tissues, especially in cases of thick soft tissue (>2 mm). ![]() Plastic components need to be changed every 12 months. The studies report prosthesis survival rates of 90–100%. Marginal bone loss ranges from 0.3 to 2.3 m. However, survival rates of implants used in IARPDs are not inferior to those reported in the literature with a range between 91% and 100%. According to a Finite Element Analysis, implants are expected to bear most of the loading, especially in cases where they are placed in premolar rather than molar areas. The stress on the periodontal membranes of abutment teeth and supporting bone around implants and mucosa decrease with implants placed at first molars sites ( 22). Stresses of chromium–cobalt frameworks in IARPDs are reduced, and the effect is most evident when the implants are placed at the molar instead of the premolar area. Implant placement for the transformation of RPDs to IARPDs entails certain biomechanical advantages. Photo panel depicting clinical and laboratory stages of the IARPD fabrication process utilizing the altered cast technique. The present report aims to describe the protocol applied to fabricate an IARPD to rehabilitate a Kennedy Class II mandible of an elderly patient by incorporating specialized methods, such as the altered cast technique. Recording mucosa in its functional form as described in the altered cast technique may improve denture biomechanical behavior in terms of stability and support. In cases of Kennedy Class I or II, where free-end saddles are present denture bases tend to move towards the mucosa during function. Ĭonventional techniques may also be used for the reduction of denture base displacement. Denture displacement reduction and possibly less bone resorption and fewer rebasing procedures are also among the benefits of IARPDs. According to the literature, tension on terminal abutment teeth is reduced, whereas the pressure on soft tissues is relieved. This treatment concept has also shown some biomechanical advantages. Incorporating implants as abutments negates the need for preparing tooth abutments, thereby facilitating the preservation of healthy dental tissues. Reduction of base displacement and forces applied upon the abutment teeth are among the advantages of IARPDs. The advantages are more evident in cases of posterior edentulism where implant placement can convert a Kennedy Class I or II to Class III. Implant-assisted RPDs (IARPDs) have been proposed as simple means for lessening the adverse effects of conventional RPDs. This fact along with some adverse biomechanical effects of removable partial dentures (RPDs), the rates of inadequate retention and retreatment of this type of prosthesis have led to the incorporation of implants as abutments for RPDs ( 7). However, a decrease in the frequency of complete edentulism is expected in the foreseeable future. The McGill consensus in 2002 was a milestone that established the use of implants for the support of removable prostheses providing improved retention, support, and stability. ![]() Īt first, implants were used for the support of fixed partial dentures (FPDs). Implants are currently used not only for the rehabilitation of complete but also for partial edentulism. These results have led to the expansion of indications for their use. ![]() ![]() Nowadays, implants have achieved a survival rate of 96.4%, which can be characterized as satisfactory and has emerged by understanding several biomechanical factors and their effect upon parameters, such as marginal bone loss, which is determined by both local and systemic factors, including age, history of periodontitis, oral hygiene, smoking, implant surface, and prosthesis type. Implant therapy has gone through major advancements since the Branemark era. ![]()
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