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Implant Prosthodontics

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Evidence-Based Implant Dentistry

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Abstract

The goal of a prosthetic restoration is to provide good esthetic and functional outcomes on a long-term basis. For the clinician, implant prosthodontics poses many decision-making challenges.

Choice of screw- or cement-retained implant prosthesis is still a matter of personal preference, although some specific indications and contraindications are retrievable from the literature. Ease of manufacturing, risk of complications, cost, and chair time are all factors that need to be evaluated in the choice of a retention system.

Another doubt may arise regarding the adoption of cantilever prosthesis in place of more complex surgical or prosthetic options. Finite element analysis studies and clinical trials may help in providing survival and complication rates of cantilevers.

In selected cases, advanced treatment options are necessary. It is the case of zygomatic implants, which are useful when more traditional approaches are unfeasible. Considering the delicate structures involved and the surgical skills required, placement and restoration of zygoma implants should be performed in adequate structures by properly trained clinicians.

The All-on-FourTM is a prosthetic concept which employs four implants in the anterior jaw, of which the distal two are maximally angulated. The sparse evidence coming from the literature suggests that this can be a reliable option in selected cases.

Another question that seeks for an answer regards the ideal number of implants to achieve optimal results. Clear indications are available for full-mouth fixed rehabilitations, in which minimum four implants in the mandible and six implants in the maxilla are considered the most reliable solutions.

Implant overdentures are still an important option for edentulous patients, especially in the elderly. Analysis of the various attachment systems and the number of implants can help in selection of the best treatment options.

Accurate impression taking is a fundamental step for achievement of optimal prosthetic results. Materials adopted should possess some fundamental basic properties. Regarding the impression techniques in implant dentistry, two options are available: transfer and pick up.

Finally, optimal esthetic results depend by numerous factors; it is the mimicry with the natural tissues that ensures the best outcomes. It is not easy to arrive at strong evidence-based conclusions on this topic, mainly due to the lack of RCTs and a poorly standardized way of reporting the esthetic outcomes.

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Authors and Affiliations

  1. International Medical School, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy

    Oreste Iocca DDS

  2. Private Practice Limited to Oral Surgery, Periodontology and Implant Dentistry, Rome, Italy

    Oreste Iocca DDS

  3. Centro Polispecialistico Fisioeuropa, Viale dell’Umanesimo, 308, Rome, 00144, Italy

    Giuseppe Bianco DDS, PhD

  4. Oral Surgery, Periodontology and Implantology, Clínica Pardiñas, A Coruña, Galicia, 15003, Spain

    Simón Pardiñas López DDS, MS

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  1. Oreste Iocca DDS
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    Oreste Iocca

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Iocca, O., Bianco, G., Pardiñas López, S. (2016). Implant Prosthodontics. In: Iocca, O. (eds) Evidence-Based Implant Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-319-26872-9_9

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