前牙美学区种植.ppt

Treatment planning of implants in the aesthetic zone ● The predictability of aesthetic success depends on tissue loss at the initiation of treatment.● Specific implant systems and designs do no guarantee aesthetic outcomes.● Hard and soft tissue deficiencies must be addressed prior to implant placement.● Recreating papilla between multiple adjacent implants is not predictable. In the last 10 years the focus has shifted from osseointegration, to creation of an implant borne restoration which is in harmony with the surrounding hard and soft tissue.. Replacement of multiple missing teeth inthe aesthetic zone is challenging particularlywhen the three dimensional architecture of theexisting bone and soft tissue is deficient .. There is not a single component available from a manufacturer which would be the ideal replacement for a maxillary central incisor.. The predictability of the aesthetic outcomeof an implant restoration is dependent on manyvariables including but not limited to the following:1) Patient selection and smile line2) Tooth position3) Root position of the adjacent teeth4) Biotype of the periodontium and tooth shape5) The bony anatomy of the implant site6) The position of the implant. 1.Patient selection and smile line Notice:The clinician must understand the patient’s desires .The aesthetic zone is where the patient thinks it is.The clinician should be aware that the patient who presents with unacceptable tooth health, shade or position may not give a full smile when asked. 2.Tooth position In many instances teeth with a poor prognosis are thoughtlessly extracted. Apico-coronal: more apical, more coronal or ideal and mimic the level of the adjacent gingival margin. orthodontic extrusionFacio-lingual: positioned too far facially, bone augmentation procedures ; positioned more lingually, more favourableMesio-distal: be equal to that of the contra lateral tooth ; orthodontics, enameloplasty or restorations 3.Roo