Beruflich Dokumente
Kultur Dokumente
31
Anterior Single-Tooth
Implant Restorations
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abutment,
and
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Segmented, screw-retained
restoration
Segmented restorations may
be considered those that fit
over titanium abutment cylinders rather than connect
directly tc the implant fixtures.
Thus, there are various segments to the restaration.
Advantages of having the
titanium abutment include the
tact that there is now a titanium-titanium interface at the
level of the implant fixture.
Galvanism and corrosion
should no longer be o concern. The interface at this level
is now between two machined
companents and thus the
technique sensitivity of a casting is eliminated. Also, there
now exists a titanium-soft" tissue
interface. Although some
researchers oonsider the
potential hemidesmosomal
attachment betvyeen the titanium and soft tissue to be an
important factor for long-term
success,^'^ others feel that this
sa-called biologic seal may
minimize pocket depth but will
in no way inhibit epitheliol
downgrowth. should the
implant become mobile," Still
others mointain that o
hemidesmosomal ottachment
to sott tissue is not unique to
titonium and con octuolly
occur with ceramics or a voriety ct metal alloys.^ Thus, the
true significance of this interface is somewhat unclear
Ta achieve an acceptable
esthetic result, it is critical that
the restoration begin 2 to 3 mm
beneoth the mucosa. With the
nonsegmented technique, the
restorotion begins directly at
the implont fixture. With the
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40
Fig 23 (rigtit) Thefinalrestcraflon contains tfie gold cylinder, which provides the
fit of the restorafian onto the abutment
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Summary
Singie anterior implant restorations are categorized as either
nonsegmented or segmented.
Nonsegmented restorations
connect direotiy to the impiant
fixture and are screw-retained.
These restorations are fabricated with either piastic burn
out patterns resuiting in a cast
base or the use of prefabricated goid aiioy cylinders that
are cast-to, becoming part of
the metai substructure. Screwretained and cement-retained
segmented restorations are
thase that fit aver titanium
abutment cyiinders. This may
be advantageaus. because
the bioiogic considerations of
piacing titanium abutments
subgingivaiiy inciuding a titanium-titanium interface at the
levei of the impiant fixture as
References
1. Lewis S, Beurrer J, Per'i G, Homburg
W. Single-tooth implant-supported
restorations. Int J Oral Moxillotac
Implonis 1988:3:25-30.
2. Gould TRL Brunette DM, Westbury L.
The a t t a c h m e n t mechonism of
epithelial cells to fitanium in vitro. J
PeriodonI Res 1981:16:61 l-l.
3. Honsson HA, Albrektsson T Branemark
P-l. Structural aspects of the interface between tissue and titanium
implonts. J Prosthet Denf 1983
50:108-113.
4. ten Cote AR. The gingival junction. In;
Brnematk P-l, Zarb G, Albrektsson T
(eds). tissue-Integrated Proslheses:
Osseointegration in Clinical Dentistry.
C h i c a g o ' Quintessence, 1985:
145-153.
5. Jansen JA. Epittielial oeil adhesion to
dental implant materiols [thesis].
Nijmegen, The Netherlands, Caitiolic
University. 1984.
6. Lewis, S. An esthetic titanium abutment: Report af o technique. Int J
Oral Maxillofoc Implants 1991;
6:195-201.
7. Adell R, Lekholm U, Rookler B,
Branemark P-l. A 15-year study of
osseointegroted implonts in ttie
treotment ot the edentulous jow. Int
J Oral Surg 1981:0:387-416.
8. Andersson 6, Odman R Carlsson L
Branemark P-l. A new Branemark single-toath abutment: Hondling and
early clinical experiences. Int J Orol
Maxillotac Implonts 1992:7:105-111 -