25 years implant-supported supraconstructions. A synergetic development
The background starts, in accordance with my periodontological-prosthetic training, with the assertion that the highest goal of dental restoration lies in fixed prosthetics and that, after the knowledges in the periodontal and prosthetic fields coming from Michigan and Göteborg at the end of the Seventies and at the beginning of the Eighties, this represents the gold standard for the chewing comfort and the quality of life of our patient. At the same time, the common positive experiences of the Eighties with extended fixed perio-prostheses turned for us, at the beginning of the Nineties, into the forerunner of implantology which, at that time, with its first guaranteed long-term results, gave both the dentist and the dental technician the foundations for its use on patients. It is therefore the strictly periodontological orientation of the therapy and prosthetic construction, that gave us success over years and decades, that we will present. The presentation will concern both planning and clinical and technical realization as well as possible related problems, always including a systematic explanation and patient motivation by the dentist and the dental technician alternately.
This goes from the simple increase in the number of pillars and prostheses in edentulous cases at the beginning of the Nineties to absolute support in cases of frightened patients with a “declining dentition”, i.e. an all-on-4 prosthesis built in one day starting from 2010. We will also consider the question of connecting the implants to the overconstruction, from simple screwing to the framework to all-ceramic solutions, either cemented or non cemented, also from the technical and materials viewpoints. This will also include our experiences with the newest materials. We will present options with hybrid prostheses with the use of “stable base principles”, also known as the so called “rescue prosthetics” of once fixed, implant-supported reconstructions.
The conclusion draws attention to the importance of a team approach between dental technician and dentist for the long-term success of the overconstructions, without excluding an analysis of possible failures.
