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AAP ICP 2 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
95 1 2 3 The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 3
505070 (1) (2) (3) ( (1) (2) (3) (4) powerpoint 10545 4 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
1 贋 58 The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 5
Asymmetrical face Square outline form Normal lip line while smiling No Gummy smile Straight profile Nasolabial angle : nearly 90º W Denture W/o Denture Normally functioning muscles of mastication The temporomandibuar joints were normal with freedom of eccentric movements. MIP #21,22,23 ill-fitted FPDs with advanced periodontitis #35,34,33xxxx43,44 ill-fitted FPDs Missing : #11-17;24-27;36-37;45-47 No torus Arch form : Maxilla asymmetrical ovoid #21-23 labial flare out Mandible asymmetrical parabolic Maxillary ill-fitted RPD Mandibular ill-fitted RPD Canine relationship : R & L : Angle Class I Molar relationship : R : Angle Class I L : Angle Class II Horizontal overlap : 9 mm Vertical overlap : 3 mm Occluding pairs : zero (Eichner classification ) 6 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
W shift to R't NW NW shift to L't W P P P X #21 #22 #23 #44 #43 #33 #34 #35 Tooth #21 #22 #23 PD(B) 377 333 385 PD(P) 867 323 3510 M Dx Severe periodontitis Severe periodontitis Severe periodontitis Tooth #44 #43 #33 #34 #35 PD(B) 333 533 333 333 533 PD(L) 233 323 323 323 633 M - + + Dx moderate periodontitis moderate periodontitis 97.05.22 97.06.17 Severe periodontitis Severe periodontitis The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 7
FM Chronic periodontitis Localized severe periodontitis # 21,22,23,34,35 Ill-fitted maxillary & mandibular RPD Faulty mandibular FPDs Retained roots : #34,#35 Deep carious lesions : #33,43,44 Emergency & Corrective care 贋 97.06.27 97.07.14 #33,43,44 8 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Tx Option 1 (dental implant-supported FPDs) : maxilla : implant-supported FPDs mandible : #44,43,xxxx,33 PFM FPDs or #44,43,33 PFM crowns, #42-32 implant-supported FPDs ; #45,46,47,34,35,36,37 implants-supported FPDs Tx Option 2: maxilla : complete denture mandible : #44,43,xxxx,33 PFM FPDs ; bilateral distal free-end kennedy class I RPD - 贋 Maxillary master cast and occlusal rim set up Jaw relationship establishment The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 9
Maxillary complete wax denture try-in FPDs wax up and vacuum-formed index 97.08.15 #33,43,44 posts and cores fabrication 10 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Mandibular FPDs master cast take bite silicone index Full mouth diagnostic wax-up Cut back Mandibular PFM FPDs copings fabrication The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 11
Mandibular PFM FPDs copings try-in and check bite Mandibular PFM FPDs delivery Final impression for mandibular distal free-end 12 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Dental surveyor evaluation Mandibular RPD metal framework fabrication & try-in Occlusal rim set up & bite registration for mandibular RPD The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 13
Full mouth wax dentures try-in Flasking before packing 14 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
W R NW NW L W Laboratory remounting & occlusal adjustment P P P The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 15
W R NW NW L W P P P 16 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Tooth #44 #43 #33 PD(B) 223 222 332 PD(L) 222 223 222 M - - - Maintenance care Oral and prosthesis hygiene reinforcement - dental brush & super-floss + inter-proximal brush Periodic recall (per 6 months) - check occlusion and stability of dentures - periodontal supportive Tx The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 17
Follow-up after 6 Months checking list powerpoint Slides 10 Combination syndrome + 18 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
2 28 Personal habits 2 : No Smoking: No Alcohol: No Betel nut chewing: No Front facial view: Symmetry TMJ pain and click: No Facial profile: concave Jaw deviation: No Lip line: average Bruxism: No The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 19
Intra-Oral Examination Dentition: Midline: on Occlusion : Canine Class I, R't molar- Class I Overjet: 3 mm, overbite: 3 mm Crowding over 31~44 24 mesial-in rotation 37 mesial tilting Low gingival line and incisal plane of 13 Missing: 15, 23, 36 Ill-fitted prosthesis: 22 Provisional restoration: 12 Caries: 13, 24, 25, 26, 42, 45, 46, 47 Amalgam filling : 17, 26, 27, 37, 45, 46, 47 Resin restoration: 13, 25 IRM filling: 35 Incomplete RCT: 11, 12, 14, 21, 22, 24 Apical R/L lesion: 12, 14, 21 Root resorption: 12 X DistalBuccalMesial 17 16 15 14 13 12 11 A.L. 4 2 3 4 4 3 3 2 3 3 3 3 3 3 3 3 2 3 P.D. 4 2 3 4 4 3 3 2 3 3 3 3 3 3 3 3 2 3 P.D. 4 3 5 4 3 5 5 3 4 4 2 3 3 2 3 3 2 3 A.L. 4 3 5 4 3 5 5 3 4 4 2 3 3 2 3 3 2 3 M 0 0 0 0 1 0 F.I. P G G F G G G Palatal MesialBuccalDistal 21 22 23 24 25 26 27 A.L. 3 3 3 3 2 4 4 2 4 4 3 4 4 3 3 3 2 3 P.D. 3 3 3 3 2 4 4 2 4 4 3 4 4 3 3 3 2 3 P.D. 3 3 3 3 3 4 4 5 4 3 3 3 3 3 4 4 3 3 A.L. 3 3 3 3 3 4 4 5 4 3 3 3 3 3 4 4 3 3 M 0 0 0 0 0 0 F.I. P G G G G G G Palatal 20 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
DistalLingualMesial 47 46 45 44 43 42 41 A.L. 3 3 4 5 3 4 4 3 4 3 3 3 4 3 3 3 2 3 3 2 3 P.D. 3 3 4 5 3 4 4 3 4 3 3 3 4 3 3 3 2 3 3 2 3 P.D. 4 2 5 4 2 4 4 2 4 4 2 5 4 2 4 4 2 3 3 2 3 A.L. 4 2 5 4 2 4 4 2 4 4 3 5 4 2 4 4 2 3 3 2 3 M 0 0 0 0 0 0 0 F.I. P G G G G G G G Buccal MesialLingualDistal 31 32 33 34 35 37 38 A.L. 3 2 3 3 2 3 3 2 3 3 2 3 4 3 3 4 3 3 4 3 3 P.D. 3 2 3 3 2 3 3 2 3 3 2 3 4 3 3 4 3 3 4 3 3 P.D. 2 2 2 2 2 2 2 2 4 3 2 4 4 2 4 3 3 3 3 2 3 A.L. 2 2 2 2 2 2 2 2 4 3 2 4 4 2 4 3 3 3 3 2 3 M 0 0 0 0 0 0 0 F.I. P G G G G G G G Buccal Incomplete RCT: 11, 12, 14, 21, 22, 24 Dental caries: 13, 24, 25, 35, 42, 45, 46, 47 Chronic apical periodontitis: 12, 14, 21 Localized chronic periodontitis Problem lists Poor oral hygiene 12 radiolucent lesion about 10x10 mm. Apical root resorption was noted. 21 radiolucent lesion about 4x4 mm; casting post was found Supraeruption of 13 The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 21
Oral hygiene instruction OD of 25, 26, 35, 42, 45, 46, 47 Remove 11, 14, x 16, 21, 22 PFM crowns Remove caries of 24 and re-evaluation Extraction of 12 with cyst enucleation 21 apicoectomy 11, 14, 22, 24 endodontic re-treatment 2008.6.5 removal of 11, 21 PFM crowns 2008.6.11 removal of 24 caries palatal margin subgingival for 2 mm, poor prognosis 2008.6.19 removal of 14 PFM crown vertical root fracture 2008.6.30 removal of x16 FPD Extraction of 12, 14, 24 Cyst enucleation of 12 Endo. Re-treatment of 11, 22, 25 Apicoectomy with retrograde filling of 21 OD of 25, 26, 35, 42, 45, 46, 47 16, 12, 14, 24 Definitive treatment plan I Implantation of 14, 15, 23 Implant-supported FPD of 14, 15, 23 FPDs of 11x13, 16, 21, 22, 25 22 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Definitive treatment plan II FPDs of 11x13xx16, 21 22x25 Diagnostic wax up The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 23
2008.7.18 ~ 9.15 11, 22, 25 endo. Tx. 2008.7.29 extraction of 14, 24 21Apicoectomy 2009.1.5 OPD f/u 24 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Anterior guide table fabrication Full wax pattern Cut-back wax pattern The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 25
Framework try-in soft tissue model Biscuit bake try-in 26 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
X The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 27
2 months f/u 16 months f/u X 16 months f/u W NW NW W canine guidancegroup function 28 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
1. 2. framework 1. 2. 3. Q 12 A 12crown-root ratio>1 Q 2122x25 A 2324pontic2322 23 pontic21 Q 11x13xx16long-span FPD A 1. tooth preparation taper 2. ponticconnector 3. framework modulus of elasticityyield strength 2% gold alloy 4. solder 5. The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 29
3 50 #36 -- 20 #26 -- 20 #35, 45 -- 2~3#35x37#45 30 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Face formsquare Facial midlineon Front facial view: symmetry Gummy smile(+) TMJ-related examination Mouth opening: 48 mm Clicking sounds: No Muscle palpation pain: No Joint palpation pain: No Open mouth deviation: No lower lip protruded to E-line Convex profile 1 mm #13Angle class I#23Angle class II, #46Angle class I Ill-fitted Single crown#26 ; Ill-fitted PFM bridge#35x37 Missing#28, 36, 38 #23,24 #13 disocclusion The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 31
XGM-BP I ) 18 17 16 15 14 13 12 11 Mobility I I I I Furca B:GM-BP(I) 96/11 P:GM-BP(I) 96/11 B:6 D:4 B:2 D:3 X 3102 223 223 533 723 724 322 X 332 214 224 625 1085 853 323 21 22 23 24 25 26 27 28 Mobility I I I I Furca B:GM-BP(I) 96/11 P:GM-BP(I) 96/11 B:2 M:5 D:6 B:2 D:4 223 327 422 423 313 9210 333 X 323 257 223 322 223 937 322 X 48 47 46 45 44 43 42 41 Mobility I Furca B:3 B:3 31 32 33 34 35 36 37 38 Mobility I I Furca L:4 B:GM-BP(I) 96/11 X 833 433 322 322 313 321 213 B:GM-BP(I) 96/11 222 212 212 313 212 X 221 X L:GM-BP(I) 96/11 X 1032 323 223 222 222 312 222 L:GM-BP(I) 96/11 222 222 222 213 213 X 353 X Generalized moderate and localized severe chronic periodonotitis Necrotic pulp / Chronic apical periodontitis#26, 35 Ill-fitted crown & bridge#26, 35x37 32 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
OHI Remove ill-fitted prostheses26,35x37 Temporary prostheses fabrication of 26, 35x37 Endodontic re-treatment26, 35 # 26 MB root canal transportation Floor perforation Periodontal treatment Extraction 97/04 Full mouth ultrasonic scaling + GM-BP I.. (96/11) Full mouth subgingival curettage and polishing GM-BP II (97/03) Periodontal surgery treatment 16-17, 46-47,15-23 GM-BP III (98/03) Periodontal charting GM-BP III (98/03) 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 Mobility I I Furca B:2 D:0 GM-BP III Buccal GM-BP III Palatal B:0 D:0 332 323 323 323 313 313 312 322 313 222 323 323 322 223 223 223 323 313 422 323 233 224 222 323 323 321 B:2 D:0 The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 33
48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 Mobility Furca GM-BP III Buccal GM-BP III Lingual I B:1 B:1 L:1 333 222 222 212 222 221 212 222 212 212 212 212 222 423 223 223 222 222 212 212 222 222 212 223 213 323 Prosthetic treatment options 26 > Option 126 implant > Option 225x27 PFM bridge 36 > Option 136 implant+35,37 single crowns > Option 235x37 PFM bridge Definite treatment plan Implant26 PFM bridge35x37 Treatment sequence 26 implantation...97/10/17 Impression of 26 implant...98/02/20 Temporary prostheses of 26...98/02/26 Final impression of 35x37...98/05/14 Full wax up...98/05/26 Metal framework try in...98/06/04 Bisque try in...98/06/18 Delivery...98/06/24 Follow up Face bow transfer 34 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Diagnostic wax up Surgical stent of 26 Panoramic film X-ray & Tomography #26 implantation ITI SLA Standard Plus implant 4.8x12 mm Good oral hygiene (PI< 3%) Good wound healing Planning for temporary prostheses fabrication The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 35
Final impression of 26 implant Impression cap synocta positioning plastic cylinder synocta analog 26 SynOcta post for temporary restorations 26,35x37 Occlusal analysis - left working side 36 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Follow up Stable occlusion No TMJ symptom & sign Stable periodontal condition 35x37 mounting 26Full wax up Temporary crown SynOcta abutment for cemented crowns and bridges Full wax up The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 37
Cut backsilicone putty verification Metal frameworks 38 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Metal framework try in #26Vita A3.5#35-37A3.5 Bisque Glazing & staining Pontic designmodify ridge lap Margin design0.3-.05mm metal collar The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 39
disocclusion Working side Non-working side Protrusion Dental floss ( > or Super floss Interdental brush 40 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
GM-BP IV 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 Mobility Mobility Furca B:2 D:0 B:0 D:0 Furca B:2 D:0 B:GM-BP() X 333 323 333 323 333 323 212 P:GM-BP() X 323 233 323 323 333 322 323 B:GM-BP() 322 333 322 333 323 323 X P:GM-BP() 232 323 322 333 323 322 X 48 47 46 45 44 43 42 41 Mobility Furca B:1 B:1 B:GM-BP() X 333 232 222 232 222 222 312 L:GM-BP() X 423 223 323 222 232 312 212 31 32 33 34 35 36 37 38 Mobility Furca L:2 B:GM-BP() 322 222 222 212 212 X 323 X L:GM-BP() 222 232 212 223 223 X 333 X The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 41
6 follow up 13 follow up MI working side nonworking side Occlusal view 42 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
CASECASE CASE CASECASE paper support Q 36implant35x37bridge A 3537 implant CASE36 implant Q A 3537furca maintainableabutment ENDOCASE36implant Q 26implantemergency profile A fixture 4.812mmperio Perio The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 43
123 1 full denturecomplete over-denturekennedy class I RPDclass I RPD implantsover-denture class I RPD class I RPD 1. X 2. pre-prosthetic management 3. RPD altered cast impression) 4. 5. RPDbiomechanics (surveyed crowns ) 44 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
2 canine-to-canine 1. X 2. pre-prosthetic management 3. diagnostic wax-up 4. 5. Post-core foundation 6. staticdynamic conditioncustomized incisal guiding table 3 ( molars premolars 1. X 2. pre-prosthetic management 3. foundationpost and core 4. framework designpontic design 5. staticdynamic The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 45
Q A 46 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Q A Q A The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 47
Dr. J Loyola Loyola Loyola 48 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Dr. S a s h a Jovanovic The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 49
Sasha Dr. Pascal Magne academic clinical experience common sense clinical experience common sense evidence-based medicine technique 50 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 51
1990 Feldspathic VeneerInlayOnlay Vita In- ceramivoclarvivadent LeuciteEmpress BrånemarkAlumina Oxide Procera Zinc Phosphate cementpolycarboxylate cement Moisture control 30um 1 Immediate Dentin Seal Dentin Bonding 35% Phosphate Acid Bonding agent 95% 2 1. 52 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
2. #21 Porcelain Laminate Bonded Porcelain Restoration (Inlay/Onlay) Silane agent Silane agent Temporary cementation Moisture control Glycerin Silica- based Glass- infiltrated Flexural strength Polycrystalline CeramicsAlumina OxideZirconia Oxide BiocompaKbility Flexural strength Al2O3 Ve n e e r InlayOnlay The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 53
Alumina O x i d e Zirconia Oxide Implant Abutment Feldspathic Porcelain Empress PressEmpress e- max Press CAD/ CAM Empress e- max CAD VeneerInlayOnlayEmpress II Ivoclar Vivadent Vita In- ceramvita Company Alumina OxideNobel BiocareProcera Zirconia OxideNobel Biocare Procera3MLavaDentsplyCercon TDS 54 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
Palatal side1mm Veneer porcelain 3. Coefficiency of Thermal Expansion 45C 4. 5. 6. Fine Diamond bur Round bur Diamond bur Dr. Ariel J Raigrodski Ludwig- Maximilians Daniel Edelhoff 1. 2. Framework Tension side Nobel Biocare, Ivoclar Vivadent The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 55
20 2011AAP 56 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
201110 AAP 100115 The Academy of Prosthetic Dentistry, Republic of China/ 中華民國贋復牙科學會 57
99 20111029-30AAP.http://www.dentech.com.cn/en/dongtaiView.asp?ID=46 International College of Prosthodontists(ICP)ICPChina ICPhttp://www.icp-org.com/Membership_Organizations.html 2000 58 中華民國贋復牙科學會 / The Academy of Prosthetic Dentistry, Republic of China
中華民國贋復牙科學會民國 100 年行事曆 公告事項 日期活動內容備註 514 618 54 103 98-12 14ICP 910 924 55 1029-30 (AAP) 115 1119-20 1210 56