T-scan II application in Implant Prosthodontics

1. T-scan II application in Implant Prosthodontics 嘉泉醫大 吉病院 齒科센터 主任敎授 : 金滿龍 GDC

2. Purpose / treatment sequence • The occlusal forces that applied to an implant prosthesis and be a potentially destructive factor in shortening the potential longevity of any implant prosthesis. • Both material failure and implant deosseointegration have been attributed to excessive occlusal loading to dental implants GDC

3. Purpose / treatment sequence • The occlusal forces that applied to an implant prosthesis and be a potentially destructive factor in shortening the potential longevity of any implant prosthesis. • Both material failure and implant deosseointegration have been attributed to excessive occlusal loading to dental implants GDC

4. Purpose • Poorly directed and non-uniform occlusal loading will torque a prosthesis and apply stresses that may ultimately result in prosthetic failures. GDC

5. T-scan II occlusal analysis • By occlusal adjustment – can be quantitatively represented for improved correction • Occlusal force distribution can then be far less destructive to the prosthesis, and the underlying implant-bone interface. GDC

6. T-scan II occlusal analysis • By occlusal adjustment – can be quantitatively represented for improved correction • Occlusal force distribution can then be far less destructive to the prosthesis, and the underlying implant-bone interface. GDC

7. T-scan II occlusal analysis • Articulating paper is not capable of demonstrating any occlusal force and time data. • By interpretationthis information (T-scan data) and using it to guide the insertion occlusal adjustment procedure, occlusal forces on the final prosthesis can be axially directed and distributed uniformly in a non-destructive arrangement GDC

8. T-scan II occlusal analysis • Articulating paper is not capable of demonstrating any occlusal force and time data. • By interpretationthis information (T-scan data) and using it to guide the insertion occlusal adjustment procedure, occlusal forces on the final prosthesis can be axially directed and distributed uniformly in a non-destructive arrangement GDC

9. Application in Implant prosthesis • Balancing and centering the occlusal forces on a full arch complete implant supported fixed prosthesis • Removal of lateral interferences in excursive function that will place excessive forces on the occlusal materials while inducing shear stress in the supporting bone GDC

10. Application in Implant prosthesis • Balancing and centering the occlusal forces on a full arch complete implant supported fixed prosthesis • Removal of lateral interferences in excursive function that will place excessive forces on the occlusal materials while inducing shear stress in the supporting bone GDC

11. Application in Implant prosthodontics • Establishing delayed implant loading to follow natural tooth loading, in combination cases involving implants and natural teeth GDC

12. Centering occlusal forces on a full arch complete implant supported fixed prosthesis GDC

13. .203sec GDC

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15. Several more corrective adjustment GDC

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17. before after Accuform film으로 여러 번 occlusal adjustment를 한후 balancing과 centering이 이루워지도록 10번 GDC

18. Removal of lateral interferences in excursive function GDC

19. #13 cuspid guidance시 .7second동안 interference GDC

20. Short Disclusion Time (<.5 seconds per excursion) is a desirable treatment goal to attempt to develop, as this time frame is indicative of true and measured (not visualized) immediate posterior disclusion . GDC

21. 3. Establishing delayed implant occlusal contacts, which follow natural tooth occlusal contacts, in mixed implant-natural tooth occlusal schemes. In order to minimize excessive force loading to the implant prosthesis, the occlusal scheme could be designed to include a quantifiable time delay, such that the natural teeth occlude in advance of the implant prosthesis. The elapsed time of the delay should be long enough for the natural teeth to depress into their Periodontal Ligament fibers GDC

22. When natural teeth are occluded upon, they move in a two stage process. The first stage is the Intrasocket stage, during which a tooth moves within the confines of the periodontal ligament. The second stage has been described as a gradual elastic deformation of the alveolar bone,in response to increasing horizontal forces11. GDC

23. Degree of movement Healthy, non-mobile posterior teeth depressed about 28 microns vertically moved laterally 56-75 microns (Parafitt G.S) Healthy, non-mobile anterior teeth moved laterally 90-110 microns Dental Implant : Vertical 5 microns laterally 12 –66 microns (Sekinie) GDC

24. Clinical Treatment Procedures Seat the segmental prosthesis and evaluate interproximal contact to insure complete seating. 1. Record a Force Movie of Full Closure only. 2. Play back the recording and watch for when the segmental prosthesis loads in comparison to the natural teeth nearby. GDC

25. 3. Mark the implant prosthesis with AccufilmÔ once more, and gently shave off the occlusal contact marks. You are trying to remove a thin layer of the occlusal material so as to create a sliver more space between the implant prosthesis and the opposing occlusal surfaces. Record a new Full Closure Force Movie, and playback as described above. GDC

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27. {.530 seconds - .122 seconds} = .408 seconds GDC

28. Thank you for your attention 감사 합니다 GDC