CAMLOG Hybrid Restorations

5 HYBRID RESTORATIONS WITH THE CAMLOG ® IMPLANT SYSTEM SYSTEM INTRODUCTION GENERAL GUIDELINES FOR THE FABRICATION OF IMPLANT-SUPPORTED PROSTHETICS Modern implant prosthetics is now an established component of dentistry. The expectations and demands of patients are steadily increasing. There- fore, the ultimate goal of modern implant-supported treatment concepts is for full esthetic, functional, phonetic, and psychosocial rehabilitation. This applies equally to replacements of lost single incisors associated with trauma and the complex rehabilitation of periodontally compromised re- maining teeth or the treatment of an edentulous heavily atrophied maxilla and mandible. Increasingly higher demands for quality and specialization require a multi- disciplinary team approach to combine the members acquired knowledge and experience. Modern implant-supported restorations need a high level of attention to detail and clinical experience. This is true equally for the re- storative dentist, the surgeon, the dental technician, and the dental office support staff such as the nurse, hygienist, and chair assistant. The CAMLOG team concept takes all of these demands into consideration. The sequence of treatment procedures is structured, and specific procedures are clearly assigned to specific team members once the joint planning phase is com- plete. The implant-supported prosthetic restoration should be designed as simple and as safe as possible in regards to planning and fabrication. The required number of implants, as well as their length and diameter are determined based on the restoration planned later and the available bony implant site. The preimplantation planning should be oriented exclusively to prosthetic needs (backward planning). The patient is the focus of the implantological restoration. The patients needs and desires must play a part in the fabrication of the prosthetic res- toration. This also requires taking into account anatomical relationships and conditions. Natural teeth are attached elastically by the periodontium to the alveolar bone. However, implants are rigidly anchored to the alveo- lar bone by the ankylotic connection to the bone substance. Mastication forces placed on implant-borne crown and bridge restorations are trans- ferred directly to the bone. For this reason, the mastication forces should be transferred by a possible physiological process in the form of a suitable occlusion design thus supporting the long-term success of the integrated implants. This can be achieved in the posterior occlusal area with a surface area of approx. 1 mm² that allows lateral freedom of movement of approx. 1 mm in habitual intercuspation. This makes it possible for the cusps to glide smoothly between the retrusive contact position (centric occlusion) and the maximum intercuspal position called «freedom in centric». In conjunction with a premolarized forming, overloads can be avoided. Extreme cusp for- mations should be avoided due to dentition that is too strong and vertical mastication forces affect the implant/antagonist axis preferably physiolog- ically. Guidance functions of crown restorations on individual implants can lead to lateral force affects that are too strong and should be avoided. Ap- propriate planning (e.g. wax-up) is therefore essential. RECALL Resilient supported full dentures with retention devices should be regu- larly checked in three-month intervals after insertion. When harmful movements of the prosthesis occur, they can be eliminated promptly by through appropriate measures (occlusion check, activation / replacement of the matrices, relining). Patients with inadequate oral hygiene are remo- tivated and instructed again as part of oral hygiene and denture care. For patients with good oral hygiene, the intervals between the functional and hygiene checks can be extended.