implant position: its effect on implant aesthetics and health dr steven soukoulis
TRANSCRIPT
![Page 1: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/1.jpg)
Implant position:
Its effect on implant aesthetics and health
Dr Steven Soukoulis
![Page 2: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/2.jpg)
SPECIALIST CASES
![Page 3: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/3.jpg)
Goal
Implant crown should occupy same 3D space as original crown
Implant crown and gingival complex should replicate original architecture
The implant position should allow this goal to be realised
![Page 4: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/4.jpg)
FACTORS AFFECTING IMPLANT POSITION
ANATOMICALFACTORS
PROSTHETICFACTORS
![Page 5: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/5.jpg)
Implant position
Anatomical structures; bone, gingival tissues, lips, adjacent teeth, surgical skill/technique, implant type
Prosthetic considerations; type of restoration (single/multiple), screw retained or cement on, posterior or anterior, crown or precision attachment
![Page 6: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/6.jpg)
![Page 7: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/7.jpg)
Aesthetics
Various anatomical structures can be used as reference points when trying to determine how the proposed prosthesis would satisfy the aesthetic demands of the site and patient.
This pre-surgical assessment is paramount to establishing a good position of the dental implant
![Page 8: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/8.jpg)
Pre-Surgical Assessment
SMILE LINE
GINGIVAL MARGIN
MIDLINE
CROWN LENGTH
CROWN WIDTH
![Page 9: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/9.jpg)
![Page 10: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/10.jpg)
Aesthetics
Maxillary incisor inclination
Evaluate the labio-lingual inclination of the maxillary anterior teeth
This can be done using: cephalometric radiographs orpatient’s maxillary posterior occlusal plane
Generally, the labial surface of the maxillary central incisors should be perpendicular to the occlusal plane allowing maximum direct light reflection from the central incisors (Kokich et al 1997)
![Page 11: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/11.jpg)
![Page 12: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/12.jpg)
Insert daryl here
![Page 13: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/13.jpg)
Aesthetics Gingival considerations:
The ideal gingival levels are determined by establishing the correct width-to-length ratio of the maxillary anterior teeth (Sterrett et al 1999)
By determining the desired amount of gingival display
By establishing symmetry between right and left sides of the maxillary dental arch (Kokich et al1999)
Tooth Width Length Ratio (%)
Central
Incisor
8.59 mm (M)
8.06 mm (F)
10.19 mm (M)
9.39 mm (F)
0.85 mm (M)
0.86 mm (F)
Lateral
Incisor
6.59 mm (M)
6.13 mm (F)
8.70 mm (M)
7.79 mm (F)
0.76 mm (M)
0.79 mm (F)
Canine
7.64 mm (M)
7.15 mm (F)
10.06 mm (M)
8.89 mm (F)
0.77 mm (M)
0.81 mm (F)
80%
![Page 14: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/14.jpg)
Perceptions of dental professionals and
Lay persons to altered dental esthetics:
Asymmetric and symmetric situations
Vincent O. Kokich, Vincent G. Kokich,H. Asuman Kiyakc (Am J Orthod Dentofacial Orthop 2006; 130:141-51)
![Page 15: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/15.jpg)
80% 100%
![Page 16: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/16.jpg)
Crown Lengthening
![Page 17: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/17.jpg)
Aesthetic assessment
Maxillary tooth aestheticsappraisal of the position of the maxillary central incisors relative to the upper lip
Determination of midline relationship/position
![Page 18: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/18.jpg)
![Page 19: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/19.jpg)
SURGICAL CONSIDERATION
S
![Page 20: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/20.jpg)
Standard implantESTHETIC PLUS implant
2.8 mm1.8 mm
Standard vs. ESTHETIC PLUS
![Page 21: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/21.jpg)
ESTETHIC PLUS Implant
![Page 22: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/22.jpg)
≥ 6.2 mm ≥ 6.2 mm
WB 4.8 mm WNI 4.8 mm
≥ 5.5 mm
S 4.1 mm
![Page 23: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/23.jpg)
≥ 4.8 mm ≥ 4.8 mm
NNI 3.3 mm S 3.3 mm
![Page 24: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/24.jpg)
![Page 25: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/25.jpg)
![Page 26: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/26.jpg)
![Page 27: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/27.jpg)
Ideal Implant placement in biotype I
![Page 28: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/28.jpg)
Ideal Implant placement in biotype II
![Page 29: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/29.jpg)
Biotype
Type 1 Type 2
![Page 30: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/30.jpg)
Predicted
gingival margin
![Page 31: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/31.jpg)
![Page 32: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/32.jpg)
![Page 33: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/33.jpg)
With these assessment criteria/protocols lets look at several cases to determine how to approach these to
ensure a good aesthetic and peri-implant health result.
![Page 34: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/34.jpg)
HOW NOT TO DO IT!
![Page 35: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/35.jpg)
TOO DEEP
TOO BUCCAL
![Page 36: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/36.jpg)
Mc DENTISTRY
![Page 37: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/37.jpg)
HOW DO YOU DO IT?
![Page 38: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/38.jpg)
![Page 39: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/39.jpg)
![Page 40: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/40.jpg)
![Page 41: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/41.jpg)
![Page 42: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/42.jpg)
![Page 43: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/43.jpg)
![Page 44: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/44.jpg)
![Page 45: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/45.jpg)
![Page 46: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/46.jpg)
![Page 47: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/47.jpg)
GOOD POSITION BUT
PROSTHETICS?
![Page 48: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/48.jpg)
![Page 49: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/49.jpg)
![Page 50: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/50.jpg)
TOO DEEP
![Page 51: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/51.jpg)
![Page 52: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/52.jpg)
![Page 53: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/53.jpg)
![Page 54: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/54.jpg)
![Page 55: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/55.jpg)
![Page 56: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/56.jpg)
TOO SHALLOW
![Page 57: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/57.jpg)
![Page 58: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/58.jpg)
In Summary
Pre-surgical assessment should carried out prior to implant placement
Use surgical guides where possible
Consider temporary implant crowns in high aesthetic zones
NEVER bury implants
![Page 59: Implant position: Its effect on implant aesthetics and health Dr Steven Soukoulis](https://reader035.vdocuments.site/reader035/viewer/2022081602/551a25bf550346545e8b4644/html5/thumbnails/59.jpg)
THANKYOU