Implant supported single-tooth occlusion

Abstract

Nedostatak zuba uzrokuje funkcijski i estetski problem te se mora nadomjestiti. Terapijske mogućnosti su višestruke, a izbor terapijskoga sredstva ovisi o sposobnosti i znanju terapeuta, ali i o kliničkoj slici, oralnoj higijeni, željama te financijskim mogućnostima samoga pacijenta. Nedostatak zuba možemo nadoknaditi privremenim i/ili trajnim nadomjescima. Od privremenih nadomjestaka koriste se najčešće akrilatne proteze ˝žabice˝ i fleksibilne proteze. Trajni fiksnoprotetski radovi mogu biti adhezivni mostovi ojačani Ribbond vlaknima, konvencionalni most, privjesni most i adhezijsko cementiran most. Implantoprotetska terapija je metoda izbora jer se izbjegava brušenje susjednih zdravih zubi. Planiranju okluzije u sklopu implantoprotetske terapije treba posvetiti dovoljno pozornosti uzimajući u obzir sve bitne činjenice i prateći određene smjernice. U planiranju se rabe koncepti preuzeti iz klasične protetike, s većim ili manjim modifikacijama. Uglavnom je riječ o uzajamno zaštićenoj okluziji i njezinim inačicama prilikom koje se stražnjim zubima štite prednji prilikom maksimalne interkuspidacije, a stražnji prednjima u kliznim kretnjama. Dobrim planom okluzije i modificiranim dizajnom protetske suprastrukture izbjegavaju se rizični faktori koji dovode do okluzijskoga preopterećenja. Njih moramo poznavati jer okluzijsko preopterećenje dovodi do brojnih mehaničkih komplikacija. Postoji niz smjernica koje terapeutu pomažu prilikom planiranja okluzijskih koncepata, ali svakoga pacijenta treba promatrati kao zaseban slučaj čijoj se situaciji treba u najvećoj mjeri prilagoditi kako bi se mogućnost komplikacija svela na najmanju razinu.The lack of a tooth causes functional and aesthetic problems, and therefore the tooth must be replaced. Therapeutic possibilities are multiple, and the choice of a therapeutic agent depends on the skills and knowledge of the therapist, as well as the patient’s clinical state, oral hygiene, desires and financial capabilities. The lack of a tooth can be compensated with temporary and/or permanent restorations. Temporary restorations used in this situation are acrylate dentures or flexible removable partial dentures. Permanent fixed partial dentures can be Ribbond bridges, bilateral anchored bridges, cantilever or adhesion cemented bridges. Implant therapy is a method of choice, because grinding of healthy teeth is avoided. Planning of the occlusion within implantoprosthetic therapy should be done in detail, taking into account all the relevant facts and following the specific guidelines from the literature. Occlusal concepts are taken from classic prosthodontics, with greater or lesser modifications. Generally, mutually protected occlusion and its variants are discussed, where distal teeth protect frontal teeth in maximal intercuspidation, and frontal teeth protect distal teeth by guiding the mandible in its movements. With a good occlusal scheme and proper design of the prosthetic suprastructure, the risk factors that lead to occlusal overload can be avoided. We need to be aware of them because the occlusal overload leads to numerous mechanical complications. There are many guidelines that assist the therapist while planning the concept of occlusion, but each patient should be approached as an individual case to which we need to adapt in order to provide the satisfying function and minimize the possibility of complication