Prosthesis does NOT fit in implants. Once the implants are placed, a dental impression is made and then the prosthesis is made for those particular implants.
Basically, the surgical protocol does not change anything from the ideal one. As that protocol states, the prosthesis is previously designed and a surgical splint is moulded to place the implants.
It can be a splint for oriented surgery, leaving the final position of implants in the hands of the surgeon, or for guided surgery.
In order to align the prosthetic attachments properly, a prosthetic splint is also moulded.
The prosthesis is moulded with a titanium grade 4 internal framework, covered with new generation composites and high quality PMMA teeth.
Once the healing time is over, that prosthesis can be rebased, polished, the colour can be changed and even all teeth and composites can also be changed, keeping the real essence of it –the titanium framework – untouched.
Moulding a new hybrid prosthesis is not necessary, as this one can be rebased and re-jointed regarding the necessities of the patient.
We do not defend not using ceramic prostheses thorough any system: CAD/CAM, traditional casting, etc. What we emphasise is that there is NO NECESITTY for those prostheses.
In case the CAD/CAM prosthesis is used after the healing period, the prosthesis ArtOn 4® plays a far superior role -as a provisional one- than any other, increasing the success rate of implants, comfort for the patient, aesthetics and hygiene.
The ArtOn 4® is made of an internal titanium grade 4 framework, specifically designed to distribute the chewing forces along the whole framework as well as to maximize implants stability and to be flexible enough to adapt to maxillary and mandibular bones micro-movements.
The body of the ArtOn 4® is made of new generation composites that confer many advantages due to its 68% to 85% of ceramic in its composition:
- Comfortable; reduced volume.
The teeth used are last generation PMMA, with 5 layers and 12% of ceramics that confer them great aesthetic along with similar hardness to natural teeth.
The surgeon, depending on the patient´s anatomic and functional conditions, determines the number of implants required.
ArtOn Systems recommends internal conical connection implants, which confers more stability, less micro-movement of posts and reduction of the implant-post gap, besides a homogenous distribution of the load along the surface of the implant.
Even though, the first development of ArtOn 4® was made with universal external connection implants, managing a success rate of healing and stabilisation over 96%.
Of course, from the very beginning distal extensions are placed on the prosthesis. It depends on the particular situation every patient faces.
The surgeon decides whether to add them at the beginning or after healing period and if they are placed in occlusion or non-occlusion.
It depends on the specific characteristics of the patient. In a standard way, it is recommended a first occlusion from 4 to 4 and proceeds to full occlusion after the healing time. Disocclusion must be group guided by canine and first premolar, in order to prevent early overload in one single unit.
Of course it is highly recommended establishing maximum intercuspation in TMJ Centric Relation.
After the healing period and generally, it is recommended establishing full occlusion in centric relation and disocclusion canine or group guided.
It is always recommended making a night guard splint.
Final disocclusion will always depend on the specific characteristics of the patient:
– Carrier of removable prosthesis as antagonist
– Antagonist to natural teeth
– Ceramic antagonist
Even the final decision is always the doctor´s choice, the closer to centric occlusion the less stress on the prostheses and better long-term predictability.
Whenever full mouth rehabilitations take place, we make the most for giving the TMJ centric relation in case it is possible. If not, for giving the most suitable relation to the TMJ state.
Furthermore, in order to adapt the TMJ to its new position, a splint is always made.
The framework fits in passively on the condition that implants and attachment´s placement is right, as well as the impression taking.
Making the titanium framework produces small tensions between the posts, and they are reduced in the same way the contraction is reduced when carrying out a filling with layers.
However, it has been found that micro-tensions between the framework and implants when placing the post-surgery ArtOn 4® are eliminated during the healing period, due to the micro-movements the implants make. These movements are produced by the tense forces by the framework from the beginning and stabilised by the splint effect the ArtOn 4®’s framework generates during the whole period.
Due to the current ArtOn 4® manufacturing procedure, the solution is screwed on multiunit abutments that are fixed. So the biological sealing keeps untouched from the very moment multi-units are placed, what allows disassembling the prosthesis once a year in order to check it and clean it without losing the sealing.
By using these prostheses, we also eliminate the gap created by cement in cemented prostheses as the screwed units are prefabricated.