PROSTHETIC RECONSTRUCTIONS AND REFERRING IMPLANT SURVIVAL IN A POSTGRADUATE PROGRAM : A RETROSPECTIVE STUDY
Figure 2 . The implant survival was not significantly different for the implants supporting the different prosthetic reconstructions
• Planning : It was based on the clinical examination and comprised analysis of casts mounted with a face-bow , a prosthetic tooth setup simulating the prospective treatment outcome , evaluation of the best treatment plan based on objective criteria and possible modification of the plan which reflect the patients ’ benefit and demands , cost estimate , case presentation and establishing of the final procedures , and a virtual three-dimensional implant planning with specific software program .
• Pretreatment phase : It consisted in a smoking cessation protocol , periodontal treatment , fillings , endodontic treatment , tooth extraction and tooth setup , mockup , provisional prostheses including splints , reevaluation of the pretreatment , fabrication of radiographic splints and virtual implant placement with special computer software , fabrication of surgical splints . Based on proper treatment planning and case presentation the permission by the director of the department was obtained to perform implant surgery .
• Implant surgery : In the beginning the graduate students assisted implant surgery taking the role of the nurse and eventually performed all types of surgery themselves under guidance . According to the SAC criteria this included standard implant placement and eventually more complex surgery , such as staged or simultaneous local guided bone regeneration ( GBR ), sinus floor elevation ( SFE ) with transcrestal access or with lateral fenestration , submerged healing , in selected cases immediate implants or immediate loading , small connective tissue grafts , reevaluation of surgery and case presentation . The Nobel Replace implant system ( Nobel Biocare , Gothenburg , Sweden ) was used .
• Prosthetic phase : This phase consisted in the reevaluation of the provisional prostheses and modifications needed for the final prostheses , impression taking with individual trays , bite registration , final setup with orientation index and try-in session , case presentation , delivery of finale prosthesis and case presentation . The implant-supported reconstructions ( ISRs ) consisted of fixed ( single crown ( SC ), short-span fixed dental prosthesis ( FDP ), fullarch FDP ( IB )) and removable ISR ( denture with ball attachments ( RDP ), bar-supported overdenture ( Bar-IOD )). The fixed ISRs were either cement retained on an abutment or screw retained directly to the implant .
• Maintenance : The maintenance care program comprised at least one scheduled visit per year and monitoring of the oral hygiene by the dental hygienist . It was carried out by the graduate students during their training period . Handling of complications was equally part of the educational program since patients of the maintenance care program who exhibited any kind of problem were attributed to the trainees during their curriculum period .
2.4 . Prosthesis design and materials At the beginning of the time period covered by the present study standard technologies i . e . porcelain fused to metal were applied for fabricating of SCs and FDPs . Removable prostheses were connected to soldered rigid gold bars , using prefabricated elements as provided by the manufacturer , less
226 STOMA . EDUJ ( 2016 ) 3 ( 2 )