Int J Stomatol

Int J Stomatol ›› 2024, Vol. 51 ›› Issue (1): 1-9.doi: 10.7518/gjkq.2024001

• Expert Forum •     Next Articles

Restorative space in edentulous patients and the clinical decision of implant restoration

Tang Chunbo()   

  1. Dept. of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Jiangsu Province Key La-boratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
  • Received:2023-08-23 Revised:2023-10-12 Online:2024-01-01 Published:2024-01-10
  • Contact: Chunbo Tang E-mail:cbtang@njmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(82170993)

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Abstract:

The restoration space should be fully considered in designing the implant restoration for edentulous patients to accommodate the superstructure of implant dentures and prostheses and select the appropriate restoration method. However, no unified standard exists for the evaluation of restoration space in clinical practice. Mechanical or biological complications of implant dentures occur when the restorative space in the mouth does not match the prosthesis design. This study recommends recording the correct jaw relation retained by natural teeth or old dentures before implant treatment in edentulous patients. The complete digital information of the patient’s oral and maxillofacial region can be obtained using digital technology, and a three-dimensional virtual dental patient model can be constructed. A functional and aesthetically oriented implant restoration plan can be designed according to the measured vertical restoration space and horizontal relationship.

Key words: edentulous, implant restoration, vertical space, horizontal relation

CLC Number: 

  • R783.4

TrendMD: 

Fig 1

Mechanical complications of implant-supported restorations"

Tab 1

Factors that should be considered in the decision of implant-supported fixed dentures or over- dentures for edentulous jaws"

考虑因素种植固定义齿种植覆盖义齿
牙槽嵴形状垂直/凸颊侧倾斜/凹
颌间距离较小或正常较大
水平颌位关系Ⅰ/Ⅱ类Ⅲ类
黏膜厚的，角化的薄的，可移动的
笑线低高
面部/唇部支撑无需支撑需要支撑

Fig 2

Measurement of vertical restoration space （arrows show）"

Fig 3

Patients with high smile line underwent alveolar ridge trimming to avoid the exposure of implant-abutment junction"

Fig 4

Implant restoration treatment in patients with upper jaw thrust forward"

Fig 5

Implant restoration treatment in patients with mandibular prognathism"

Fig 6

Measurement of HTRS"

Fig 7

The angle between the line of the alveolar crest and the occlusal plane at the site of the maxillary first molar"

Fig 8

Methods of restoration of the maxillary edentulous jaw"

Fig 9

Fullness of the face can be restored by using fixed dentures and overdenture"

1 Fukahori S, Kondo Y, Nodai T, et al. Implant-supported fixed prosthesis improves nutrient intake in patients with partial edentulous posterior regions[J]. J Prosthodont Res, 2019, 63(4): 411-414.
2 Messias A, Nicolau P, Guerra F. Different interventions for rehabilitation of the edentulous maxilla with implant-supported prostheses: an overview of systematic reviews[J]. Int J Prosthodont, 2021, 34: s63-s84.
3 Ahuja S, Cagna DR. Classification and management of restorative space in edentulous implant over-denture patients[J]. J Prosthet Dent, 2011, 105(5): 332-337.
4 Tunkiwala A, Kher U, Vaidya NH. “ABCD” implant classification: a comprehensive philosophy for treatment planning in completely edentulous arches[J]. J Oral Implantol, 2020, 46(2): 93-99.
5 Hsu YT, Fu JH, Al-Hezaimi K, et al. Biomechanical implant treatment complications: a systematic review of clinical studies of implants with at least 1 year of functional loading[J]. Int J Oral Maxillofac Implants, 2012, 27(4): 894-904.
6 Bertolini MM, Del Bel Cury AA, Pizzoloto L, et al. Does traumatic occlusal forces lead to peri-implant bone loss? A systematic review[J]. Braz Oral Res, 2019, 33(): e069.
7 Alvarez-Arenal A, Gonzalez-Gonzalez I, deLlanos-Lanchares H, et al. Influence of implant positions and occlusal forces on peri-implant bone stress in mandibular two-implant overdentures: a 3-dimensional finite element analysis[J]. J Oral Implantol, 2017, 43(6): 419-428.
8 Emami E, Michaud PL, Sallaleh I, et al. Implant-assisted complete prostheses[J]. Periodontol 2000, 2014, 66(1): 119-131.
9 Carpentieri J, Greenstein G, Cavallaro J. Hierarchy of restorative space required for different types of dental implant prostheses[J]. J Am Dent Assoc, 2019, 150(8): 695-706.
10 Figueras-Alvarez O, Clua-Palau A, Caponi LQ, et al. Interarch space assessment in edentulous patients rehabilitated with complete removable dentures using open-access software[J]. J Dent, 2022, 123: 104127.
11 Ahuja S, Cagna DR. Defining available restorative space for implant overdentures[J]. J Prosthet Dent, 2010, 104(2): 133-136.
12 Lee CK, Agar JR. Surgical and prosthetic planning for a two-implant-retained mandibular overdenture: a clinical report[J]. J Prosthet Dent, 2006, 95(2): 102-105.
13 Ataoglu H, Kucukkolbasi H, Ataoglu T. Posterior segmental osteotomy of maxillary edentulous ridge: an alternative to vertical reduction[J]. Int J Oral Maxillofac Surg, 2002, 31(5): 558-559.
14 Calamita M, Coachman C, Sesma N, et al. Occlusal vertical dimension: treatment planning decisions and management considerations[J]. Int J Esthet Dent, 2019, 14(2): 166-181.
15 Goldstein G, Goodacre C, MacGregor K. Occlusal vertical dimension: best evidence consensus statement[J]. J Prosthodont, 2021, 30(S1): 12-19.
16 Drummond J, Maillou P, Smith KT, et al. A useful solution to a space problem: a striking plate[J]. Dent Update, 2003, 30(5): 269-270.
17 Zhu ZH, Ni SL, Sun XM, et al. Posterior mandibular segmental split osteotomy: a novel technique for edentulous space reconstruction in patients with skeletal class Ⅲ malocclusion[J]. J Craniofac Surg, 2022, 33(7): e712-e714.
18 张煜强, 于海洋. 颌间距离还是目标修复空间值——实测数值引导的无牙颌种植修复的临床决策[J]. 华西口腔医学杂志, 2021, 39(2): 233-237.
Zhang YQ, Yu HY. Interarch distance is a target restorative space value: clinical decisionmaking of implant restoration guided by measured value[J]. West China J Stomatol, 2021, 39(2): 233-237.
19 Sanghvi SJ, Bhatt NA, Bhargava K. An evaluation of cross-bite ridge relationships. A study of articula-ted jaw records of 150 edentulous patients[J]. J Prosthet Dent, 1981, 45(1): 24-29.
20 Tan WL, Wong TL, Wong MC, et al. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans[J]. Clin Oral Implants Res, 2012, 23(): 1-21.
21 Lago L, Rilo B, Fernández-Formoso N, et al. Implant rehabilitation planning protocol for the edentulous patient according to denture space, lip support, and smile line[J]. J Prosthodont, 2017, 26(6): 545-548.
22 Bidra AS. Three-dimensional esthetic analysis in treatment planning for implant-supported fixed prosthesis in the edentulous maxilla: review of the esthetics literature[J]. J Esthet Restor Dent, 2011, 23(4): 219-236.
23 Pollini A, Goldberg J, Mitrani R, et al. The lip-tooth-ridge classification: a guidepost for edentulous ma-xillary arches. Diagnosis, risk assessment, and implant treatment indications[J]. Int J Periodontics Restorative Dent, 2017, 37(6): 835-841.
24 Hochman MN, Chu SJ, Tarnow DP. Maxillary an-terior papilla display during smiling: a clinical study of the interdental smile line[J]. Int J Periodontics Restorative Dent, 2012, 32(4): 375-383.
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