Prosthesis with dental implants
There is no doubt, that with the rise of the treatments in oral implantology, many patients likely use through the night prosthetic appliance of intraoral mandibular advancement, they will be or are already carriers of implants and a high percentage of them with removable or fixed prostheses removable. Just as in partially edentulous patients, making the foundations, that support mechanisms for driving the jaw, it is done on the edentulous space taking advantage of the natural and artificial fasteners, like a retention for those bases. From this past year on, the advanced appliances allow the opening drive with increased mandibular advancement, allowing unrestricted lateral movement of sliding planes too and ideals acts on the mandibular position as a help for dentist. This apparatus, in which the Orthoapnea ® device is the most innovative, can be applied to remaining pieces, totally or partially edentulous fasteners or artificial bases.
The implant dentures PR-4 (implant supported) and PR-5 (muco supported) as ranked by Misch need to withdraw the prosthesis, to use that space to the base of the GPA. Otherwise, we would be increasing the vertical dimension of the patients mouth, when it is not already presumably increased for aesthetic or functional reasons by making the prosthesis. On the other hand, if you use this dual retention and therefore getting a higher altitude, there would be more disturbances of use and possible failures in the attachment of the brace at its nocturnal funtion. For PAM retention implant, the patient uses the same media and / or deductions for holding the prosthesis, which for the brace, the use of DPM, routine cleaning of the stand as much of the prosthesis is favorized.
Making implant orthotics may seem, a priori, expensive, but not because of alternative materials and manufacturing restraint, which are used. The manufacturing concept is different, the functional purpose of the PAM itself is not intended aesthetic, neither the base support is a product itself, it is part of a treatment in the brace itself, which does not imply an exponential increase in its price. For this reason, a budgetary defensive adjustment is not necessary in visits, based on tuning, aesthetic or malocclusion problems, how they usually occur in prosthesis. The premise is to simplify and economize the treatment, because the modern mandibular advancement devices are linked together by a device, that connects the two jaws, and maintain their vertical dimension in permanent contact of discharge plates. Therefore, no retention mechanism must be highly accurate. The cost of materials should be smaller, than those of the prosthesis, because among other reasons, it shouldn't be held independently and retentively.
In some cases, the patient can take a wrong, inadequate or outdated approach to the attachment of the prosthesis, that is when we can offer a double proposal, new prosthetics and orthotics, to take advantage of the change of support or anchoring. The most common are single divergent anchorages, which have lost the peripheral bone by functional tensions. That is when splinting should be offered by a bar or structure as a way to extend life to these implants. And you can build both units simultaneously the prosthesis and the orthosis, that protects it.