Universitat Internacional de Catalunya
Introduction to Prosthetic Implantology
Other languages of instruction: Catalan, Spanish
Teaching staff
Jordi Ortega Martínez jortega@uic.es
Bárbara Pàmies Jordana babipam@uic.es
Introduction
Students attend face-to-face classes for the implant prosthesis subject.
Lectures are given by the teaching staff, with a total of 14 topics related to the bases of implant prostheses.
The students to whom the subject is taught are MUORE 1 and IMOS 1.
Reviews of classic and current literature will also be carried out, with oral presentations by the students.
At the end of each theoretical session, clinical cases that treat CUO are presented to discuss treatment options.
Pre-course requirements
Knowledge of the anatomical bases of the stomatognathic system and dental prostheses
Objectives
- Knowledge of prosthetic implantology.
- Know the necessary attachments for prosthetic implants and correct diagnosis and case planning.
- Ability for discussion
- Ability to analyse the literature in a critical way
Competences/Learning outcomes of the degree programme
- CB10 - Students should acquire the learning skills that allow them to continue to study.
- CB6 - Students should have and understand knowledge that provides the basis for or opportunity to be original in terms of the development and application of ideas, often within a research context.
- CB7 - Students should know how to apply the knowledge they have acquired and be able to resolve problems in new or little known environments within a broader (or multidiciplinary) context, related to their area of study.
- CB8 - Students should be able to incorporate knowledge and tackle the complexity of making judgements based on information which, being incomplete or limited, includes reflections on the social and ethical responsibility linked to the application of their knowledge and judgement
- CB9 - Students should know how to express their conclusions, and the knowledge and reasoning these are based on, to specialised and non-specialised audiences in a clear and unambiguous way.
- CE1 - Students should be able to undertake a proper analysis and an extraoral diagnosis, and underline the aesthetic and functional aspects of the teeth and the soft areas of the lower part of the face as well as a analysis and clinical and lab-based diagnosis, using diagnostic and therapeutic wax models, in order to rehabilitate dental occlusion with good functional and aesthetic balance, while taking into account multidisciplinary factors related to the masticating apparatus.
- CE10 - Students should acquire the ability to apply scientific methods, and apply the knowledge acquired to resolving problems in a scientific field. They should learn how to develop research projects both in vitro and in vivo, within the fields of mechanics, biology and microbiology applied to prosthetic and restorative dentistry and dental implants.
- CE11 - Students should be autonomous in terms of developing and applying new technologies to aesthetic restorative dentistry and searching for new scientific information, as well as acquiring the ability to evaluate and undertake the research and development projects the industry offers in an ethical way, and manage the financial and human resources, as well as be aware of the strategic basis for the transfer of new knowledge to the industry.
- CE12 - Students should update their knowledge of molecular biology, biochemistry and microbiology so they can apply it.
- CE2 - Students should be able to work as a clinical professional and/or researcher in the field of aesthetic restorative dentistry, and act as a real specialist or expert in the material; as well as know how to diagnose, treat, prevent and research oral disorders and have updated knowledge of the diagnostic and treatment-related advances which continue to arise throughout their professional life.
- CE3 - To undertake the selective drilling of teeth to balance the jaw and dental occlusion, as well as make splints for articular and occlusal protection in cases where there is a pathology that requires this.
- CE4 - To acquire the ability to make oral preparations on mucosa, teeth, and dental implants, to build dental prostheses in patients with advanced oral and multidisciplinary disorders; as well as identify and undertake the procedures and various checks for the prosthetic components during construction.
- CE5 - To be able to give public presentations on your own clinical cases based on the scientific literature, and correctly use the scientific terminology related to temporomandibular dysfunction and aesthetic restorative dentistry.
- CE6 - To acquire the ability to make scientific informed opinions so as to choose the type of material a dental prosthesis is built of in order to fit the patient with it, as well as know how to continuously update your knowledge of the dental biomaterial used in the field of aesthetic restorative dentistry, know how to manipulate it, and about its properties, indications, biocompatibilities, toxicity and environmental impact.
- CE7 - To be able to search for, organise and analyse, from a critical point of view, and using biomedical sources of information, scientific literature on issues related to temporomandibular dysfunction and aesthetic restorative dentistry, in order to pursue continuing education in a self-directed and autonomous way.
- CE8 - To know how to apply epistemological, ethical, legislational and humanitarian factors to research and the disclosure of scientific data in the field of aesthetic restorative dentistry.
- CE9 - To recognise and interpret images and specialised diagnostic techniques that are significant in research, as well as know how to apply bioinformatic tools and new technologies to the fields of prosthetic and restorative dentistry and dental implants.
- CG1 - To have the ability to communicate with patients with the aim of explaining, based on scientific criteria but in accessible language, their diagnosis, treatment plan and prognosis, in the case of pathologies that tend to be either advanced or multidisciplinary in nature.
- CG2 - To be autonomous in terms of obtaining a patient's anamnesis and oral explorations in patients with pathologies that might be either advanced or multidisciplinary in nature; and fill in their medical record and other clinical paperwork using scientific language and terminology that is suited to an aesthetic restorative dentistry professional.
- CG3 - To know how to apply the protocols established in the University Dental Clinic in relation to diagnosis, complementary explorations and treatment for patients, as well as treatment plans, taking into account the fact that the patients being addressed have pathologies that are either advanced or multidisciplinary in nature.
- CG4 - To know how to apply protocols for the use of the equipment in the dental laboratory-workshop to the point of undertaking the necessary procedures that help in oral rehabilitation or the treatments common to a restorative dentist.
Learning outcomes of the subject
- - Scientific Evidence in Aesthetic Restorative Dentistry - - The student knows the bases and criteria of aesthetic diagnosis and smile analysis - The student understands the principles of osseointegration and prosthetics on implants - The student knows the mechanisms and materials of adhesion in dentistry on different materials - The student knows in depth dental and oral anatomy - The student analyzes the scientific literature with a critical spirit. - The student analyzes the quality of the scientific literature by its content rather than by its presentation and format. - The student searches for scientific information on topics related to the function of aesthetic restorative dentistry. - The student carries out a bibliographic review on specific topics in the field of aesthetic restorative dentistry and takes into account its relationships with other areas of dentistry, in order to be able to act in an advanced and multidisciplinary way. - The student learns to apply the research methodology in his scientific works. - The student learns the bases of statistical analysis necessary for the development of his research works and the analysis of the results obtained. - Students assume that the review of scientific literature must be an essential tool in their professional work and that all clinical procedures used in the profession must be based on scientific evidence. - Students publish bibliographic reviews by having the theoretical and practical bases to carry them out. - Students integrate knowledge and face the complexity of formulating judgments based on clinical and bibliographic information that can sometimes be limited.
- - New Technologies in Aesthetic Restorative Dentistry - Students are constantly updated in the field of new technologies and professional materials in order to become restorative dentists in continuous training. - Students learn to prepare teeth in order to perform complex treatments in direct and indirect surgery. - Students learn to perform the most complex treatments in direct and indirect dental surgery. - Students maintain contacts with industry and commercial firms in order to communicate their needs as an expert professional in the advanced and multidisciplinary field of aesthetic restorative dentistry. They also work with them to initiate new research or technologies.
- - Multidisciplinary or complex clinical planning - The student is able to correctly use the scientific terminology related to aesthetic restorative dentistry, carrying out a correct extraoral analysis and diagnosis of the lower third of the patient's face, highlighting the aesthetic and functional aspects of the teeth and soft tissues of the mouth in this analysis. He/she also knows how to carry out a correct intraoral exploration and diagnosis of the masticatory apparatus of patients. - Students are able to identify and reproduce the criteria of dental macroaesthetics and microaesthetics, also in the hard and soft tissues of the mouth. - The student is able to analyse and diagnose highly complex clinical cases as well as carry out multidisciplinary planning. - The student is able to present and discuss their treatment plans based on scientific literature in the field of Aesthetic Restorative Dentistry. - The student has a basic multidisciplinary training that allows him/her to plan treatments that encompass Orthodontics, Surgery, Periodontology, Prosthodontics and Occlusion. - Students are able to make public presentations on clinical cases, with all the diagnostic details and complementary examinations required, making proposals for treatment plans referenced in the scientific literature. - Students have a clear and advanced knowledge of concepts such as osseointegration, passive adaptation, torque, implant connection, implant surface, type of prosthetic abutment, types of impressions to be made, transfer of functional and aesthetic occlusal parameters... They also choose, in a personalized way for each patient, the different implant abutments and carry out the different tests and checks of the prosthetic components during the process of making oral prostheses, managing to control this process at all times so that the finished stomatological prostheses meet the functional and aesthetic objectives set at the beginning. - Students have scientific knowledge to choose the type of material with which the rehabilitation to be installed in the patient is made. - Students have the tools to keep their continuing education up to date. They must know how to adapt their clinical practice and technological equipment to the advances and modifications that occur throughout their professional life, which can be autonomous and self-directed.
- - Multidisciplinary restorative therapy - - The student is able to correctly use the scientific terminology related to aesthetic restorative dentistry and temporomandibular dysfunction, and perform a correct extraoral analysis and diagnosis of the lower third of the patient's face, highlighting the aesthetic and functional aspects of the teeth and soft tissues of the mouth in this analysis. He/she also knows how to perform a correct intraoral examination and diagnosis of the masticatory apparatus of patients. - Students are able to identify and reproduce the criteria of dental macroaesthetics and microaesthetics, also in the hard and soft tissues of the mouth. - The student communicates with patients in order to explain, with scientific criteria but with accessible language, the diagnosis, the treatment plan and its prognosis, in relation to scientific evidence. This "rehabilitator/patient" relationship allows the latter to choose between the types of dental prostheses proposed and with the most reliable prognosis possible. - Students carry out oral preparations on mucosae, teeth and implants (carvings, impressions, structural tests, occlusal examinations, etc.) in order to create dental prostheses for patients with advanced oral disorders in a multidisciplinary professional environment. - Students have a clear and advanced knowledge of concepts such as osseointegration, passive adaptation, torque, implant connection, implant surface, type of prosthetic abutment, types of impressions to be made, transfer of functional and aesthetic occlusal parameters, etc. They also choose, in a personalized way for each patient, the different implant abutments and carry out the different tests and checks of the prosthetic components during the process of creating oral prostheses, managing to control this process at all times so that the finished dental prostheses meet the functional and aesthetic objectives set out at the beginning. - The student installs the stomatological prostheses (removable, fixed on teeth, implantological, mixed and maxillofacial) in the patient's mouth, training the patient in their proper use and maintenance. He/she also monitors the adaptation that the patients must make to the new prostheses, making the necessary prosthetic modifications in each specific case. - The student has scientific knowledge to choose the type of material with which the rehabilitation to be installed in the patient is made. - The student is able to carry out clinical and laboratory analyses and diagnoses of dental occlusion and mandibular dynamics, carrying out diagnostic and therapeutic wax-ups on plaster models of the patients' mouths, in order to rehabilitate their dental occlusion, achieving a balance between aesthetics and joint and occlusal functions, taking into account multidisciplinary factors of the masticatory apparatus. - The student performs selective carvings of the teeth to achieve a balance between mandibular dynamics and dental occlusion. - The student makes joint and occlusal protection splints.
- - Laboratory Techniques for Oral Rehabilitation - - Formulates appropriate research questions. - The student understands the fundamental concepts of removable prostheses. - The student prepares a treatment plan for removable prostheses. - The student makes partial and total removable prostheses with different materials. - The student understands the fundamentals of temporomandibular disorders. - The student interprets diagnostic tests for temporomandibular joint disorders. - The student knows and understands the updated treatments for temporomandibular disorders. - The student makes appliances for the treatment of temporomandibular joint disorders. - The student understands and executes the principles of dental tissue preparation for direct and indirect operative treatments. - The student understands and executes the principles of dental tissue preparation for adhesive and non-adhesive fixed prosthesis treatments. - The student understands the fundamentals of adhesive and non-adhesive fixed prostheses. - The student makes provisional and definitive fixed prostheses.
- - Master's Thesis - Design a research protocol based on the scientific method - Learn how to get started in clinical or laboratory research, develop a research project by applying new techniques learned and managing time and resources. - Properly write the introduction, justification, objectives, hypothesis, state of the art, materials and methods, results, discussion and conclusions of your Master's Thesis. - Defend your "Master's Thesis" before a competent Dentistry tribunal.
Syllabus
THEORETICAL PROGRAMME
LESSON 1. INTRODUCTION TO PROSTHESES ON IMPLANTS.
Terminology in implant prosthetics.
Differential features between an implant and a natural tooth.
Implant characteristics, different shapes and surfaces.
Biomechanics, different types of forces and their effect on the implant.
The different phases in the development of treatment.
Different types of prostheses.
LESSON 2. DIAGNOSIS AND SELECTION OF THE PATIENT
History and examination of the patient.
Utilities of the study models.
Most used complementary explorations and why.
Know the absolute and relative indications and contraindications.
LESSON 3. WAX, RADIOLOGICAL AND SURGICAL GUIDE
Importance of diagnostic wax and its applications.
Conceptualising the terms radiologic guidance and surgical guide.
Importance of radiological guidance in planning treatment.
Radio diagnostic tests and their indications.
LESSON 4. SELECTION OF THE BASES
Factors that define the type of base used.
Characteristics and impressions.
Screw-retained versus cemented prosthesis.
LESSON 5. IMPRESSION TAKING
Differences between natural teeth and implants and their importance in taking impressions.
Aims of impressions for implants.
Different attachments needed to take impressions.
Open tray technique and closed tray. Features and indications.
Necessary materials for taking the impression.
Practice in taking impressions.
LESSON 6. TEMPORARY PROSTHESES
Importance of the provisional prosthesis.
Types of temporary prostheses, indications.
Immediate loading and aesthetics.
LESSON 7. UNITARY PROSTHESES
Know the different characteristics of unitary anterior and posterior prostheses.
Risk factors for achieving an aesthetic result in the leading edge.
Know the importance of the distribution of forces in the posterior as well as the relation between implant and crown.
LESSON 8. PARTIAL PROSTHESES
Materials used in their preparation.
Know the different stages in the preparation of an anterior partial prosthesis and posterior.
Know the type of occlusion in partial prosthesis.
LESSON 9. COMPLETE FIXED PROSTHESIS
Know the different types of prosthesis to be performed depending on the materials and prostheses to be made. Concept of Hybrid Prosthesis and Full Arch.
Identify the different attachments and materials used in the preparation of a complete fixed prosthesis.
Know which type of occlusion must give to the implant-supported fixed prostheses.
LESSON 10. OVERDENTURES IMPLANT RETAINED
Conceptualising an overdenture.
Clinical indications and contraindications.
Conceptualising the terms of implant-retained overdenture and overdenture implant- mucous supported.
Practice of activation of an overdenture with anchors.
Know the clinical sequence to follow in the preparation.
PRACTICAL PROGRAMME
1. Fixings Closure screws. Healing pillars. Transepithelial pillars
Pillars for cement-retained implants Transfers and replicas.
External and internal connection.
Objectives: To recognise the fixings used for different implant systems, including their form and function, and to familiarise oneself with how they are used.
2. Taking implant impressions. Open and closed tray. Direct impression and transepithelial impression. Splints
Objectives: To understand every way of taking implant impressions and have the knowledge to undertake said impressions.
3. Planning a case. Diagnostic wax-up. Radiographic guide and surgical guide
Objectives: To plan several cases using a diagnostic wax-up, then create a surgical and radiographic guide.
4. Computer-aided dental implant planning. A guide to surgical guides
Objectives: To understand navigation systems and how to use them to plan cases
5. Planning cases. Mapping and surgery on models.
Objectives: Create a model that reproduces the soft gingiva and correct 3D positioning of the implant. Creation of guides using the implant model.
6. Unitary implants. Step by step. Screw-retained and cemented implants. Pillars for unitary implants. Materials. Provisional prostheses over multiple implants.
Objectives: To understand the steps to installing a unitary prosthesis Techniques for preparing provisional prostheses over unitary implants.
7. How to create a full arch prosthesis Occlusion rims fixed to implants.
Testing of implant-fixed teeth. Selection of transepithelial pillars. Screw-retained implant test. Materials. Provisional prostheses over multiple implants
Objectives: To understand how to installing multiple prostheses. Techniques for creating an occlusion rim and fixed teeth testing strategies. Selection of transepithelial pillars from different manufacturers. Provisional over multiple prostheses and immediate loading.
8. CAD/CAM protocol. Impression copings and scan bodies. Model scanning. CAD/CAM pillar design for unitary implants. Multiple CAD/CAM structures. Assessing dental composite
Objectives: To familiarise oneself with CAD/CAM prostheses. Understand the different systems for obtaining three-dimensional virtual models. Introduction to attachment design using CAD/CAM.
9. Contact with the laboratory. Laboratory visits.
10. Laboratory photography
Objective: To take photographs of implants in the different laboratory phases. To submit a photobook of the time spent working in the laboratory.
Teaching and learning activities
In person
- Lectures
- Clinical sessions
- Theoretical seminars
- Seminars and laboratory
Evaluation systems and criteria
In person
Continuous assessment of students
- Assessment of the quality of presentations
- Assessment of the literature review
- Partial and final exams
Bibliography and resources
Carl E. Misch. Contemporary Implant Dentistry, 3rd Edition, 2007. ISBN: 0978-0-323-04373-1 2007
Carl E. Misch. Dental Implant Prosthetics. 2004. ISBN: 0978-0-323-01955-2 2004
We mainly rely on classic and current literature published in article format that is indexed and searchable in Pubmed.