All-on-X

Requirements:

• 15mm of space required from head of implant to incisal edge of crown

  • Hybrid & Zirconia needs more than 15mm space

  • Needs 3mm of space between implants

  • Doesn't need implant straight up and down, can angle in posterior (can increase AP spread)

AP Spread:

• Mx: 20mm cantilever one-half of A/P spread, no more than 10mm

• Mandible: 10mm with cantilever, 1.5-2x A/P spread but no more than 20mm

• ??

Cannot open space like we can with prosth

• Implants don't adapt

• They do not change position when neutral zone is altered

• SO, we need bone reduction if overclosed VDO

CBCT relating to tooth position

• Mount one set of casts

• Add "Dimples" with round bur (4-5), then lab scan

• Wax one set to optimum esthetics & occlusal design (follow wizard)

• Can see where teeth are in relation?

Base of prosthesis:

• Needs 2 convex surfaces!

Implant Guide:

• Upper Anchor Pin Guide:

  • Make sure coming out at right angle

• 1st guide: for bone reduction

• 2nd guide: stacks on and then shows where to place implants

• PMMA Provisionals