Implant Prosthodontics
Implant Prosthodontics tests prosthetically driven planning, implant position, loading decisions, retention method, emergence profile, and complication management. The exam emphasizes that the restoration plan determines implant placement, not the reverse.
Core rules
- Plan from the planned crown, not from available bone alone; use CBCT and a surgical guide when indicated.
- Respect interocclusal space, mesiodistal width, and implant-to-tooth distance.
- Screw retention improves retrievability; cement retention can improve esthetics but requires complete cement removal.
- Avoid excessive cantilevers; assess occlusal load and parafunction.
- Monitor peri-implant mucositis and peri-implantitis with probing, radiographs, and maintenance.
Worked example
A single mandibular first molar is planned. The edentulous space is 10 mm mesiodistally, with 7 mm of interocclusal space and a flat ridge. Reasoning: a standard-diameter implant can be placed prosthetically, but the restorative space must allow a screw-retained crown with a cleanable emergence. If the implant is too buccal, the screw channel exits the facial surface; if too deep, biologic width is compromised. Verify the planned screw access with a diagnostic wax-up and guide before surgery.
Traps that cost marks
- Placing an implant without a restorative plan.
- Ignoring interocclusal space and screw access.
- Using a long cantilever in a parafunctional patient.
- Leaving excess cement around an implant.
- Failing to check occlusion in excursive movements.