Darin Ditcher, DMD discusses implant stability, retention in overdentures, prosthetic design for limited dexterity patients, and digital dentistry in denture fabrication. Topics include locators vs. Conus attachments, path of insertion, and evolving technology in dentistry.
Using locators in conjunction with palate support can enhance stability and manage potential implant loss.
Conus attachment system offers a rigid connection between housing and abutment, reducing off-axis loading and potentially minimizing implant overloading.
Deep dives
Prosthesis Stability and Preventing Implant Failure
Clinicians often face challenges in ensuring the stability of prostheses and preventing implant failures, particularly in the maxilla. The fear of compromising the osseointegration between the bone and implant can lead to cautious decisions regarding prosthetic designs. Despite biases against certain attachments like locators, the literature does not strongly support these concerns. Strategies to minimize risks include using locators in conjunction with palate support to enhance stability and manage potential implant loss.
Exploring Alternative Attachment Systems
While locators are commonly known and used, there are various attachment designs available beyond locators. The Conus attachment system offers a rigid connection between housing and abutment, reducing off-axis loading and potentially minimizing implant overloading. Conus attachment, with its conical design and pre-manufactured parts, provides stability and ease of use, although it may require more vertical prosthetic space.
Digital Workflow in Denture Fabrication
The integration of digital workflows in denture fabrication presents both advantages and challenges. Digital technologies offer efficiency in the laboratory phase, allowing for tasks like custom tray fabrication to be done digitally. However, some limitations such as accuracy in full-arch scans and reliability in printing compared to traditional methods are still factors to consider. Clinicians are adapting to the evolving digital landscape while acknowledging the need for further advancements in accuracy and workflow optimization.
Balancing Digital Dentistry and Clinical Realities
The rapid evolution of technology and digital workflows in dentistry presents exciting opportunities for efficiency and improved patient outcomes. However, clinicians must navigate the integration of digital tools while maintaining clinical judgment and patient-centered care. While digital advancements offer benefits in workflow streamlining, there is a continual need for a human component in treatment planning and decision-making, ensuring patient voice and optimal outcomes.
Dr. Dichter brings nearly 20 years of clinical, research and teaching experience — as a general practitioner and prosthodontist — to his position with Spear. He serves as an instructor in the Treating the Terminal Dentition and Fully Edentulous Patient seminar, in addition to multiple Spear Workshops.
Dr. Dichter has served as a guest lecturer and clinical instructor at Oregon Health and Science University School of Dentistry, teaching occlusion and esthetics. He has been a Spear faculty member since the company’s inception, as well as a contributing author for Spear Digest. He is passionate about education and is involved with multiple study groups in the U.S. and Canada.
After earning his D.M.D. from OHSU in 1995, Dr. Dichter practiced general dentistry and eventually joined a startup practice in his hometown in coastal Oregon before moving to a practice in Portland. He brought 16 years of restorative dental experience into UCLA’s world-renowned, full-time advanced prosthodontics residency, which he completed in 2014.
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