It was definitely not a simple decision. Quite frankly, I was hesitant about whether it was appropriate for me to discuss implant-assisted removable partial dentures (IARPD) despite the contradictory advice from many experts that - in addition to my own lack of clinical experience - there is sparse scientific evidence on the discipline itself.
Working at a university hospital, I was exposed to a significant number of returning patients bearing problems from previous treatments. One of the common findings in patients treated with IARPD was that clinicians tended to rely too much on implants. There are several arguments related to the extent of protection implants require; nevertheless, there is no doubt that implants are vulnerable to lateral and rotational forces rather than vertical.
I would not say that IARPD is a new treatment method at all. When only a few natural teeth remain to be used as abutment teeth, implants augment the retention, support, and stability of the RPD. One of the basic principles of RPD, as we have learned in school, is to avoid exerting adverse forces on abutment teeth. I believe that abiding by this principle when treating IARPD would reduce any potentially harmful forces on implants.
There have been many clinical and laboratory trials in published literature research papers research papers on implant overdentures and relatively numerous established treatment methods, whereas there is almost nothing available on IARPD. However, the argument I would like to pose concerns the conceptual difference between implant overdentures and IARPD. What is the difference between the concepts underlying the treatments of IARPD and conventional RPD? I believe that these three types of treatments are all based on the same principles.
IARPD is not specifically difficult to understand, but having a thorough understanding of the basic principles of conventional RPD and its complicated intraoral movements can be challenging. Over the past ten years, I have been giving numerous lectures nationwide, and I have aggregated numerous questions from the audience.
This book is a compilation of answers to those questions and the thoughts that I have mulled over while studying IARPD. Most of the clinicians asked for solutions for problems encountered in their clinical cases. It was difficult to give definite answers to their questions without fully understanding the various conditions of their specific clinical cases. Hence, I resolved to provide problem-solving skills rather than giving a definite answer.
This book contains topics that aim to briefly summarize the basic principles of RPD. Details such as diagnostic procedures in RPD patients, components of RPD such as major and minor connectors, and laboratory procedures were omitted. I have tried to provide the readers with a better understanding of how to efficiently distribute forces and control denture movements to minimize adverse stress on implants. Therefore, I would recommend this book to those who have the basic knowledge of the principles of RPD; otherwise, reference to an RPD textbook is strongly recommended.
I, sincerely and humbly, hope that this book will strengthen your understanding of IARPD rather than provide a rigid go-to solution. And I hope that it could ultimately provide your patients with a solution that will enable them to pursue a better treatment option.
CHAPER 1 Scientific evidence on implant-assisted removable partial dentures (IARPD)
1. Scientific evidence on implant-assisted removable partial dentures (IARPD)
CHAPER 2 What are the roles of teeth and implants in an RPD?
1. What are the roles of teeth and implants in an RPD?
2. How can the damage caused by rotational movements of RPDs to abutment teeth be reduced?
3. Designing the RPD to accomplish an efficient lever action
4. The path of dislodgement and the path of insertion and removal must differ in RPDs
5. Cantilever support can be harmful to RPD abutments, especially to implant abutments
CHAPER 3 Understanding the stability of an implant-assisted RPD is crucial to its success
1. Understanding the stability of an implant-assisted RPD is crucial to its success
2. Combining a small number of implants to enhance RPD stability
3. Appropriate impression-taking to enhance stability in distal extension RPDs
4. Understanding how an occlusion can enhance the stability of the RPD
5. Appropriate relining techniques can yield additional stability in the RPD
CHAPER 4 The success of implant-assisted RPDs relies on establishing sufficient stability
1. Implant placement in the posterior edentulous area to prevent tissue-ward movements in a distal extension RPD
2. Fabrication of an IARPD featuring a small number of implants with surveyed crowns
3. Fabrication of IARPDs using implants with attachments
4. IARPDs using a combination of implant bars and attachments
5. Application of attachment systems on implants in patients with complete edentulism
CHAPER 5 Representative clinical researches and the summary derived from those studies on IARPD with implant surveyed prostheses
1. A clinical retrospective study of distal extension removable partial dentures with implant-surveyed bridges or stud-type attachments
2. Retrospective clinical evaluation of implant-assisted removable partial dentures with implant-surveyed prostheses
3. Summary of guidelines for treatment of patients with partially edentulous maxilla opposing dentate mandible
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