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“RULES OF 10”
plane and mandibular tooth position,
where the mandibular denture can
be duplicated in radiopaque acrylic
for a radiographic stent. The amount
of alveolectomy needed can then be
determined from the CBCT images.
Rule No. 3 requires an understanding
of the anatomy of the edentulous
mandible in relationship to the location
of the planned prosthetic teeth, as
well as the ability to translate this
information to the implant placement,
generally via a surgical guide. This can
be accomplished practically in one
of two ways. One method involves
evaluation of the CBCT images using
3-D planning software (e.g., Simplant ®
[Materialise Dental; Glen Burnie, Md.] or
NobelClinician [Nobel Biocare; Yorba
Linda, Calif.]) and then modifying a
duplicate denture made from clear
acrylic (Figs. 10, 11). The other involves
use of a third-party company to
fabricate a digital surgical guide.
Conclusion
Dental implant therapy for the edentulous
mandible has been successful. Data
concerning implant survival is high
and reflects the quality and quantity
of bone available for osseo-integrated
implant function. The complications
associated with both removable and
fixed dental implant prostheses reflect
the constraints of current materials and
design limitations. The Rules of 10 assure
that there is: 1) adequate bone
for osseointegration and its long-term
success; 2) sufficient dimension for
fabrication of an esthetic, comfortable,
and robust prosthesis; and 3) proper
distribution of imposed forces from occlusal
function within the prosthesis, at
the implant-abutment screw interfaces,
and at the implant-bone interfaces. Following
these simple geometric and linear
guidelines to treatment planning
enables proper implant placement
decisions that underscore robust and
lasting prosthesis construction. IM
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Originally published in: Cooper LF, Limmer BM,
Gates WD. “Rules of 10” — Guidelines for Successful
Planning and Treatment of Mandibular Edentulism
Using Dental Implants. Compend Contin Educ Dent.
2012;33(5):328-335.
Copyright © 2012 to AEGIS Publications, LLC. All
rights reserved. Reprinted with permission from the
publisher.
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