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Prosthetic 3

Full Arch Fixed and Removable Implant Prosthetics, including Immediate Load

 (All-on-4). FASTP Plastic Aesthetic Surgery

(20 CPD)   Pre-requisite Prosthetic 2

© Brener Implant Institute (Bii)

3.1 Fixed and Removable Implant Prosthetics


This prosthetic implant course covers full arch removable and fixed implant prosthodontics. The use and indications of fixed cement vs. screw in prostheses - their step by step manufacture and relative benefits are presented.


Implant overdenture bar design and attachment selection for the maxilla and mandible and the step-by-step removable prosthesis fabrication are presented.

An Intraoral photography section is included to assist with medico-legal documentation. Methods of determination of vertical dimension and maxillo-mandibular relationships are presented.


Occlusal considerations, overdenture design according to implant and/or soft tissue support are presented to simplify denture manufacture and enhance prosthesis and implant longevity.


Hands-on training workshops, phlebotomy laboratory, live clinical prosthetic and live FASTP surgical demonstrations are an integral feature of Prosthetic 3.


Advanced photographic techniques and digital aesthetic planning

are included.



Biological and physiological rationale to immediate loading of

  implant restorations

Risks of immediate load

Indications and complications of cement vs. screw in prostheses

Removable prosthetic options

Terminology of implant components and overdentures

Maxillary implant overdentures

Maxillary denture occlusal modifications against lower implant

  retained implant prostheses

Mandibular implant overdentures

Factors of stress

Dental photography intraoral, perioral & extraoral photography


Demonstrate and conduct complete dental history and clinical evaluation for the full arch immediate load patient


Fixed treatment planning options for implant retained prostheses in

the completely edentulous jaw


CT / CBCT diagnosis and planning implant overdentures or fixed prostheses using radiographic imaging, with diagnostic casts and

dual scanning techniques


Plan prostheses per the available bone, crown height, aesthetic and vertical dimension requirements


Understand the advantages and disadvantages of full arch fixed screw retained vs. cement retained prostheses


Appreciate the implant protective occlusal schemes for use in full arch fixed restorations


Appreciate the indications, advantages and disadvantages of implant retained overdentures compared to implant retained fixed prostheses


Understand the attachments and different components for implant overdentures


Understand the biomechanics of the maxilla in relation to planning maxillary implant overdentures


Plan the necessary clinical and laboratory sequencing to provide immediately loaded mandibular overdentures in a completely

edentulous patients


Understand the effect of bone morphology on the prosthetic design

for implant overdentures in completely edentulous patients


Appreciate the selection of implant overdenture attachments and bar designs used in implant dentistry


Understand the importance of attachment selection and positioning

on prosthesis movement in implant overdentures


Understand the principles of mucostatic and mucocompressive

principals for construction of maxillary dentures


Appreciate the differences between maxillary denture occlusion fabrication opposing a denture vs. an implant prosthesis


Learn and perform photographic techniques required for medicolegal implant prosthetics


3.2 Immediate Load Prosthetics (All-on-4)


This part of the course covers the methods of diagnosis, practical treatment planning, pre-surgical prosthodontics, imaging, armamentarium, and clinical techniques needed for this exciting treatment modality. Crucial to this treatment modality is the understanding of the biomechanical aspects and functional loading of the immediate full arch prostheses. The aesthetic and phonetic requirements, space requirements, laboratory communication, insertion techniques post-operative follow-up and hygiene requirements are key to this treatment.


Hands-on training workshops, phlebotomy laboratory, live clinical prosthetic and live FASTP surgical demonstrations are an integral feature of Prosthetic 3.


Advanced photographic techniques and digital aesthetic planning are included.

© Brener Implant Institute (Bii)



Patient evaluation and treatment planning

Rationale for immediate load of full arches

Presurgical prosthodontics

Aesthetic and phonetic requirements

Space requirements

Minimally invasive surgery

Bone density and loading protocols

Alternatives to bone grafting

Healthcare ethics

Anatomical grounding

Tilted implants - biomechanical aspects and survival rates


Treatment planning - pre- and postoperative radiographic

  examinations and 3D imaging

Prosthetic restoration - impressions, registration and

  jaw relationships

Laboratory communication and collaboration

Follow-up protocols

Dental hygiene requirements

Post insertion complications

Zygomatic anchorage and the Zygomatic implant


Establish a systematic and organised approach to the prosthetic techniques for this modality of treatment


Recognise and explain the impact of fully edentulous arches as a national health problem in dentistry


Develop an organised treatment planning approach following biomechanical aspects of stress


Co-ordinate the surgical and laboratory phases of treatment


Understand the requirements and design of diagnostic and surgical templates


Complete sequential treatment planning from patient examination to post insertion follow up and protocols


Explain the anatomical maxillary and mandibular considerations and limitations in relation to immediate load of full arches


Recognise diagnostic imaging procedures for the assessment of the edentulous arch

© Brener Implant Institute (Bii)

3.3 FASTP (Fibrin Assisted Soft Tissue Promotion Technique Plastic)

Aesthetic Surgery for the Treatment of Muco-Gingival Recession


One of the most common findings in the population is gingival recession.

Amongst 60 year olds, 90% have at least 1 tooth with 1mm recession and 40% presenting multiple sites with >3mm recession. There is an increasing need to treat gingival recession defects in the population or to improve the biotype of gingival tissue.


There are several treatment options available to correct muco-gingival recession. The use of a tunneling technique and autologous fibrin is a valuable adjunct to help patients with Millers Class 1 and Class 2 recession are presented and demonstrated.


Hands-on training workshops, phlebotomy laboratory, live clinical prosthetic and live FASTP surgical demonstrations are an integral feature of Prosthetic 3.


Advanced photographic techniques and digital aesthetic planning

are included.



Screw retained versus cement retained full arch prosthodontics

Verification of casts and accurate Maxillo-mandibular

  relation records

Planning of aesthetics and phonetics with full arch implant


Millers classification of gingival defects

Autologous blood draw and production of Advanced Platelet

  Rich Fibrin membranes

The use of autologous stem cells, growth factor concentration

  and slow release in soft tissue grafting for predictable


Surgical tunnelling technique

Biotensegrity - the theory that helps to guide force transmission

  and orchestrate multi-molecular responses to stress

Physiological displacement of the flap

Passive flap closure without tension

Novel advanced suturing techniques to stabilise the grafts and

  apically position recession defects

The use of AlloDerm – an acellular dermal matrix (freeze-dried

  skin) for this technique

Instrumentation requirements


Understanding the FASTP treatment of Millers Class 1 and Class 2 recession defects


Correction of Millers Class 1 and Class 2 defects



The use of autologous blood draw to manufacture Advanced Platelet Rich Fibrin and Injectable Platelet Rich fibrin to improve the Biotype of soft tissue



Learn the necessary surgical tunnelling, tissue release, graft placement, graft stabilization and novel suturing techniques


Appreciate Patient medical history and the effect of LDL Cholesterol, blood vitamin C titre, diabetes and tobacco use on the long-term results of soft and hard tissue surgery


A Brener Implant Institute (Bii) Implant Program

Bii programs are fully CPD compliant with current Dental Board of Australia Guidelines on Continuing Professional Development


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