Assessment of the Restorative Space

Restorative space is the 3-dimensional oral space available to receive the proposed prosthodontic restoration.²² It may be measured conventionally using mounted casts on an articulator (Figure 6) or digitally during implant planning (Figure 7).²² Misch suggests that at least 7-8mm of vertical restorative space (dimension between the implant platform and the occlusal plane) should be available for restoring a single implant crown esthetically and functionally.²³ Inadequate restorative space leads to the development of restorations with suboptimal contours (ball on a stick appearance).²² However, excessive vertical restorative space results in an increased vertical cantilever and ultimately a magnified, off-axis load on the implant.²⁴ In the mesiodistal dimension, at least 7mm of restorative space is necessary for optimal restoration of a single implant.²⁵ Restoring implants with excess space in the mesiodistal dimension also results in a horizontal cantilever and consequently magnified, off-axis forces that can overload the implant-restoration system.²⁶ It has also been noted that an emergence angle of > 30 degrees is associated with an increased risk for peri-implantitis and limited restorative space may also result in increasingly high emergence angle.²⁷

Figure 6. Restorative space assessed on an articulator using a clinically approved wax-up.

Figure 6. Restorative space assessed on an articulator using a clinically approved wax-up.

Figure 7. Restorative space measured digitally during implant planning.

Figure 7. Restorative space measured digitally during implant planning.