J Korean Acad Prosthodont.  2018 Jul;56(3):235-242. 10.4047/jkap.2018.56.3.235.

Retreatment of fractured implant overdenture due to long-term maintenance failure

• Kim M
• Hong S
• Paek J
• Noh K
• Pae A
• Kim HS
• Kwon KR

• KMID: 2416816
• DOI: http://doi.org/10.4047/jkap.2018.56.3.235

Abstract

Periodontal and prosthodontic maintenance of implant overdenture is a very important factor for the long term success of the prosthesis and implants. Failure of maintenance can lead to prosthetic failure due to peri-implant bone loss and fracture and wear of the prosthesis or components. In this case, the existing gold milled bars were reconstructed with cobalt chrome milled bar in a manner that does not interfere with the external shape for the retreatment of fractured implant overdenture by maintenance failure. Two implants of mandible were selected strategically and the CM LOC attachments were connected to the two implants, and implant overdentures were fabricated. As a result, prosthesis with a functional and esthetic design that facilitates good hygiene management of the patient was delivered, which is advantageous for long term maintenance, and regular check-ups were scheduled for proper maintenance.

Keyword

Implant overdenture; Milled-bar; CM LOC; Maintenance

MeSH Terms

Cobalt
Denture, Overlay*
Humans
Hygiene
Mandible
Prostheses and Implants
Retreatment*
Cobalt

Figure

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  Fig. 1 Preoperative extraoral photographs. (A) Frontal view, (B) Lateral view.

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  Fig. 2 Intraoral photographs showing existing implant overdenture that fractured on mandible. (A) Maxilla, (B) Right lateral, (C) Frontal, (D) Left lateral, (E) Mandible.

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  Fig. 3 Postoperative view after treatment 13 years ago. (A, B) Gold milled bar with magnet attachments, (C, D) Fixed implant prosthesis; Tescera resin fused on gold framework.

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  Fig. 4 Radiographic view. (A) Panoramic view. Generalized alveolar bone resorption is observed, especially on implant near mandibular right canine region, (B) Periapical view on implants placed on mandibular both central incisor area.

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  Fig. 5 (A) Existing implant overdenture invading lingual space, (B) Newly fabricated implant overdenture solving the problem.

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  Fig. 6 Final impression taking (B, E) with individual tray (A, D), and definitive cast fabrication (C, F).

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  Fig. 7 Wax trial denture. Bilaterally balanced occlusion achieved with lingualized occlusion. (A) Frontal view, (B) Posterior view.

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  Fig. 8 Design of milled bar using Exocad program. (A) Master cast, (B) Wax trial denture, (C) designed milled bar by superimposition, (D) Existing Bar, (E) Newly designed milled bar, (F) Comparison of existing and new bar.

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  Fig. 9 Newly fabricated Co-Cr milled bar. (A) Occlusal view, (B) Frontal view.

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  Fig. 10 (A) Definitive implant overdenture, (B) Intaglio of maxillary and mandibular overdenture, (C) Female housing and separator of attachment before direct resin application.

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