J Korean Acad Prosthodont.  2019 Oct;57(4):364-373. 10.4047/jkap.2019.57.4.364.

Utilization of digital technology in fabricating mandibular implant overdenture for skeletal class II edentulous patient: A case report

• Lee YY
• Hong S
• Paek J
• Noh K
• Kwon KR

• KMID: 2461143
• DOI: http://doi.org/10.4047/jkap.2019.57.4.364

Abstract

Unlike class I patients, skeletal class II patients have unstable occlusion thus leading to instability of mandibular complete denture. Therefore, mandibular implant overdenture has been the standard of care due to its advantages in stability and retention. The types of attachments can be divided into two categories: solitary and bar type. The indications vary between two categories. In this clinical report, digital technology was utilized from the implant planning to the choice of appropriate attachment. Implants were placed at the desired location as previously planned in terms of angle and depth. Maxillary removable partial denture and mandibular implant overdenture are expected to have fair prognosis.

Keyword

Class II jaw relation; Implant overdenture; CM LOC; GOM Inspect software; Spatial analysis

MeSH Terms

Denture, Complete
Denture, Overlay*
Denture, Partial, Removable
Humans
Prognosis
Spatial Analysis
Standard of Care

Figure

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  Fig. 1. Pre-operative extraoral photographs. (A) Frontal view, (B) Lateral view.

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  Fig. 2. Radiographic view. (A) Panoramic view, (B) Right temporomandibular joint, (C) Left temporomandibular joint.

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  Fig. 3. Intraoral photographs. (A) Maxilla, (B) Right lateral, (C) Frontal, (D) Left lateral, (E) Mandible.

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  Fig. 4. Model analysis showing existing conventional complete denture. (A) Frontal view, (B) Right lateral view, (C) Anterior teeth.

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  Fig. 5. Esthetics and function were verified with interim prostheses. (A) Maxilla, (B) Right lateral, (C) Frontal, (D) Left lateral, (E) Mandible.

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  Fig. 6. Space analysis - bar type attachment. (A) Frontal view, (B) Occlusal view.

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  Fig. 7. Space analysis - CM LOC attachment. (A) #42 area, (B) #32 area.

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  Fig. 8. Space analysis - CM LOC attachment. (A) #43 area, (B) #33 area.

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  Fig. 9. Application of surgical stent using (A) Superposition of CT data and analysis model, (B) Intra oral photograph surgical stent fixed with pins, (C) Post operative panoramic view.

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  Fig. 10. (A) Face-bow transfer, (B) Mounting with mandibular temporary denture and maxillary occlusal rim to make maxillary fixed prostheses.

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  Fig. 11. Preparing for impression. (A) Definitive fixed prostheses on maxilla, CM LOC abutment (B) on mandible connected with CM LOC Female (C).

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  Fig. 12. Final impression taking (B, E) with individual tray (A, D) and definitive cast fabrication (C, F).

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  Fig. 13. (A) Centric relation record, Evaluation of occlusal vertical dimension with (B) interim prostheses (C), occlusal rim.

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  Fig. 14. Bilaterally balanced occlusion. (A) Left Lateral movement, (B) Centric occlusion, (C) Right Lateral movement.

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  Fig. 15. Direct method for solitary attachment. (A) Metal frame work connected with (B) CM LOC female.

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  Fig. 16. Clinical remounting. (A) Right side view, (B) Frontal view, (C) Left side view.

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  Fig. 17. Postoperative intraoral view. (A) Maxilla, (B) Right lateral, (C) Frontal, (D) Left lateral, (E) Mandible.

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