J Dent Rehabil Appl Sci.  2021 Sep;37(3):147-156. 10.14368/jdras.2021.37.3.147.

Full mouth rehabilitation of edentulous patient with fixed implant prosthesis

Affiliations
  • 1Divison of Prosthodontics, Department of Dentistry, Asan Medical Center, Seoul, Republic of Korea
  • 2Divison of Prosthodontics, Department of Dentistry, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea

Abstract

There are various treatment options such as conventional complete denture, hybrid prosthesis and implant-supported fixed prosthesis for fully edentulous patients. In case of implant-supported fixed prosthesis, compared to removable prosthesis, it is difficult to place the implant in the correct position considering the anatomical contours of the final prosthesis. In this case, a full mouth rehabilitation with implant-supported fixed prosthesis was performed for a patient who required extraction of all remaining teeth due to dental caries and chronic periodontitis. In the implant placement stage, the implant was placed in the desired position using a surgical guide fabricated considering the anatomical contours of the final prosthesis, and the function and esthetics were evaluated through correction and re-fabrication of the fixed provisional restoration. A final restoration of porcelain fused to gold prosthesis was delivered to the patient based on the provisional restoration. To cope with complications such as loosening of screws and fracture of porcelain, a screw-retained type prosthesis was fabricated for the posterior part and a screw-cement-retained type prosthesis for the anterior part. As a result, the patient showed an improved prognosis in terms of functional and esthetics after the final prosthesis was delivered.

Keyword

fully edentulous patient; implant-supported fixed prosthesis; implant surgical stent

Figure

  • Fig. 1 Pre-operative intraoral photographs (A - F, H), radiographic evaluation (G): severe dental caries and loss of vertical dimension were detected. (A, D) Lateral view (right side), (B) Occlusal view of maxilla, (C, F) Lateral view (left side), (E) Frontal view, (G) panoramic radiograph, (H) Occlusal view of mandible.

  • Fig. 2 Implant surgical stent fabrication artificial tooth arrangement (A - B), implant surgical stent (C - D). (A) Artificial tooth arrangement (maxilla), (B) Artificial tooth arrangement (mandible), (C) Implant surgical stent (maxilla), (D) Implant surgical stent (mandible).

  • Fig. 3 Implant surgical Planning with OnDemand 3DTM.

  • Fig. 4 After implant installation intra oral photos (A - B), radiographic evaluation (C). (A) Anterior area buccal bone was augmented, (B) Healing abutments were connected after installation, (C) Panorama radiograph after fixture installation.

  • Fig. 5 Fixture level impression (A - D). (A) Individual trays were fabricated, (B) Copings were splinted in the oral, (C) Fixture level impressions were taken, (D) Master casts were fabricated with gum replica.

  • Fig. 6 Bite registration with Recording bases (A - C), (A) Decision of vertical dimension, (B) Decision of lip support, (C) Bite registration with Alu wax.

  • Fig. 7 Provisional prosthesis (screw type). (A) Lateral view (right side), (B) Frontal view, (C) Lateral view (left side), (D) Occlusal view of maxilla, (E) Occlusal view of mandible.

  • Fig. 8 Fixture level impression (A - D). (A) Individual trays were fabricated, (B) Copings were connected in the oral, (C) Fixture level impressions were taken, (D) Master casts were fabricated with gum replica.

  • Fig. 9 Post-operative intraoral photograph (A - F, H), radiographic evaluation (G). (A) Canine guidance at right side, (B) Maxillary occlusal view, (C) Canine guidance at left side, (D) Right lateral view, (E) Frontal view, (F) Left lateral view, (G) Panoramic radiograph, (H) Mandibular occlusal view.


Reference

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