J Korean Acad Prosthodont.  2016 Apr;54(2):152-159. 10.4047/jkap.2016.54.2.152.

Implant supported fixed prosthesis for complete edentulous maxilla with severe alveolar ridge resorption: A case report

• Choi YJ
• Lee JH
• Jhin MJ

• KMID: 2162392
• DOI: http://doi.org/10.4047/jkap.2016.54.2.152

Abstract

Implant fixed prosthesis for the complete edentulous maxilla provides significant benefits in the aspects of functions and esthetics compared with the conventional denture. Implant supported fixed prosthesis are totally supported by implant, and thus stabilizes the prosthesis to the maximum degree as possible. Also, the improved retention and stability of fixed prosthesis enhance patients' psychological and psychosocial health. This clinical presentation describes a maxillary full arch implant-supported fixed prosthesis in complete maxillary edentulous patient who showed vertical and horizontal alveolar bone resorption in the anterior ridge. To rehabilitate the esthetics and proper lip support, the zirconia framework was fabricated and the pink porcelain was veneered to reproduce the natural gingival tissue. After 9 months of follow up, the restorations were maintained without complications and the patient was satisfied with the restoration both functionally and esthetically.

Keyword

Implant supported fixed prosthesis; Zirconia framework; Tissue colored porcelain; Complete edentulous maxilla; Vertical & horizontal alveolar bone loss

MeSH Terms

Alveolar Process*
Bone Resorption
Dental Porcelain
Dentures
Esthetics
Follow-Up Studies
Humans
Lip
Maxilla*
Prostheses and Implants*
Dental Porcelain

Figure

• 

  Fig. 1. Pretreament intraoral view. (A) frontal view, (B) upper occlusal view (C) upper occlusal view with old RPD.

• 

  Fig. 2. Panoramic radiograph (A) pretreatment panoramic radiograph (B) With radiolographic stent 3 months after extracton of #14, 15, 24, 25.

• 

  Fig. 3. Screw retained interim implant prosthesis. (A) Maximum intercuspation, (B) Protrusive movement, (C) Right lateral movement, (D) Left lateral movement.

• 

  Fig. 4. (A) Fabrication of repositioning jig by splinting pick up impression copings with pattern resin on the master cast, (B) Repositiong jigs are connected to check the accuracy of implant position, (C) Registration of interocclusal relationship using repositioning jig & interim prosthesis, (D) Mounted definitive cast.

• 

  Fig. 5. Fabrication of customized titanium abutment. (A) Esthetic try-in for abutment fabrication, (B) Putty index for fabrication of abutments with proper position and angulation, (C) Placement of the customized titanium abutment by repositioning jig, (D) Bite registration using pattern resin.

• 

  Fig. 6. Zirconia framework. (A) frontal view (B) occlusal view.

• 

  Fig. 7. Definitive restoration. (A) Maximum intercuspation, (B) Protrusive movement, (C) Right lateral movement, (D) Left lateral movement.

• 

  Fig. 8. Facial profile. (A) pretreatment, (B) during wearing a denture, (C) esthetic try-in, (D) post treatment.

• 

  Fig. 9. (A) Post-treatment panoramic radiograph after 3 months follow-up, (B) periapical radiograhs after 9 months follow-up.

Reference

1.Misch CE. Contemporary Implant Dentistry. 3rd ed.St. Louis: CV Mosby;2009. p. 3–25.

2.Feine JS., Carlsson GE., Awad MA., Chehade A., Duncan WJ., Gizani S., Head T., Lund JP., MacEntee M., Mericske-Stern R., Mojon P., Morais J., Naert I., Payne AG., Penrod J., Stoker GT., Tawse-Smith A., Taylor TD., Thomason JM., Thomson WM., Wismeijer D. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Montreal, Quebec, May 24-25, 2002. Int J Oral Maxillofac Implants. 2002. 17:601–2.

3.Drago C., Carpentieri J. Treatment of maxillary jaws with dental implants: guidelines for treatment. J Prosthodont. 2011. 20:336–47.

4.Misch CE. Contemporary Implant Dentistry. 3rd ed.St. Louis: CV Mosby;2009. p. 92–104.

5.Wheeler RC. The permanent maxillary central incisors. In Wheeler RC (ed): Dental Anatomy, Physiology and Occlusion. 5th ed.Philadelphia: Saunders;1974. p. 144.

6.Seibert JS. Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part I. Technique and wound healing. Compend Contin Educ Dent. 1983. 4:437–53.

7.Misch CE. Contemporary Implant Dentistry. 3rd ed.St. Louis: CV Mosby;2009. p. 367–88.

8.Misch CE. Dental Implant Prosthetics. 2nd ed.Elsevier: Mosby;2014. p. 829–73.

9.Al-Amleh B., Lyons K., Swain M. Clinical trials in zirconia: a systematic review. J Oral Rehabil. 2010. 37:641–52.