J Adv Prosthodont.  2015 Jun;7(3):264-270. 10.4047/jap.2015.7.3.264.

Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report

• Agustin-Panadero R
• Penarrocha-Oltra D
• Gomar-Vercher S
• Ferreiroa
• Penarrocha-Diago M

• KMID: 2284713
• DOI: http://doi.org/10.4047/jap.2015.7.3.264

Abstract

This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene.

Keyword

Horizontal insertion prosthesis; Horizontal Denture(R); Alveolar bone atrophy; Dental prosthesis design; Dental implants; Edentulous jaw

MeSH Terms

Alveolar Bone Loss
Dental Implants
Dental Prosthesis Design
Denture, Overlay*
Dentures
Follow-Up Studies
Humans
Hygiene
Jaw, Edentulous
Malocclusion
Maxilla
Prostheses and Implants
Rehabilitation
Dental Implants

Figure

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  Fig. 1 Classification of the Horizontal Denture® designs, (A) Platform design (class I and II), (B) Claw design (class III).

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  Fig. 2 (A) Extraoral view of the loss of lip support of the patient without the prosthesis, (B) Intraoral view of the upper maxilla before treatment. (C) Intraoral view of the location of the 8 TSA® implants with Avantblast surface (Phibo Dental Solutions, Senmenat, Barcelona, Spain) in the maxilla.

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  Fig. 3 (A) CAD/CAM design of the primary structure with the planes of insertion, slots and insertion groves, (B) Best fit between the primary structure with tooth testing for designing the secondary structure, (C) STL file of the design of the secondary structure, with the different grooves, slots and planes for correct coupling to the primary structure.

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  Fig. 4 (A) View of the Horizontal Denture® primary structure screwed directly onto the implant prosthetic platform, (B) Panoramic X-ray view showing the fit of the upper Horizontal Denture® structure, (C) Periapical X-rays showing passive fit of the primary structure.

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  Fig. 5 (A) Extraoral view of the Horizontal Denture® secondary structure, (B) Intraoral view of the Horizontal Denture® secondary structure fitted to the primary structure.

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  Fig. 6 (A) Patient smile after rehabilitation, (B) Extraoral view of the recovered lip support with the prosthesis in place.

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