J Korean Acad Prosthodont.  2020 Jan;58(1):58-66. 10.4047/jkap.2020.58.1.58.

Implant-assisted removable partial denture using freely removable abutment in a fully edentulous patient: A case report

Affiliations
  • 1Department of Prosthodontics, School of Dentistry, Pusan National University, Yangsan, Republic of Korea. neoplasia96@hanmail.net

Abstract

Implant-Assisted Removable Partial Dentures (IARPDs) treatment is being performed in a fully edentulous patient using implant surveyed prosthesis as an abutment. Implant-supported prosthesis as an abutment of IARPDs is classified into screw-retained and cement-retained type according to the retention type, and each has advantages and disadvantages. The EZ crown system (Samwon DMP, Yangsan, Korea) has a cylinder combined with abutment, and the nickel-titanium spring in this cylinder provides a constant force on the zirconia ball to obtain retention in EZ crown system. In this patient, the natural abutment teeth of the mandibular overdenture was hopeless. We planned implant assisted removable partial denture using anterior implant surveyed prosthesis considering functional and esthetical rehabilitation, cost and patient's needs. When fabricating IARPDs using implant as abutment, we could compensate for the shortcomings of existing implant-supported prosthesis retention type and made the design of removable partial denture easy due to using EZ crown system.

Keyword

EZ crown system; Implant surveyed prosthesis; Implant-Assisted removable partial denture; Microlocking abutment system

MeSH Terms

Crowns
Denture, Overlay
Denture, Partial, Removable*
Gyeongsangnam-do
Humans
Prostheses and Implants
Prosthesis Retention
Rehabilitation
Tooth

Figure

  • Fig. 1 Schematic Design of EZ crown system (Samwon DMP, Yangsan, Korea). (A) Abutment connected to implant fixture, (B) Cylinder connected to abutment, (C) Cylinder inner structure, (D) All components of EZ crown system connected.

  • Fig. 2 Panoramic radiograph before treatment.

  • Fig. 3 Panoramic radiograph after implantation.

  • Fig. 4 Intraoral photographs after implantation. (A) Right view, (B) Frontal view, (C) Left view, (D) Occlusal view (Maxilla), (E) Occlusal view (Mandible).

  • Fig. 5 Fabrication of provisional restoration. (A) Intraoral photographs after cap delivered (Occlusal view, Mandible), (B) Impression taking of mandible, (C) Registration of inter-occlusal relationship with leaf gauge, (D) Occlusal view of provisional restoration, (E) Frontal view of provisional restoration.

  • Fig. 6 Fabrication of implant surveyed prosthesis. (A) Occlusal view of abutment before gingivectomy, (B) Occlusal view of abutment after gingivectomy, (C) Occlusal view of cap delivered, (D) Final impression taking for implant surveyed prosthesis.

  • Fig. 7 Fabrication of implant surveyed prosthesis. (A) Facebow transfer, (B) Registration for inter-occlusal relationship with resin base and wax rim, (C) Shade taking.

  • Fig. 8 Computer-aided design for zirconia implant surveyed prosthesis. (A) Frontal view, (B) Frontal view of implant surveyed prosthesis design, (C) Occlusal view of implant surveyed prosthesis design, (D) Occlusal view of implant surveyed prosthesis on working model.

  • Fig. 9 Cementation process of implant surveyed prosthesis. (A) Occlusal view of cap attached, (B) Cementation (G-cem linkace), (C) Excess cement around cap, (D) Bottom surface of implant surveyed prosthesis after removing excess cement.

  • Fig. 10 Intraoral photographs after implant surveyed prosthesis placement. (A) Right view, (B) Frontal view, (C) Left view, (D) Occlusal view (Maxilla), (E) Occlusal view (Mandible).

  • Fig. 11 Fabrication of metal framework. (A) Final impression for removable partial denture, (B) Metal framework on working model, (C) Intraoral try-in of metal framework.

  • Fig. 12 (A) Functional impression for removable partial denture, (B) Altered cast fabrication, (C) Metal framework and occlusal rim, (D) Bite registration.

  • Fig. 13 Definitive prosthesis.

  • Fig. 14 Intraoral photographs after definitive prosthesis delivery. (A) Right view, (B) Frontal view, (C) Left view, (D) Occlusal view (Maxilla), (E) Occlusal view (Mandible).


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