Implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition: A clinical report

In-Ju Kim; Jong-Hee Park; Ju-Mi Park; Kwang-Yeob Song; Seung-Geun Ahn; Jae-Min Seo

doi:10.4047/jkap.2015.53.1.51

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Kim, Park, Park, Song, Ahn, and Seo: Implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition: A clinical report

Case Report

J Korean Acad Prosthodont 2015;53(1):51-57.

Published online: 9 February 2015

DOI: https://doi.org/10.4047/jkap.2015.53.1.51

Implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition: A clinical report

In-Ju Kim, Jong-Hee Park, Ju-Mi Park, Kwang-Yeob Song, Seung-Geun Ahn, Jae-Min Seo^∗

Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University, Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Republic of Korea

^∗Corresponding Author: Jae-Min Seo Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Biomedical Research Institute, Chonbuk National University Hospital 664-14 Dukjin-Dong, Dukjin-Gu, Jeonju 561-756, Republic of Korea +82 63 250 2696: e-mail, jmseo@jbnu.ac.kr

Received 5 November 201423 December 2014 Accepted 14 January 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

When an implant-supported maxillary full-arch fixed prosthesis is planned for patients with the horizontal and vertical bone resorption induced by periodontal disease, it is necessary to consider the masticatory function, esthetics and phonetics when placing implants. For this reason, thorough clinical and radiological diagnosis is necessary. Extensive bone and soft tissue grafting may be required as well. Since there is no clear guideline for proper number of implants, segment or splinting of substructure and method of retaining prosthesis, these should be considered during diagnostic process. This clinical report describes a patient who has experienced several tooth extractions and periodontal treatment due to severe periodontitis on maxilla and mandible. With bone and soft tissue graft before dental implant placement, the patient have satisfactory result in esthetic and functional aspect with the implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition.

Keywords: Alveolar bone resorption, Hard tissue graft, Soft tissue graft, Implant, Zirconia

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Fig. 1.

Panoramic view shows residual dentition and bone loss due to advanced periodontal disease.

Fig. 2.

Two months after extractions in maxilla and mandible. (A) Upper occlusal view, (B) Lower occlusal view.

Fig. 3.

Panoramic view was taken after implant placement in maxilla and mandible. There was not any special findings.

Fig. 4.

Intraoral photographs show healing abutment connection on each implants at second surgery stage. (A) Upper occlusal view, (B) Lower occlusal view.

Fig. 5.

Provisional restorations. (A) Right lateral view, (B) Frontal view, (C) Left lateral view.

Fig. 6.

CR recording was carried out with pattern resin.

Fig. 7.

Try-in of customized abutment was performed. (A) Upper occlusal view, (B) Lower occlusal view.

Fig. 8.

Try-in of zirconia framework was performed. (A) Upper occlusal view, (B) Lower occlusal view.

Fig. 9.

Esthetics and function were restored with the zirconia restorations. (A) Right lateral view,(B) Frontal view, (C) Left lateral view, (D) Upper occlusal view, (E) Lower occlusal view, (F) Zirconia restorations, (G) Initial panorama of the zirconia fixed restorations.

Table 1.

Diameter and location of installed implant fixture

Implant distribution	Implant diameter ∗length (mm)
#12	∅4.0 ∗10
#13	∅4.5 ∗12
#14	∅4.5 ∗10
#15	∅4.0 ∗10
#16	∅4.5 ∗12
#22	∅4.0 ∗08
#23	∅4.5 ∗08
#24	∅4.0 ∗10
#25	∅4.5 ∗10
#26	∅4.5 ∗12
#36	∅5.0 ∗10
#46	∅5.0 ∗10

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