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Ju-Nam An1
, Jung-Jin Lee1, Jae-Min Seo1, Kyoung-A Kim2
, Jung-Jin Lee1, Jae-Min Seo1, Kyoung-A Kim2
Abstract
Prosthetic treatment using implants in fully edentulous patients includes implant-supported fixed prosthesis, implant hybrid prosthesis, implant retained- or supported-overdenture and implant supported fixed prosthesis has advantages such as psychological stability, pronunciation. If an implant supported fixed prosthesis is planned, the implants should be placed in consideration of pronunciation, esthetics, and oral hygiene. For this, clinical and radiological diagnosis is indispensable. When placing the prosthetic driven implant at the site determined from the diagnosis, a sufficient amount of alveolar bone and soft tissue support are required. If these requirements found to be insufficient, a wide range of bone grafting should be performed in advance. In this case, a fully edentulous patient with severe alveolar bone resorption due to periodontal disease was treated with a full mouth rehabilitation using implant-supported fixed prosthesis preceding maxillary sinus graft and alveolar bone augmentation. We report this patient were satisfied with esthetic and function.
Figures and Tables
Fig. 4
Occlusal view of clinical images at bone graft. (A) Pre-operative view of maxillary left area, (B) After sinus graft and alveolar bone augmentation of maxillary left area, (C) Flap closure of maxillary left area, (D) Pre-operative view of maxillary right area, (E) After alveolar bone augmentation of maxillary right area, (F) Flap closure of maxillary right area, (G) Pre-operative view of mandible, (H, I) After alveolar bone augmentation of mandibular posterior region, (J) Flap closure of mandible.
Fig. 6
(A) Implant surgery on maxilla, (B) Implant surgery on mandible, (C) Panorama view was taken after implant placement in maxilla and mandible.
Fig. 7
(A) Computer aided design of individualized abutment, (B) Individualized zirconia and titanium abutments was connected to working model of maxilla, (C) Individualized titanium abutments was connected to working model of mandible, (D) Bonnet crown are connected to implant abutment of maxilla, (E) Bonnet crown are connected to implant abutment of mandible, (F) Pick-up impression of maxillary implant bonnet crown, (G) Pick-up impression of mandibular implant bonnet crown, (H) Registration of inter-occlusal relationship with auto-polymerized acrylic resin bite jig & silicone bite registration material, (I) Additional milling of individualized implant abutment on newly created working model.
Fig. 8
Full contour wax-up for provisional restorations. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view (D) Left lateral view, (E) Lateral movement - right side, (F) Mandibular occlusal view, (G) Lateral movement - left side.
Fig. 10
(A) Final impression taking of maxilla, (B) Final impression taking of mandible, (C) Final working model of maxilla, (D) Final working model of mandible, (E) Registration of inter-occlusal relationship with auto-polymerized acrylic resin bite jig, (F) Fabrication of customized anterior incisal guide table.
Fig. 11
Definitive prosthesis. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.
Fig. 12
Fabricating abutment replica with hot melt adhesive material. (A) Abutment replica of maxillary anterior prosthesis, (B) Abutment replica of mandibular anterior prosthesis.
Fig. 13
Eccentric occlusion with definitive prosthesis. (A) Anterior movement: posterior teeth of both side were disoccluded, (B) Lateral movement - right side: group function, (C) Lateral movement - left side: group function, (D) Occlusal analysis using T-scan III: Equal distribution of occlusal force for whole dentition, (E) Post-treatment panoramic radiograph.
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