Retreatment of fractured implant overdenture due to long-term maintenance failure

Minjee Kim; Seoungjin Hong; Janghyun Paek; Kwantae Noh; Ahran Pae; Hyeong-Seob Kim; Kung-Rock Kwon

doi:10.4047/jkap.2018.56.3.235

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Kim, Hong, Paek, Noh, Pae, Kim, and Kwon: Retreatment of fractured implant overdenture due to long-term maintenance failure

Case Report

The Journal of Korean Academy of Prosthodontics 2018; 56(3): 235-242.

Published online: 20 July 2018

DOI: https://doi.org/10.4047/jkap.2018.56.3.235

Retreatment of fractured implant overdenture due to long-term maintenance failure

Minjee Kim

, Seoungjin Hong, Janghyun Paek, Kwantae Noh, Ahran Pae, Hyeong-Seob Kim, Kung-Rock Kwon

Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.

Corresponding Author: Ahran Pae. Department of Prosthodontics, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea. +82 (0)2 958 9340: ahranp@khu.ac.kr

Received 8 May 2018 Revised 5 June 2018 Accepted 15 June 2018

The Korean Academy of Prosthodontics

(open-access):

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

Periodontal and prosthodontic maintenance of implant overdenture is a very important factor for the long term success of the prosthesis and implants. Failure of maintenance can lead to prosthetic failure due to peri-implant bone loss and fracture and wear of the prosthesis or components. In this case, the existing gold milled bars were reconstructed with cobalt chrome milled bar in a manner that does not interfere with the external shape for the retreatment of fractured implant overdenture by maintenance failure. Two implants of mandible were selected strategically and the CM LOC attachments were connected to the two implants, and implant overdentures were fabricated. As a result, prosthesis with a functional and esthetic design that facilitates good hygiene management of the patient was delivered, which is advantageous for long term maintenance, and regular check-ups were scheduled for proper maintenance.

Keywords: Implant overdenture, Milled-bar, CM LOC, Maintenance

Figures and Tables

Fig. 1

Preoperative extraoral photographs. (A) Frontal view, (B) Lateral view.

Fig. 2

Intraoral photographs showing existing implant overdenture that fractured on mandible. (A) Maxilla, (B) Right lateral, (C) Frontal, (D) Left lateral, (E) Mandible.

Fig. 3

Postoperative view after treatment 13 years ago. (A, B) Gold milled bar with magnet attachments, (C, D) Fixed implant prosthesis; Tescera resin fused on gold framework.

Fig. 4

Radiographic view. (A) Panoramic view. Generalized alveolar bone resorption is observed, especially on implant near mandibular right canine region, (B) Periapical view on implants placed on mandibular both central incisor area.

Fig. 5

(A) Existing implant overdenture invading lingual space, (B) Newly fabricated implant overdenture solving the problem.

Fig. 6

Final impression taking (B, E) with individual tray (A, D), and definitive cast fabrication (C, F).

Fig. 7

Wax trial denture. Bilaterally balanced occlusion achieved with lingualized occlusion. (A) Frontal view, (B) Posterior view.

Fig. 8

Design of milled bar using Exocad program. (A) Master cast, (B) Wax trial denture, (C) designed milled bar by superimposition, (D) Existing Bar, (E) Newly designed milled bar, (F) Comparison of existing and new bar.

Fig. 9

Newly fabricated Co-Cr milled bar. (A) Occlusal view, (B) Frontal view.

Fig. 10

(A) Definitive implant overdenture, (B) Intaglio of maxillary and mandibular overdenture, (C) Female housing and separator of attachment before direct resin application.

References

1. Doundoulakis JH, Eckert SE, Lindquist CC, Jeffcoat MK. The implant-supported overdenture as an alternative to the complete mandibular denture. J Am Dent Assoc. 2003; 134:1455–1458.

2. Sanna A, Nuytens P, Naert I, Quirynen M. Successful outcome of splinted implants supporting a ‘planned’ maxillary overdenture: a retrospective evaluation and comparison with fixed full dental prostheses. Clin Oral Implants Res. 2009; 20:406–413.

3. van Kampen F, Cune M, van der Bilt A, Bosman F. Retention and postinsertion maintenance of bar-clip, ball and magnet attachments in mandibular implant overdenture treatment: an in vivo comparison after 3 months of function. Clin Oral Implants Res. 2003; 14:720–726.

4. Trakas T, Michalakis K, Kang K, Hirayama H. Attachment systems for implant retained overdentures: a literature review. Implant Dent. 2006; 15:24–34.

5. Krennmair G, Krainhöfner M, Piehslinger E. Implant-supported mandibular overdentures retained with a milled bar: a retrospective study. Int J Oral Maxillofac Implants. 2007; 22:987–994.

6. Asvanund C, Morgano SM. Restoration of unfavorably positioned implants for a partially endentulous patient by using an overdenture retained with a milled bar and attachments: a clinical report. J Prosthet Dent. 2004; 91:6–10.

7. Astrand P, Engquist B, Dahlgren S, Gröndahl K, Engquist E, Feldmann H. Astra Tech and Brånemark system implants: a 5-year prospective study of marginal bone reactions. Clin Oral Implants Res. 2004; 15:413–420.

8. Becker W, Becker BE. Replacement of maxillary and mandibular molars with single endosseous implant restorations: a retrospective study. J Prosthet Dent. 1995; 74:51–55.

9. Misch K, Wang HL. Implant surgery complications: etiology and treatment. Implant Dent. 2008; 17:159–168.

10. Watson CJ, Tinsley D, Sharma S. Implant complications and failures: the complete overdenture. Dent Update. 2001; 28:234–238. 240

11. Andreiotelli M, Att W, Strub JR. Prosthodontic complications with implant overdentures: a systematic literature review. Int J Prosthodont. 2010; 23:195–203.

12. Osman RB, Payne AG, Ma S. Prosthodontic maintenance of maxillary implant overdentures: a systematic literature review. Int J Prosthodont. 2012; 25:381–391.

13. Hong HR, Pae A, Kim Y, Paek J, Kim HS, Kwon KR. Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis. Int J Oral Maxillofac Implants. 2012; 27:e69–e76.

14. Phoenix RD, Engelmeier RL. Lingualized occlusion revisited. J Prosthet Dent. 2010; 104:342–346.

15. Kim HY, Lee JY, Shin SW, Bryant SR. Attachment systems for mandibular implant overdentures: a systematic review. J Adv Prosthodont. 2012; 4:197–203.

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ORCID iDs: Minjee Kim
https://orcid.org/0000-0001-7478-5996
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