All-on-4 implant restoration with full-digital system preserving existing occlusion: A case report

Kyoung Hee Kim; Seung-Mi Jeong; Ye Chan Lee; Xue Yin An; Byung-Ho Choi

doi:10.4047/jkap.2018.56.4.330

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Kim, Jeong, Lee, An, and Choi: All-on-4 implant restoration with full-digital system preserving existing occlusion: A case report

Case Report

The Journal of Korean Academy of Prosthodontics 2018; 56(4): 330-337.

Published online: 30 October 2018

DOI: https://doi.org/10.4047/jkap.2018.56.4.330

All-on-4 implant restoration with full-digital system preserving existing occlusion: A case report

Kyoung Hee Kim¹, Seung-Mi Jeong¹

, Ye Chan Lee¹, Xue Yin An¹, Byung-Ho Choi²

¹Department of Prosthodontics, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.

²Department of Oral and Maxillofacial Surgery, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.

Corresponding Author: Seung-Mi Jeong. Department of Prosthodontics, Wonju College of Medicine, Yonsei University, 20 Iisan-ro, Wonju 26426, Republic of Korea. +82 (0)33 741 2114: smj3@yonsei.ac.kr

Received 3 July 2018 Revised 14 August 2018 Accepted 17 August 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

In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.

Keywords: Edentulous, All-on-4 implant, 3D printer, Immediate interim prosthesis, Digital dentistry

Figures and Tables

Fig. 1

Pre-operation. (A) Frontal view without existing denture, (B) Frontal view with existing denture, (C) Panoramic radiograph.

Fig. 2

Direct scan of residual ridge. (A) Marking on residual ridge using radiopaque resin, (B) 3D scan image of residual ridge.

Fig. 3

Data of Occlusion. (A) Impression using denture, (B) Biting image, (C) Deletion of lower denture image.

Fig. 4

Merging CT image with scan file and Planning of implant placement. (A) Right, (B) Front, (C) Left.

Fig. 5

Surgical guide for flapless implantation.

Fig. 6

Design of interim prosthesis. (A) Frontal view, (B) Occlusion with antagonist jaw, (C) Occlusal view.

Fig. 7

Pre-fabrication of interim prosthesis. (A) Occlusal view, (B) Frontal view, (C) Inner surface.

Fig. 8

Flapless Implantation and Interim prosthesis connection. (A) Surgical guide, (B) Implantation, (C) Confirming of cylinder site using interim prosthesis, (D) Adhesion of interim prosthesis and cylinder using resin curing.

Fig. 9

Removing flange of interim prosthesis.

Fig. 10

Overlapping of scanfile of interim prosthesis and residual ridge. (A) Overlapping of scan files, (B) Confirming of implant site using interim prosthesis.

Fig. 11

Fabrication of framework. (A) Design of framework using occlusion of provisional prosthesis, (B) Intraoral check of framework, (C) Checking of cleansing space using dental floss.

Fig. 12

Fabrication of Final prosthesis. (A) Occlusal view, (B) Frontal view, (C) Right side (D) Left side.

Fig. 13

Delivery of Final prosthesis. (A) Intraoral photo, (B) Panoramic radiograph.

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ORCID iDs: Seung-Mi Jeong
https://orcid.org/0000-0002-1543-7227
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