Complete Prosthetic Rehabilitation in a Fully Edentulous Patient: Palateless Maxillary CAD/CAM Implant-Supported Overdenture Using High-Performance Polymer as Framework Material and Mandibular Implant-Retained Overdenture with Stud Attachments
A 65-year-old female patient with a history of medically controlled type II diabetes was referred to the clinic with severe esthetic and functional problems due to complete edentulism as result of generalized stage IV periodontitis. Her main complaints were difficulty when chewing all types of food and poor esthetic appearance. Clinical and CBCT analysis revealed a horizontal deficiency of the alveolar ridge caused by the extraction of the remaining teeth 4 months earlier. Please note that the SAC assessment below is based on the assessment of the mandible only!
Surgical classification
Complex
Prosthodontic classification
Complex
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 15
CME/CPD
0.25 hours
Purchase price
10
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General Risk Assessment
Patient-related Factors
| Oral hygiene | Good |
|---|---|
| Compliance | Good |
Patient-medical Factors
| Medical Fitness | Moderately compromised health, but can undergo planned anesthesia and surgical procedure (ASA II to ASA III) |
|---|---|
| Medications | No medications that would negatively affect the surgical procedure and outcomes. |
| Radiation Treatment | None |
| Growth Status | Complete |
Site-related Factors
| Access | Adequate |
|---|---|
| Pathology near the implant site | None |
| Previous surgeries in planned implant site | No previous procedures. |
Surgical Classification
Surgical Complexity
| Timing of placement | Healed (Type IV) |
|---|---|
| Simultaneous or Staged grafting procedures | Implant placement without adjunctive procedures |
| Number of implants | > Three |
Anatomy
| Keratinized Tissue | Sufficient (>4 mm) |
|---|---|
| Soft Tissue Quality | No scars or inflammation |
| Proximity to vital anatomic structures | Moderate risk of involvement |
Prosthodontic Classification
Complicating Factors
| Biological | Screw-retained restorations with appropriate contours |
|---|---|
| Mechanical/Technical | Absence of contributing factors |
| Planned contour of tissue-fitting surfaces | Appropriate contours (hygienic - accessible for maintenance) |
Prosthesis Factors
| Prosthetic volume | Adequate. Space available for ideal anatomy of the restoration |
|---|---|
| Inter-occlusal space | Adequate. Capable to create an anatomically & functionally correct planned restoration |
Occlusal Factors
| Occlusal scheme | User-defined occlusal scheme achievable |
|---|---|
| Involvement in occlusion | Involvement |
| Occlusal parafunction | Absent |
Complexity
| Loading Protocol | Early/Conventional |
|---|---|
| Interim prosthesis | Tissue or interim implant supported |
| Number of implants | >2 (non-splinted) or ≥ 2 (splinted) |
| Timing of placement | Healed (Type IV) |
Esthetic Risk Assessment
Edentulous Esthetic Risk Assessment (removable)
| Facial Support | Desired tooth position provides sastifactory labial support |
|---|---|
| Labial Support | Flange provides required lip support |
| Maxillomandibular Relationship | Class I |
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