Conventional Loading of Four Implants in the Edentulous Maxilla and Restoration with a Bar-Supported Overdenture
A 64-year-old male patient was referred to the University Medical Center Groningen, The Netherlands, for dental implant treatment. The patient had been edentulous in both the maxilla and mandible for 25 years. During these 25 years, three conventional dentures had been fabricated, the most recent one being 2 years old. The patient complained of inadequate retention and stability of his maxillary and mandibular dentures. The esthetic aspect was of medium importance to the patient. His medical history was unremarkable.
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 | Healthy, able to undergo planned anesthesia and surgical procedure (ASA I) |
|---|---|
| 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 as part of staged hard and/or soft tissue procedures |
| Number of implants | > Three |
Anatomy
| Bone Volume - Horizontal | Deficient, requiring a separate augmentation procedure prior to implant placement |
|---|---|
| Bone Volume - Vertical | Moderate deficiency requiring simultaneous horizontal augmentation. Deficient, requiring a separate augmentation procedure prior to implant placement |
| 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 |
| Upper Lip Length | Long upper lip (>20mm) |
| Buccal Corridor | Narrow corridor |
| Smile Line | No display of the Maxillary ridge at full smile |
| Maxillomandibular Relationship | Class I |
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