Mandibular Implant-Retained Overdenture on a CAD/CAM-Milled, Parallel-Walled CrCoMo Bar
A 72-year-old male patient, partially dentate, presented with a request for a more functional and esthetic solution for his mandibular arch. He had lost his mandibular teeth over a period of more than twenty years due to a combination of periodontal disease and dental caries. He was not satisfied with his existing mandibular prosthesis, which was stabilized by his single remaining tooth 43. A pretreatment panoramic radiograph confirmed the absence of pathology. The patient was ambulatory, alert, and philosophical, and denied any health problems that would affect the dental treatment.
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 | Fair |
|---|---|
| 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 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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