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Patient's
Treatments
(Oral rehabilitation Treatments) |
| Fixed Partial
Denture specialty and Implants |
This is a 72 y.o. female
patient, who was missing several teeth in her lower jaw.
The top panorex shows the condition of her mouth when we first saw
her.
The bottom panorex shows the end of the treatment with 5 implants
and the
prosthetic rehabilitation replacing the missing teeth and the reconstructed
anterior teeth.
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One of the
great benefits for this patient is that the upper teeth are protected
from ¨supraeruption¨. Another benefit with the implant treatment
is that the anterior teeth(superior and inferior) are protected from
displacement. The best advantage of this treatment is that she will
not wore a removable partial denture. The patient´s commentaries
were: ¨I am happy. The teeth are very nice.
I am chewing on both sides. They feel great¨.
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1.
View of the lower jaw and the implant and
fixed rehabilitation. |
2.View
of three implant abutments on left side
of the patient. |
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3-
Buccal view of the three implant-unit bridge on
the lower and the occlusion with the upper teeth |
4.
View of two implant abutments on the right
side of the patient. |
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| 5-Buccal
view of the three unit bridge on the lower and the occlusion with
the upper teeth. |
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| A combination
of the Denture Prosthodontic specialty (A), Fixed Partial dentures
(B) and Implants were the modalities of treatment for this patient. |
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(A) UPPER OVERLAY-DENTURE SUPPORTED BY 5 IMPLATS, connected
together by a GOLD BAR and 3 semi- precision attachments. The
bearing mucosa is also included as a supporting element in this
case.
(B) The lower arch had 2 INDIVIDUAL IMPLANT SUPPORTED CROWNS
(non precious metal/porcelain, one on each side of the mandible).
A 68 y.o. female patient with excellent general health, non-smoker,
had the following oral conditions:
Upper arch: totally edentulous. Bone ridge re-absorption Class
II (narrow and high), on the anterior area, and Class IV (broad
and reduced height) in the posterior area (Atwood´s classification)
Lower arch: Partially edentulous. Kennedy´s Class I Classification.
Total of teeth present=10: 4 premolars and 6 anterior teeth, with
1:1 crown root/ratio and without mobility. Localized marginal
gingivitis in the areas where plaque is present. Four Class II
(DO) amalgam restorations (Black´s Classification) are present
one on each of the premolars.
The patient lost her teeth 20 years earlier, because of periodontal
problems. Since then, she has used an upper denture and removable
partial denture on the lower, which she discarded. This last upper
denture, she used for 8 years ago and it was not stable and there
was a 4 mm. loss on vertical dimension of occlusion.
Her main complaint was that she did not like the palate of the
complete denture and that she was not comfortable chewing. Please
follow the sequence of treatment by looking at the following x-rays
and pictures.
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First Panoramic X-ray. (May 31st. 1999)
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| Control Panoramic X-ray.
This X-ray was taken after 6 months. All the implants are well osseointegrated.
The relationship of height of each implant with the level of the
bone is adequate. |
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| X-Ray taken at the end
of the treatment. This x-ray shows in the maxillae, the fit of the
barr with each implant. The isolated implants on each side of the
mandible have non-precious metal/porcelain crowns that fit well
in the implants. |
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BEFORE THE TREATMENT
Frontal view of the patient.
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AT THE END OF THE TREATMENT
Frontal view of the patient.
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Patient´s Profile. Sagital view.
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Patient´s profile. Sagital view.
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The upper denture had been used
for 8 Years. The 10 lower teeth presented dental plaque and
stains.
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Intraoral view at the end of
the treatment. Note the presence of the implant supported
molar crowns and the upper overlay denture.
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Occlusal view of the lower arch.
There are only 10 teeth present.
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Occlusal view of the lower arch.
Observe the implant supported metal/ Porcelain Molar crowns.
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Frontal view of the upper and
lower arches .
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Frontal view of the upper arch
gold metal bar.
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Occlusal view of the metal
bar.
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The upper overlay implant supported
denture with horseshoe shape. No palate. |
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Incisal Plane, right side with
the upper lip at rest.
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Incisal Plane, left side with
the upper lip at rest.
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Patient´s smile. Activity of
lips.
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A combination
of DENTURE PROSTHODONTICS specialty and IMPLANTS were the modalities
of treatment for this patient.
UPPER DENTURE / LOWER OVERLAY-DENTURE SUPPORTED BY 3 IMPLANTS, tooth
·33 and the bearing mucosa in the mandible. |
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A sixty two year old male patient,
that has used 4 different sets of dentures, during the last
15 years.
He had no teeth present in the upper arch. |
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The soft tissues in the anterior area were
inflamed, due to the fact that the denture in use, was not
fitting and the contacts of the teeth were strong in the anterior
area. |
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The lower inferior ridge is narrow = 5 mm.
(Ve-Li ) at the crest of the ridge. Tooth No. 33 presented
and endodontic treatment sealed with a semi-precision attachment,
which gave some retention to the lower overdenture. Stability
of the overdenture was not good, because the applience was
not relined since it was inserted in the mouth, four years
earlier. The prognosis of tooth no. 33 was fair, because it
only had 3 alveolar walls being almost absent the lingual
plate. The tooth had no mobility and on the lingual side,
the root was covered 5 mm with bone and gum. |
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The periodontal ligament was inflamed. There
were no periodontal pockets present and I decided to keep
this tooth in the mouth to preserve bone height and propioception.
Panoramic X- Ray for diagnosis. The bone in the maxillae has
reabsorbed (according to the Fallshüssel Clasification), in
the posterior area= type IV (wide maxillary crest, but reduced
height), and in the anterior curvature= type V (totally reabsorbed
crest of the ridge). The antral cavity of the maxillary sinus
is very big on both sides. The width of the bonne in the thinner
area of the right side is 2 mm. and 4mm on the left. |
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The control radiography a year and a half
after the insertion of the upper complete denture and the
lower implant/tooth supported overlay. |
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The bone around the implants is in good
condition. The level of the crest of the ridge is different
from the one in because it was lowered during the implantation
(surgery) process. The initial width of the bone was not wide
enough to 3.75 mm adequatly place 3.75 mm implants. By lowering
the ridge, we had more width of bone Bu-Li. |
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Intraoral view of the mandible (occlusal
view). The distal implant is isolated and has a Dalla Bona
attachment. The medial implants are connected with a bar.
Observe that the mucosa is healthy. Tooth No. 33 has a casted
restoration. (gold 76%, type III).
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Internal view of the overdenture. The bar
counterpart and the female of the Dalla Bonna attachent were
imbeded in the acrylic, with a pick up procedure in the mouth.
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A healthy upper maxilary edentulous arch. |
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The set of complete dentures in the patient´s
mouth. |
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| Patient´s smile. Activity of Lips.
(frontal view) |
Patient´s Profile. (Sagital view) |
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The patient´s commentary after one year and
a half of use is:
"These feel real well. Of course the bottom
one, is much better because it is really solid." |
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