Functional and esthetical full mouth rehabilitation with implant supported prostheses: A case report

Abstract

IntroductionIn cases of multiple tooth loss, treatment option can be removable partial denture, complete denture, overdenture, or implant supported prosthesis. Among them, implant supported fixed prosthesis slows down resorption of alveolar ridges and rehabilitates approximately full function of the natural teeth, 1,2 hence achieving relatively higher satisfaction on patient's behalf, compared to the conventional removable dentures.3 By providing more stable occlusal conditions, implant supported fixed partial denture can be a good alternative, when the patient shows lack of neuromuscular control for removable denture. 4 The aim of this case report was to show the functionally and esthetically satisfying full mouth rehabilitation with implant supported allceramic and porcelain-fused-to-gold prostheses. Case reportA 56-year-old female patient was referred to the Department of Prosthodontics at Seoul National University Dental Hospital. She complained discomfort derived from the fractured maxillary prostheses, and the lower removable partial denture she had been using. She wanted the prosthetic treatment using implant supported fixed partial denture. When presented, #16, 17, 25-27, 31-36, 41-47 (FDI system) were missing and mandibular removable partial denture showed excessive occlusal wear so that the vertical dimension was decreased (Fig. 1).In clinical and radiological examination after removing all spoiled prostheses, preservation of all the remaining teeth, #13, 15, 23, 24, 37, was planned. In the upper part, after caries treatment, temporary bridges were fabricated from #15 to #24. In the lower, by temporary complete denture, vertical dimension was re-established. During adjusting the prostheses, the patient was satisfied by its function and esthetics.A CT scan was ordered to evaluate the presence of sufficient bone volume. A radiographic implant CT stent was fabricated by duplicating the temporary denture. Implant position was determined as #12, 16, 22, 25, 26 area in maxilla, and #33, 34, 36, 43, 44, 46 area in mandible. In the upper esthetic zone, from #12 to #22 area, bone grafting was added to treatment plan to compensate bone resorption.After one month of adjusting period with temporary prostheses, the implant surgery was performed under IV sedation. The whole http: //dx.doi.org/10.4047/jkap.2015.53 This report describes the prosthetic treatment of a patient with multiple missing teeth. Installation of five fixtures on maxilla with sinus lift and six fixtures on mandible with ramal bone graft were performed. With implant supported all-ceramic with zirconia core using CAD/CAM technology and porcelain-fused-to-gold prosthesis, treatment with positive outcome which satisfies both functional and esthetical aspect was obtained. (J Korean Acad Prosthodont 2015;53:81-5)