[EP-13] Management of implant prostheses complications placed in inadequate space using a digitally assisted workflow and reorganized approach
[Abstract]
Introduction
A 75-year-old female patient presented with a complaint of a broken front tooth and difficulty eating. Clinical examination revealed that she has fractured her 21,22 and questionable prognosis of 11, deep overbite, and moderate wear on the anterior lower teeth. She also has defective implant bridges with inadequate crown height on the posterior maxillary arch. Radiographic images show misaligned BioHorizon Laser-Lock implants with an intact bone-implant interface that was inserted 12 years ago
Case summary and Treatment Details
Informed consent was received form patient for treatment and presentation. Preliminary record, centric relation, and digital wax-up have been carried out to determine the new vertical space using a reorganized approach. The trial mock-up was done using the printed digital model to assess esthetic and phonetics. Defective implant bridges were partially removed along with full arch teeth preparation, to allow for relining provisional shells made with CADCAM polymethyl methacrylate (PMMA) restoration. The patient was adapting well to this new vertical dimension and an intraoral scan and analog impression were used to fabricate a second set of PMMA provisional connected to the intact implant and teeth. At this new stabilized provisionals, an immediate implant placement was carried out on 11 and 22 and delayed implant on 35,36 using guided surgery with Straumann BLX system. After 3 months of uneventful healing, a series of intraoral scans, along with segmented records was carried out to deliver implant-supported fixed prostheses and partial/full coverage restoration.(1)
Progress and Discussion
Mechanical drawbacks related to lack of prosthetic space can lead to wrong prosthetic design, technical complications as well as esthetic problems. Prosthesis retreatment and space planning assisted with digital workflow allows faster previsualization of final prosthesis volume, increases patient enthusiasm when they may feel discouraged, and simplify full mouth rehabilitation.
References
(1) A guide for optimal function and clinical efficiency. Journal of Esthetic and Restorative Dentistry.2024;36(1):186-96.
Introduction
A 75-year-old female patient presented with a complaint of a broken front tooth and difficulty eating. Clinical examination revealed that she has fractured her 21,22 and questionable prognosis of 11, deep overbite, and moderate wear on the anterior lower teeth. She also has defective implant bridges with inadequate crown height on the posterior maxillary arch. Radiographic images show misaligned BioHorizon Laser-Lock implants with an intact bone-implant interface that was inserted 12 years ago
Case summary and Treatment Details
Informed consent was received form patient for treatment and presentation. Preliminary record, centric relation, and digital wax-up have been carried out to determine the new vertical space using a reorganized approach. The trial mock-up was done using the printed digital model to assess esthetic and phonetics. Defective implant bridges were partially removed along with full arch teeth preparation, to allow for relining provisional shells made with CADCAM polymethyl methacrylate (PMMA) restoration. The patient was adapting well to this new vertical dimension and an intraoral scan and analog impression were used to fabricate a second set of PMMA provisional connected to the intact implant and teeth. At this new stabilized provisionals, an immediate implant placement was carried out on 11 and 22 and delayed implant on 35,36 using guided surgery with Straumann BLX system. After 3 months of uneventful healing, a series of intraoral scans, along with segmented records was carried out to deliver implant-supported fixed prostheses and partial/full coverage restoration.(1)
Progress and Discussion
Mechanical drawbacks related to lack of prosthetic space can lead to wrong prosthetic design, technical complications as well as esthetic problems. Prosthesis retreatment and space planning assisted with digital workflow allows faster previsualization of final prosthesis volume, increases patient enthusiasm when they may feel discouraged, and simplify full mouth rehabilitation.
References
(1) A guide for optimal function and clinical efficiency. Journal of Esthetic and Restorative Dentistry.2024;36(1):186-96.