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Case Study Presentation:
The Fabrication of a Implant-Retained Mandibular Denture.
Stèfan SchoemanIn partial fulfilment of BTech: Dental
Technology.
Topics of Discussion:
Patient History.Conditions and Background Information.Clinical Treatment Options.Technical Treatment Options. Most Suitable Treatment Option. Treatment option of choice. Laboratory procedures.
Patient History:
Male.43 years of age. Amiloblastoma in mandibular arch. First diagnosis 1993, age 32.Second diagnosis 1995, age 34.
Conditions and Background Information:
Biopsy showed cystic follicular amiloblastoma. 3
Removed cancerous tumour.Cancer is malignant.Regular tissue graphs.Numerous dentures.
Clinical Treatment Options:
Chemotherapy. Radiation therapy. Mandibulectomy. Bone graph.Tissue graph.3
Technical Treatment Options:
Full lower conventional monoplast denture. +/- R 400
Implant retained denture. +/- R 2000
Implant retained ceramic restoration. +/- R 8000 – R10 000
Most Suitable Treatment Option:
Advantages:
Good support and stability.
Aesthetically pleasing.
Corrosion resistant.1
Disadvantages:
Infections due to implant failure.
Expensive.Difficult to keep
clean.1
Treatment Option of Choice
Implant retained denture supported by: 2
Bar and clips.Ball attachments.
Mezo–Bar.
Implant Retained Overdenture:
Ball attachments.
Implant Retained Overdenture:
Mezo–Bar.
Implant Retained Denture:
Advantages:
More affordable. Aesthetically
pleasing. Good load
distribution.Stable and
retentive.
Implant Retained Denture:
Disadvantages:
Infections due to implant failure.
Reconstruction of denture and bar.
Bulky.Patient
corporation.
Laboratory Procedure 1:
Primary impression of mandible.
Mandibular special tray made on primary model.
Final impression taken of mandibular arch.
Laboratory Procedure 2:
Final impression cast in stone.
Record block made.
Bite registration taken.
Laboratory Procedure 3:
Lower denture waxed up and processed.
Stent is fabricated for correct position of implants.
Laboratory Procedure 4:
Implants placed in mandibular arch.
Mezo–Bar wax up.4
Cast and finished.4
Placement of bar attachment.
Final Placement:
Try-in done.Denture processed with clips.Denture placed, excellent fit.
References:
1) M. Dunitz, Implants and Restorative Dentisry, 2nd ed. Hong Kong: Imago. 2001: 241 – 264.
2) D. Harold, Overdentures Made Easy, 3rd ed. Londen: Quintessence Publishing Co Ltd. 1996: 105 – 139.
3) K. Whaley, Muir’s Textbook of Pathology, 15th ed. 2001 : 680.
4) Southern Implant Catalogue.
Acknowledgements
Dr van Zyl Prof. Morkel Ms Nortjè Mr Mazema Mr Steyn Mrs Wright