Presurgical implant-supported prosthesis: technique for cementation of a definitive prosthesis immediately after surgery

A fixed prosthesis, supported by implants, was fabricated prior to surgery and cemented with passive fit immediately after placement of 14 implants in the mandible. The prosthesis was constructed before implant surgery on a plaster cast that precisely reproduced the patient's hard and soft tissues. The cast was built using a method that allowed the transfer of hard and soft tissue anatomy from computerized tomograms. A rigid surgical stent, cast in gold, was used to place the implants into prosthetically ideal positions under three-dimensional control. The prosthesis was placed immediately after implant placement, using an occlusion-driven method, which avoided the need for occlusal adjustments to the prosthesis.     

A technique for fabricating a definitive immediate implant-supported prosthesis for the edentulous mandible

A technique for fabricating a definitive immediate fixed implant-supported prosthesis to rehabilitate the edentulous mandible is described. Temporary abutments were used first as impression copings, later modified to achieve parallelism, and finally incorporated in the definitive framework. The metal framework was fabricated with holes for the abutments and connected to the abutments with composite resin cement intraorally to obtain passive fit. This technique reduced the number of steps, thereby decreasing insertion time of the definitive prosthesis to 2 days.     

Vacuum-formed tooth position record as an index for the fabrication of an endosseous implant-supported prosthesis.

An endosseous implant-supported prosthesis usually requires a metal substructure and/or retentive elements in addition to the prosthetic teeth and soft tissue substitute. It is crucial that the metal substructure and all of the prosthetic components of an implant-supported prosthesis be confined within the contour of the prosthesis. This article describes a procedure for fabricating an index to record and maintain the anatomic contour of the trial denture to the master cast.     

The periodontal prosthesis mode of transition to an implant-supported dentition

In recent years, implant-supported reconstructions have become a welcome alternative to dentures for those who have lost their natural dentition. While the benefits of the final implant-supported reconstruction may be obvious, the planning and execution of therapy to achieve this result may be bewildering to many dentists. Four main modes of transfer have evolved: an uncontrolled or "haphazard" transition; the traditional "dentures first" mode, an immediate transition, and a staged transition. This article proposes an additional mode of transition called periodontal prosthesis, which has the potential to make the transition process smoother and more predictable while providing optimal retention of alveolar supporting structures and generating optimal esthetics.     

A digital technique for fabricating an interim implant-supported fixed prosthesis immediately after implant placement in patients with complete edentulism

The conversion of a denture into an interim implant-supported, screw-retained restoration has become the standard method for immediate interim restoration in patients with complete edentulism. The most critical steps of the denture conversion process are the creation of appropriate denture access holes to prevent displacement of the denture by the interim cylinders and removal of the denture flanges to facilitate both good esthetics and accessibility for oral hygiene after the denture is connected to the interim cylinders. This article presents a digital technique for designing and fabricating an interim implant-supported, fixed prosthesis for edentulous patients. The interim prosthesis has cylinder access holes that are digitally prefabricated and a denture flange part that is designed to be easily sectioned. This technique facilitates more straightforward and efficient immediate restoration for edentulous patients after implant placement.     

The use of three different matrices to ensure proper spatial dimension in fabricating definitive implant-supported prostheses

Implant concepts continue to evolve not only in terms of materials, surfaces, and designs but also in clinical experience and technical management. This article presents a clinical and laboratory procedure describing how to plan, ensure, and achieve proper spatial dimension in fabricating definitive implant-supported prostheses with the use of 3 different matrices. This will in turn aid in restoring the patient with a predictable outcome from the outset of the treatment.     

Converting an implant-supported fixed prosthesis to an overdenture because of fixture loss: a case report

A patient with a failed implant-supported prosthesis was treated with an immediate interim overdenture. After insertion of a bar modified from the prosthesis substructure, the patient was restored with an implant-supported overdenture. A bar soft liner retention system was used to aid retention and stability of the overdenture.     

Stabilization of an interim obturator prosthesis using a denture duplicator.

Concomitant radiotherapy and chemotherapy given within weeks after major surgical procedures may require that an interim obturator prosthesis be worn for extended periods of time. Interim reline materials used in fabricating the interim obturator prosthesis may become rough and difficult to clean. With a Lang denture duplicator it is possible to easily convert an interim obturator prosthesis to an all acrylic resin prosthesis. A technique is described for this procedure.     

Replacement of a mandibular implant-fixed prosthesis with an implant-supported overdenture to improve maintenance and care

PatientsA 69-year-old woman presented to the Osaka University Dental Hospital. She had two chief complaints, (a) food accumulation under the lower teeth and (b) poor maxillary denture retention while eating. On clinical examination the patient presented with a maxillary complete denture and fixed mandibular implant prosthesis. For preventing food accumulation under the fixed implant prosthesis and to keep the maxillary denture stable by providing posterior occlusal contact for bilaterally balanced occlusion, the use of a mandibular implant-supported overdenture with self-adjusting magnetic attachments provided a prosthetic solution for this patient. After provided the new dentures, the patient was pleased and was comfortable with the aesthetic, stability and retention of the dentures. There were no discernable clinical or radiographic changes after 1 year of use.DiscussionTo prevent food accumulation beneath the fixed implant prosthesis and maintain the stability of the maxillary denture by providing posterior occlusal contact for bilaterally balanced occlusion, a mandibular implant-retained overdenture with magnetic attachments was used to provide a prosthetic solution for this patient.ConclusionIn this clinical case, an implant-fixed prosthesis in the edentulous mandibular region was replaced into an implant-supported overdenture with considerations for (a) preventing the food accumulation beneath the lower prosthesis, (b) achieving the proper occlusion in the posterior part for maxillary denture stability and (c) ease of maintenance and care for the prostheses.     

Conversion of an interim into a definitive speech aid: a predictable approach.

In patients with partial or total soft palatectomy, an interim prosthesis generally is inserted as soon as possible after surgery. Over the average postoperative healing period of 3 months, numerous clinical appointments are needed to shape the prosthesis. When the definitive prosthesis is completed, reshaping the pharyngeal portion of the speech aid unnecessarily involves duplication of work by the clinician. A laboratory procedure is described that can save clinic time, increase cost-effectiveness, and shift work normally performed by the maxillofacial prosthodontist to the maxillofacial laboratory technician. This technique is particularly useful with prostheses that are difficult to shape because of trismus or lack of residual lateral and posterior pharyngeal movement.     

Magnet-retained auricular prosthesis with an implant-supported composite bar: a clinical report

The use of craniofacial implants to assist in retaining auricular prostheses often requires complex laboratory procedures, involving production of an accurate casting, fitting of a precious alloy bar, and the use of clips. A simplified method for the retention of an auricular prosthesis with a composite bar and magnets is described in this article.