Implants

I 23 case report _ Immediate loading I implants1_2013 tulous patients to a normally textured diet, normal nutritional intake, better health and improved self-confidence.1–3 A locator-supported overdenture is a well-documented modality of treatment. The conventional method of treatment is to place the implants in a submerged two- stageapproach.Afterallowingtheimplants to osseointegrate for three months, the im- plants are uncovered and the locators are delivered to support the overdenture. The concept of immediate functional loading has been documented in the mandible and the maxilla: implants are connected rigidly and immediately after placement to avoid micro-motions, which can have a negative impact on the osseointegration process.4–8 A higher failure rate has been reported in only very few reports in the literature about immediate functional loading of individual implants to support a mandibu- lar overdenture.9 This case report demon- strates the use of tapered implants in the mandible to immediately load and support four separate implants by means of a lo- cator-supported mandibular overdenture. _Patient presentation A 55-year-old female patient without any medical contra-indication for implant therapy presented with an ill-fitting, lower complete denture that she had been wear- ing for four years. The clinical and radio- graphic findings revealed slight to moder- ate mandibular ridge resorption with an ill-fitting lower denture (Figs 1 & 2). The patient was given the option of placing four implants to support her existing lower denture. The treatment plan was accepted and included an immediate functional loading by using a locator attachment- supported mandibular overdenture. _Surgical treatment At the surgical appointment, following the administration of local anaesthetic, a mid-crestal incision was performed and a full-thickness flap was reflected. In addi- tion, osteotomies were prepared in type II bone. Bone taps were used to countersink the sites, after which four OSSEOTITE Ta- pered Certain implants (BIOMET 3i; 4 mm in diameter, 13 mm in length) were placed with the handpiece and hand ratchet. The implants were torqued to 35 N (Figs 3 & 4). _Prosthetic treatment Immediately after implant surgery, the mandibular denture was seated in the patient’s mouth and adjusted to provide clearance in the area of the locator(s). Four locators (4 mm in length) were torqued to 30 N (Figs 5 & 6). Following the suture Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig 9_Occlusal view of the locators two weeks post-implant placement Fig 10_Buccal view of the locators two weeks post-implant placement Fig 11_The processing rings were removed ten weeks post- placement Fig 12_The blue retention rings were placed as the final rings Fig 13_Occlusal view of the overdenture in place at ten weeks post-placement Fig. 14_Buccal view of the overdenture in place Fig 15_Occlusal view of the locators six months post-placement Fig 16_Buccal view of the locators six months post-placement