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ePaper created 2016-10-04, 09:33:57 | version 1.38.0
| ce article fixed and removable implant restorations 24 CAD/CAM 3 2016 Fixed and removable implant restorations: A solution for every arch Introduction When a patient presents with an edentulous arch or terminal dentition, implant treatment can be providedthatimprovesnotonlyformandfunction, but also quality of life. For patients desiring better chewingcapability,stability,aestheticsandcomfort thanatraditionaldenturecanoffer,bothremovable and fixed implant restorations are superior alter- natives.1 While the appropriate implant solution can vary depending on the patient’s oral health, anatomy,qualityandquantityofbone,andfinancial resources, full-arch prosthetics have progressed to the point where virtually every patient can be restored. Although fixed, implant-supported restorations offer the highest levels of stability, function and patient satisfaction, removable overdentures are a dramatic improvement over conventional com- plete dentures as well.2 Both treatment options effectively mitigate the bone resorption that oc- curs following the loss of teeth, helping to preserve the oral and facial structures and, by extension, the self-confidence of the fully edentulous patient. Determining which solution is appropriate re- quires a careful evaluation of the individual pa- tient’s circumstances and desires. Even when an implant overdenture is delivered, the prosthesis can eventually be converted to a fixed restora- tion. As evidenced by the case that follows, in which one arch is restored with an implant overdenture and the other with a BruxZir Full-Arch Implant Prosthesis (BruZir), practitioners today have a great deal of clinical flexibility. Whatever prosthetic ap- proach is adopted, immediate, life-changing relief can be provided to patients suffering from terminal dentition or an uncomfortable, poorly functioning traditional denture. Further, the dramatic overhaul of this patient’s oral health demonstrates the life-changingcapabilitiesofimplanttherapy,which helped him overcome severe functional and aes- thetic challenges that were impacting practically every facet of his life prior to treatment. Case presentation A 47-year-old male presented with terminal denti- tion in both arches resulting from periodontal dis- ease and severe caries (Figs. 1a–c). The patient had alreadylostmanyofhisteeth,andthedentitionthat remained had been rendered unstable by his peri- odontal condition (Fig. 2). He had saved up enough money for a fixed implant restoration for his upper arch, for which he desired the most functional, life- like prosthesis possible. While he couldn’t afford Figs. 1a–c: Preoperative condition of the patient. Note the high lip line, severe cervical decay present on the patient’s remaining teeth, and lack of gingival support. Author: Dr Paresh B. Patel USA Fig. 1a Fig. 1b Fig. 1c CE credit This article qualifies for CE credit. To take the CE quiz, log on to www.dtstudyclub.com. Click on ‘CE articles’ and search for this edition of CAD/CAM. If you are not registered with the site, you will be asked to do so before taking the quiz. 32016