CAD/CAM international magazine of digital dentistry No. 4, 2016

full mouth restoration case report | 17 CAD/CAM 4 2016 the lab and incorporated into the final prosthetic design. In the following case report, a fully edentulous patient with limited vertical bone volume is pro- vided with a cementable FP3 prosthesis, helping reestablish the hard- and soft-tissue architecture needed for a functional, esthetic restoration. A treatment plan is executed in which the latest advancementsindentalimplantdesign,CAD/CAM technology and prosthetic materials are utilized to overcome difficult anatomical circumstances and meet the immediate and long-term needs of the patient. Case report A male patient in his early sixties presented for treatment with an edentulous maxilla and grossly decayed, hyper-erupted mandibular den- tition (Fig. 1). The patient was a heavy smoker, had not seen a dentist in nine years, and was not taking proper care of his remaining teeth due to pain and discomfort (Fig. 2). The patient’s upper denture had become increasingly loose- fitting since losing his teeth nearly a decade prior. Hisdesireforarestorationthatfeltandfunctioned more like natural teeth led him to my practice, where he could undergo the surgical and pros- thetic phases of treatment under one roof. In- traoralandradiographicevaluationindicatedsuf- ficient bone volume for full-arch implant therapy (Fig. 3). Treatment options were presented to the patient for his edentulous upper arch and non-restorable mandibular dentition, including various com- binations of fixed and removable implant pros- theses. This involved a discussion of complete edentulism and its problems, consequences and solutions (PCS), the effect of tooth loss on oral health, and the differences in stability and function afforded by each treatment option. Dental financing programs were explained, which is an important part of treatment presentation, as it can help make implant therapy feasible for patients who cannot cover the entire cost upfront. Figs. 5a & b: The implant osteotomies were created following a straightforward, user-friendly surgical protocol. Figs. 6a & b: The Hahn Tapered Implants were initially threaded into position with a handpiece. Fig. 7: With high primary stability established, 3-mm-tall healing abutments were connected to the maxillary implants. Fig. 8: After extracting the patient’s mandibular teeth, a bone-leveling guide was placed over the arch to assist with the alveoplasty procedure. Fig. 9: Bone-level surgical guide seated over the mandible. Fig. 7 Fig. 8 Fig. 9 Fig. 5a Fig. 5b Fig. 6a Fig. 6b 42016

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