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ePaper created 2017-05-10, 16:12:25 | version 1.38.0
| case report restoration of the edentulous maxilla Removable prosthesis in digital times Authors: Drs Gualtiero Mandelli, Guiseppe Salvato & Carlo Borromeo, Italy Fig. 1 Fig. 2 Fig. 3 Fig. 1: Initial situation— patient’s profile. Fig. 2: Initial situation—front view. Fig. 3: Teeth try-in of the temporary prosthesis. The main problem that brings patients to our surgery is an edentulous maxilla, which motivates the patient to want a functional restoration, with particular attention to the aesthetic result. The evaluation of the soft tissues of the face, from front and side view, shows a big reduction of the labial support induced by a centripetal bone re- traction. More than that, the lack of sagittal and vertical bone support reduces the degree of den- Fig. 4 Fig. 4: Intraoral situation after implants placement and before the reopening. Fig. 5: Teeth set-up on preliminary impressions after performing the occlusal jigs and mounted models in the articulator. Fig. 6: Duplication of the teeth set-up with a transparent resin. Fig. 5 18 CAD/CAM 2 2017 tal-gingival exposure in case of peri-prosthetic crestal design (Figs. 1 & 2). Considering the above parameters, to centre the aesthetic requirements it is proposed to the patient a removable implant-prosthetic rehabilitation; the goal is to achieve, with the prosthetic flange, a “prosthetic reconstruction” of the atrophic bone, thus favouring a suitable labial support with a cor- rect teeth set-up. The operating sequence therefore seeks to verify the soft tissues’ support by using an intraoral try-in of the set-up made on a model from a preliminary impression in alginate (Fig. 3). The aesthetics were controlled and also confirmed by the patient’s involvement and approval who wanted a removable prosthetic solution without the palate area, and still have a good stability. Fig. 6