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| CE article fixed and removable implant restorations Fixed and removable implant restorations: A solution for every arch Author: Dr Paresh B. Patel, USA CE credit Introduction This article qualifies for CE cred- it. To take the CE quiz, log on to www.dtstudyclub.com. Click on ‘CE articles’ and search for this edition of the magazine. If you are not registered with the site, you will be asked to do so before tak- ing the quiz. When a patient presents with an edentulous arch or terminal dentition, implant treatment can be pro- vided that improves not only form and function, but also quality of life. For patients desiring better chew- ing capability, stability, aesthetics and comfort than a traditional denture can offer, both removable and fixed implant restorations are superior alternatives.1 While the appropriate implant solution can vary de- pending on the patient’s oral health, anatomy, quality and quantity of bone, and financial resources, full- arch prosthetics have progressed to the point where virtually every patient can have their teeth restored. Although fixed, implant-supported restorations of- fer the highest levels of stability, function and patient satisfaction, removable overdentures are also a dra- matic improvement over conventional complete den- tures.2 Both treatment options effectively mitigate the bone resorption that occurs following the loss of teeth, helping to preserve the oral and facial structures and, by extension, the self-confidence of the fully edentu- lous patient. Determining which solution is appro- priate requires a careful evaluation of the individual patient’s circumstances and desires. Even when an implant overdenture is delivered, the prosthesis can eventually be converted to a fixed restoration. 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, practitioners today have a great deal of clinical flex- ibility. Whatever prosthetic approach is adopted, Fig. 1a Fig. 1b Fig. 1c Fig. 2 Fig. 3 Figs. 1a–c: Pre-operative condition of the patient. Note the high lip line, severe cervical decay present on the patient’s remaining teeth and lack of gingival support. – Fig. 2: Pre-op- erative panoramic X-ray exhibits periodontal disease, cervical caries, terminal state of the patient’s dentition and the compromised state of the surrounding periodontium, which had rendered the teeth mobile. – Fig. 3: Maxillary implants with parallel pins in place exhibit the axial placement of the anterior implants and the tilted angulation of the posterior implants. 24 CAD/CAM 2 2017