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| CE article fixed and removable implant restorations Fig. 24 Fig. 25 Fig. 26 Fig. 27 Fig. 28a Fig. 28b Fig. 24: Quick Up cold cure acrylic was used to pick up the metal housings in the overdenture and fill in the minor voids between the denture caps and recess wells of the prosthesis. Note: In many cases, the doctor elects to have the overdenture caps processed by the lab. – Fig. 25: The black processing inserts were replaced with the appropriate retentive caps, which are colour coded according to strength. – Fig. 26: Patient with the final Locator overdenture and the upper provisional implant prosthesis in place. – Fig. 27: The definitive maxillary restoration was milled from BruxZir Solid Zirconia, incorporating the slight adjustments that were made to the PMMA provisional appliance. – Figs. 28a & b: The final BruxZir Full-Arch Implant Prosthesis completed a dramatic oral reconstruction for a patient who presented with terminal dentition, restoring form, function and quality of life. With the final mandibular restoration in place, the patient wore the provisional full-arch implant prosthesis for a trial period of two weeks (Fig. 26). This opportunity to wear the appliance during ac- tual day-to-day function instilled a high degree of confidence in the prosthetic design for the patient and doctor alike. Following patient approval, the provisional implant prosthesis was returned to the lab so it could serve as the blueprint for the final restoration and the minor adjustments made to the appliance could be included in the definitive pros- thetic design. The final BruxZir Full-Arch Implant Prosthesis was digitally fabricated with precision (Fig. 27). As an exact reproduction of the test-driven provi- sional, the definitive prosthesis fit perfectly and Photos provided by Dr Paresh B. Patel. about Dr Paresh B. Patel, DDS, graduated from the University of North Carolina at Chapel Hill School of Dentistry in 1996. He graduated from the Medical College of Georgia/American Academy of Implant Dentistry MaxiCourse in 2009. He has been in private practices in Lenoir and Mooresville, NC, from 1996 through the present. Patel is a founding member and on the editorial board of Journal of the International Academy of Mini Dental Implants. He is a clinical instructor at the Reconstructive Dentistry Institute and a diplomat of American Academy of Small Diameter Implants. Patel was president of the Iredell County Dental Society in 2012; is a member of the American Dental Association, the North Carolina Dental Society and the American Academy of Implant Dentistry; and is a clinical consultant on dental implants and prosthetics. He lectures nationally on implant and restorative dentistry, and he has published numerous articles in leading dental journals. 30 CAD/CAM 2 2017 offered the aesthetics and function the patient had come to expect (Figs. 28a & b). The final resto- ration effectively addressed the unique circum- stances of the case, providing the most durable, stable prosthesis possible for his upper and a lower restoration that greatly improves prosthetic re- tention and can be upgraded to a fixed prosthesis should the patient’s situation change. Conclusion Practitioners now have the clinical flexibility to offer patients a wide range of treatment options, from entry-level, economical restorations like the Inclusive Locator Implant Overdenture, to the fixed, highly durable BruxZir Full-Arch Implant Prosthesis. There is a viable means of treating nearly all patients, whatever their oral health, needs and finances. Given the life-changing benefits of implant therapy and the straightforward restorative protocols of today, all patients should be offered this service to confront the challenges presented by complete edentulism._ References [1] Yunus N, Masood M, Saub R, Al-Hashedi AA, Taiyeb Ali TB, Thom- ason JM. Impact of mandibular implant prostheses on the oral health-related quality of life in partially and completely edentu- lous patients. Clin Oral Implants Res. 2015 Jul 14. [2] Martín-Ares M, Barona-Dorado C, Guisado-Moya B, Martínez- Rodríguez N, Cortés-Bretón-Brinkmann J, Martínez-González JM. Prosthetic hygiene and functional efficacy in completely eden- tulous patients: satisfaction and quality of life during a five-year follow-up. Clin Oral Implants Res. 2015 Apr 20.