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ePaper created 2018-02-16, 11:17:41 | version 1.38.0
| industry report rehabilitation of edentulous maxilla Rehabilitation of the edentulous maxilla—digital approach Authors: Dr Francesco Benvenuto & Giorgio Poma, Italy Fig. 1 Fig. 2 Fig. 3 Initial situation A 57-year-old male presented with a partial upper removable prosthesis, with mucous support held by cast clasps on teeth 17 and 18, which were parodon- Fig. 4 Fig. 5 Fig. 6 36 CAD/CAM 4 2017 topathic. Part of tooth 27 still remained, which would be extracted; in the lower arch was a removable frame denture with cast clasps (Figs. 1–3). The patient had a very pronounced third class occlusal relationship. The patient’s request was to be able to chew properly with a stable prosthesis that could partially harmonise the volume of the perioral tissues. In the first clinic session, alginate impressions were taken and chewing patterns were studied to produce study models on which to develop the diagnostic wax-up. The analysis of the models showed a considerable overjet discrepancy between the two arches; the up- per one showed an irregular bone crest with paraffinic keratoses caused by the existing prosthesis. The diagnostic wax-up was then produced without considering the crests of the patient, but instead plac- ing the dentiton according to the first class occlusal relationship. This increased the vestibular flange vol- umes to give correct mucous support in order to re- store a pleasing profile of the patient’s lip. After the aesthetic and functional tests, the patient approved the design of a total prosthesis supported