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ePaper created 2017-12-19, 09:30:25 | version 1.38.0
20 TRENDS & APPLICATIONS Lab Tribune Asia Pacific Edition | 12/2017 Fixed and removable implant restorations: A solution for every arch By Dr Paresh B. Patel, US 1a 1b 1c 2 3 4a 4b 4c 5 Figs. 1a–c: Pre-op condition of the patient. Note the high lip line, severe cervical caries present on the patient’s remaining teeth and lack of gingival support.—Fig. 2: The pre-op panoramic radiograph demon- strated periodontal disease, cervical caries, the 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 exhibiting the axial placement of the anterior implants and the tilted angulation of the posterior implants.—Fig. 4a: Inclusive Tapered Implant.—Figs. 4b & c: The im- plants were threaded into place, achieving excellent initial stability.—Fig. 5: Multi-unit abutment with carrier in place illustrates correction of the implant’s angulation to establish a uniform prosthetic plat- form around the arch. Introduction When a patient presents with an edentulous arch or terminal den- tition, implant treatment can be provided that improves not only form and function, but also qual- ity of life. For patients desiring better masticatory capability, stability, aesthetics and comfort than a conventional denture can offer, both removable and ixed implant restorations are superior alternatives.1 While the appropri- ate implant solution can vary de- pending on the patient’s oral health, anatomy, quality and quan- tity of bone, and inancial re- sources, full-arch prostheses have progressed to the point where vir- tually every patient can have his or her teeth restored. Although ixed implant-sup- ported restorations offer the highest levels of stability, func- tion and patient satisfaction, re- movable overdentures also offer a dramatic improvement over conventional complete den- tures.2 Both treatment options effectively mitigate the bone re- sorption that occurs after the loss of teeth, helping to preserve the oral and facial structures and, by extension, the self-coni- dence of the fully edentulous patient. Determining which solution is appropriate requires a careful evaluation of the individual pa- tient’s circumstances and de- sires. Even when an implant overdenture is delivered, the prosthesis can eventually be converted to a ixed restoration. As evidenced by the case that follows, in which one arch is re- stored with an implant overden- ture and the other with a Brux- Zir Full-Arch Implant Prosthesis, practitioners today have a great deal of clinical lexibility. Whatever prosthetic ap- proach is adopted, immediate, life-changing relief can be pro- vided to patients suffering from terminal dentition or an un- comfortable, poorly function- ing conventional denture. Fur- thermore, the dramatic over- haul of this patient’s oral health demonstrates the life-changing capabilities of implant therapy, which helped him overcome se- vere functional and aesthetic challenges that affected practi- cally every facet of his life prior to treatment. “Whatever prosthetic approach is adopted. immediate. life-changing relief can be provided to patients suffering from terminal dentition or an uncomfortable. poorly functioning conventional denture.”