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case report | Fig. 20a Fig. 20c Fig. 20b Fig. 20d Figs. 20a–d: Occlusal check and implant pick-up coping splinting. be considered before planning a maxillary implant-sup- ported restoration.14 In this case, the patient was in- formed before implant surgery that his dentition was to be restored with fixed restorations in both arches. How- ever, our prosthetic evaluation determined that it was not feasible because of the horizontal distance between the teeth and implants. The patient was informed about the advantages and disadvantages of fixed or removable protheses. More- over, a tooth set-up was prepared without a buccal flange in order to analyse potential problems regarding facial support, phonetics, aesthetics and hygienic access. With the patient’s consent, it was decided to realise a remov- able solution for the maxilla and a fixed restoration for the mandible. Clinical case finalisation The implant overdenture was prepared maintaining the insertion path perpendicular to the occlusal plane. Two bars were fabricated in order to reduce the volume required for primary and secondary frameworks. In both bars were placed two different ball retentive systems (Rhein’83). The mesial one was mini, and the distal one of normal size. This kind of solution could guarantee enough retention for the restoration and durability of the attachment system. Moreover, owing to the number and position of the implants, complete palatal support was reduced, including the maxillary tuberosities as deter- minant support areas (Figs. 22a & b). Delivery and follow-up Definitive restorations were realised maintaining all of the prosthetic parameters of the temporary restoration. Patient adaptation was excellent concerning the aes- thetic, phonetic and hygienic parameters, despite at the beginning of treatment having been oriented to a max- Fig. 21 Fig. 22a Fig. 22b Fig. 21: Space evaluation. Figs. 22a & b: Implant overdenture framework fabrication and try-in. 1 2018 31