An implant-supported overdenture design with a horizontal path of insertion

Implant-supported overdenture with horizontal insertion for treating the edentulous atrophic maxilla: A case series

STATEMENT OF PROBLEM

Rehabilitation of edentulous patients with severe maxillary atrophy is a clinical challenge. Although several treatment options are available, the implant-supported overdenture has been widely advocated. However vertical insertion implant-supported overdentures have drawbacks, including wear, aging, and the continuous maintenance of retention systems. Whether an implant-supported overdenture with a horizontal insertion pathway can overcome these problems is unclear.

PURPOSE

The purpose of this observational study was to determine the clinical and biological behavior of a new type of implant-supported overdenture with a horizontal insertion pathway over a mean clinical follow-up period of 6 years.

MATERIAL AND METHODS

Ten study participants with an atrophic maxilla underwent rehabilitation with horizontal overdentures supported by 6 implants. Follow-up visits were scheduled at 3 months, 6 months, and annually thereafter. The variables analyzed were implant and prosthetic survival, peri-implant tissue behavior, mechanical complications, and patient satisfaction.

RESULTS

The follow-up period ranged from 5 to 8 years, mean ±standard deviation 6.3 ±1.2 years. A total of 60 implants and 10 horizontal overdentures were placed. The clinical survival of the implants was 98.3% (mean peri-implant bone loss, 1.3 ±0.4 mm) and was 80% of the prostheses. Overall, mean patient satisfaction as assessed with a visual analog scale was 7.4, with 8.5 for esthetics and 9.5 for function.

CONCLUSIONS

The horizontal implant-supported overdenture provided a functional alternative to conventional prostheses.

Rehabilitation of an Extremely Edentulous Atrophic Maxilla with a Pseudoskeletal Class III Relationship

The skeletal class III relationship presents complex dentoalveolar problems, requiring multidisciplinary treatment. In edentulous people, severe atrophy of the jawbone simulates the clinical appearance of a skeletal class III relationship (pseudoskeletal class III), which presents major problems for rehabilitation. This article describes the rehabilitation of a 67-year-old patient with a pseudoskeletal class III relationship. The mandible was restored with two implant-supported bar-retained overdentures using clips for retention. The extremely atrophic maxilla was restored with a combination of sinus augmentation, implant placement, and classic prosthodontic treatment using an electroformed mesostructured overdenture with swivel lock attachments on an implant-supported bar. By performing minimal augmentative and implant surgeries and using the possibilities and advantages of classic prosthetic dentistry, the clinical situation described here could be managed and the atrophic maxilla could be rehabilitated.

Fabrication of a screw-retained hybrid prosthesis following treatment of peri-implant defects: a case report

The etiology of marginal bone loss around osseointegrated implants is primarily based on the biomechanical and/or microbial factors. If stresses and strains around dental implants under functional loading conditions are expected to exceed the physiologic tolerance thresholds of the alveolar bone, the fixed hybrid prosthesis might be a more reliable treatment of choice instead of fixed metal ceramic restorations. The purpose of this article is to report the 1-year follow-up of the periodontal and prosthetic rehabilitation of a patient who has presented with symptoms of peri-implantitis due to incorrectly planned implant supported fixed metal ceramic bridge which was later replaced with screw-retained hybrid prosthesis following the treatment of peri-implant defects. Treatment helped to maintain patient’s self-confidence and comfort, as well as favorable masticatory function. Rehabilitation with screw retained hybrid prosthesis is an ideal treatment of choice for maxillomandibular skeletal discrepancies.

Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report

This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene.