Full-Arch Immediate Load Solutions for the Failing Dentition
A 65-year-old female who was intolerant of a traditional denture, but was also terrified of not having teeth, presented with a failing lower fixed partial denture. To provide a quick, predictable solution, I used an implant and prosthetic component system for the screw retention of a denture onto the implants on the day of implant placement for a full-arch implant-supported restoration.
On the day of surgery, I removed the patient?s remaining lower teeth and placed 4 tapered internal implants (BioHorizons). The multi-unit abutments were placed on the implant heads. Then, the implants were attached to the titanium copings that were embedded in the denture immediately after the surgery.
The splinting of all the implants together in a full-arch case with an acrylic denture provided stabilization of the implants, provided load distribution, and decreased the potential for movement of the individual implants. This also allowed for a ?fixed? implant-supported restoration on the day of surgery.
The restorative dentist marked the location of the implant relative to the denture by using Blu-Mousse (Parkell) indexing material. When the implant locations were noted, holes were drilled in the denture to allow room for the titanium copings, which were placed on the multi-unit abutments to pass through the denture. When a passive fit was confirmed, acrylic was placed around the copings in the mouth and on the underside of the denture. The denture was then seated in the patient?s mouth and allowed to cure.
When the acrylic hardened to the denture and around the titanium copings, the denture was ?fixed? in place on the implants. At this point, it needed to be unscrewed from the implants and cleaned because it was supported by the implants and not the soft tissue, the flanges and palate were removed from these dentures. This made a horseshoe-shaped set of teeth that was smaller than a traditional denture.
The surgical and restorative part of this case took a total of 3 to 4 hours on the day of surgery. After 4 to 6 months of wearing this ?temporary? prosthesis, it was removed, and a more permanent prosthesis was fabricated of titanium, porcelain, zirconium, and acrylic. This patient enjoyed leaving the day of implant surgery with her teeth ?fixed? in place.