Case Presentation: Stabilizing a Maxillary Denture With Narrow-Diameter Overdenture Implants
Stabilizing a Maxillary Denture With Narrow-Diameter Overdenture Implants
Figure 1—The patient presented with a loose maxillary complete denture, requesting implants to help stabilize it. Examination of the maxillary ridge shows adequate keratinized soft tissues, narrow alveolar ridges, and adequate prosthetic space for flapless dental implants.
A CBCT scan of the patient was made using cotton rolls for occlusal and soft-tissue separation in combination with a radiopaque PVS impression liner placed on the intaglio of her maxillary denture to enhance the radiographic visualization. A second CBCT scan of the denture was made and an extraoral digital impression was used with an intraoral scanner (3M True Definition Scanner, 3M). Six 2.4 mm x 12 mm Zest LOCATOR Overdenture Implants (LODI, Zest Dental Solutions) were planned in the computer software (Invivo, Anatomage). A computerized surgical guide was planned and fabricated (Anatomage Guide, Anatomage).
The patient was anesthetized, complete adaptation of the surgical guide confirmed, osteotomies prepared, and implants were placed using a minimally invasive technique. Recesses in the denture were prepared using specialized burs specifically designed for overdentures (Denture Prep & Polish Kit, Zest Dental Solutions). LOCATOR abutments (Zest Dental Solutions) were attached to the implants and connected the denture the same day using an overdenture attachment material (CHAIRSIDE, Zest Dental Solutions). The LOCATOR Black Processing Male inserts were kept inside the denture, and the patient was seen for recall 8 weeks later, when the tissues were fully healed. At the recall appointment, the inserts were changed from the processing males to the light, standard-range retentive male inserts.
The patient was followed up over the course of several years and has continued to report a high degree of satisfaction.
Figure 2—Radiopaque PVS impression material (Green-Mousse, Parkell) was placed onto the intaglio surface of the complete denture and a closed-mouth reline was performed.
Figure 3—Six 2.4 mm x 12 mm LOCATOR overdenture implants (LODI, Zest Dental Solutions) were planned in CBCT dental implant planning software (Invivo, Anatomage).
Figure 4—The patient was anesthetized, the surgical guide placed, and sequential osteotomies prepared with the assistance of the surgical guide.
Figure 5—LODI implants were placed through the guide using a minimally invasive, flapless approach.
Figure 6—LOCATOR abutments were placed onto the LODI implants using the LOCATOR core tool.
Figure 7—Final appearance of maxillary implants with abutments firmly placed onto each implant
Figure 8—Denture caps were placed on the LOCATOR abutments with block-out spacers and PVS utilized to verify passive fit of the denture over the caps. Recesses were created within the underside of the complete denture using specialized overdenture preparation burs (Denture Prep & Polish Kit, Zest Dental Solutions).
Figure 9—The denture caps were attached to the denture using an overdenture attachment material (CHAIRSIDE, Zest Dental Solutions). Processing males were left inside the denture for 8 weeks.
Figure 10—Final appearance of the LODI implants at 2 years
Tags: CHAIRSIDE Denture Prep & Polish Kit, LOCATOR Abutment Delivery Retaining Sleeve, Chairside Soft Reline Material, LOCATOR Bar Attachment System, Midmark Corporation, Midmark True Definition Scanner, LOCATOR Overdenture Implant System, Denture Material, Abutments, Digital Impressions|Scanners, Implants, Narrow Diameter Implants, Zest Dental Solutions