CHIEF COMPLAINT:
Patient was not able to stabilize or retain the inferior acrylic partial denture.
DIAGNOSIS:
Female patient, 57 years-old, non-smoker, with a full denture in the maxilla and a removable partial denture in the mandible. Teeth 43-41-41-31-32 were indicated for extraction. Posterior sectors of the mandible presented significant bone resorption.
TREATMENT PLAN:
After clinical and radiological evaluation several rehabilitation plans were discussed with the patient. It was decided to extract the remaining lower teeth and do an overdenture retained by two dental implants with the locator attachement system to achieve a better retention and stabilization of the lower denture.
TEAM PLAY ‘DENTIST – DENTAL TECHNICIAN’ NOTES:
After the implants osseo-integration, a first dental impression was done with an open-tray and a double-mix technique. Then, an individual tray was done with two openings to access the impression transfers. In this way, an accurate impression of the dental implants was done together with a functional impression of the distal extension bases. Stops were placed in this areas. The occlusal wax-rims were done in an acrylic base with an adaptation/inclusion of an implant driver to allow the screw of the base in the dental implants. Then, a functional impression was done with a monophasic silicone. The occlusal wax-rims were correct in the mouth according to the full denture guidelines. Special care was taken with the occlusal vertical dimension and the support in the soft-tissues. A silicone bite registration material was used to better defined the intermaxillary relations. Teeth set-up was done in the dental lab with the selected tooth color. Due to the fact that the base was screwed to the dental implants, the teeth set-up was functionally evaluated in the mouth. Another silicone bite registration material was used to allow final occlusal adjustments. Finally, the locators were screwed and the retention nylons were selected according to the patient needs.