Case 5: lab

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CHIEF COMPLAINT:
To replace a removable denture by an implant-supported overdenture.

DIAGNOSIS:
Male patient, 80 years old, non-smoker, presented to our clinic with four dental implants placed in each maxilla. From a prosthodontics point of view, the implants seem to be well placed. Due to the presence of this implants, and to achieve a better retention and stability, the removable dentures had a soft-tissue conditioner relining. Without the dentures, the patient presents a significant lack of support in the upper and lower lips.

TEAM PLAY ‘DENTIST – DENTAL TECHNICIAN’ NOTES:
After a careful clinical observation we have decided to develop implant-support overdentures retained by milled bars. Patient had high expectations regarding retention and chewing.

The definitive impression was done with an open tray.

Implant’s transfer pieces were incorporated into the record bases to allow its fixation over the implants, easing intermaxillary registration and functional and aesthetical evaluation in the teeth try-in step.

After the clinical evaluation of the teeth position, silicone walls were done to guide the fabrication of the milled bars.

The “initial” definitive impression was not “functional” (but only to capture implant position). As so, a pick-up functional impression technique was done over the milled bars, with an open tray, in order to record soft-tissues position. After this step, the dental technician develops the dentures metallic frameworks and mounts the teeth according to the silicone walls previously done. Before finishing the overdentures, the clinician do another tooth try-in and a new jet-bite registration to allow small occlusal adjustments.

DENTAL LABORATORY:
DentalMaia, Castelo da Maia, Portugal.