Case Study Presentation:

The Fabrication of a Implant-Retained Mandibular Denture.

Stèfan SchoemanIn partial fulfilment of BTech: Dental

Technology.

Topics of Discussion:

Patient History.Conditions and Background Information.Clinical Treatment Options.Technical Treatment Options. Most Suitable Treatment Option. Treatment option of choice. Laboratory procedures.

Patient History:

Male.43 years of age. Amiloblastoma in mandibular arch. First diagnosis 1993, age 32.Second diagnosis 1995, age 34.

Conditions and Background Information:

Biopsy showed cystic follicular amiloblastoma. 3

Removed cancerous tumour.Cancer is malignant.Regular tissue graphs.Numerous dentures.

Clinical Treatment Options:

Chemotherapy. Radiation therapy. Mandibulectomy. Bone graph.Tissue graph.3

Technical Treatment Options:

Full lower conventional monoplast denture. +/- R 400

Implant retained denture. +/- R 2000

Implant retained ceramic restoration. +/- R 8000 – R10 000

Most Suitable Treatment Option:

Advantages:

Good support and stability.

Aesthetically pleasing.

Corrosion resistant.1

Disadvantages:

Infections due to implant failure.

Expensive.Difficult to keep

clean.1

Treatment Option of Choice

Implant retained denture supported by: 2

Bar and clips.Ball attachments.

Mezo–Bar.

Implant Retained Overdenture:

Ball attachments.

Implant Retained Overdenture:

Mezo–Bar.

Implant Retained Denture:

Advantages:

More affordable. Aesthetically

pleasing. Good load

distribution.Stable and

retentive.

Implant Retained Denture:

Disadvantages:

Infections due to implant failure.

Reconstruction of denture and bar.

Bulky.Patient

corporation.

Laboratory Procedure 1:

Primary impression of mandible.

Mandibular special tray made on primary model.

Final impression taken of mandibular arch.

Laboratory Procedure 2:

Final impression cast in stone.

Record block made.

Bite registration taken.

Laboratory Procedure 3:

Lower denture waxed up and processed.

Stent is fabricated for correct position of implants.

Laboratory Procedure 4:

Implants placed in mandibular arch.

Mezo–Bar wax up.4

Cast and finished.4

Placement of bar attachment.

Final Placement:

Try-in done.Denture processed with clips.Denture placed, excellent fit.

References:

1) M. Dunitz, Implants and Restorative Dentisry, 2nd ed. Hong Kong: Imago. 2001: 241 – 264.

2) D. Harold, Overdentures Made Easy, 3rd ed. Londen: Quintessence Publishing Co Ltd. 1996: 105 – 139.

3) K. Whaley, Muir’s Textbook of Pathology, 15th ed. 2001 : 680.

4) Southern Implant Catalogue.

Acknowledgements

Dr van Zyl Prof. Morkel Ms Nortjè Mr Mazema Mr Steyn Mrs Wright