Maxillary endosseous implant interventions 415

Case 12

A full arch restoration for long edentulous spans using a prefabricated fixed denture

Not only do implants splinted to remaining natural teeth in a full arch denture help stabilize the prosthesis, they also reduce the vertical and lateral loads on the teeth themselves. In this case, a woman in her late forties was edentulous from the right cuspid to the left second bicuspid. Her remaining teeth were prepared for full crown restorations (Fig. 10-105).

A prefabricated full arch fixed denture was made (Fig. 10-106). With an indelible pencil, the areas determined by x-ray for implant insertion were marked on the fibromucosal tissue (Fig. 10-107). The marks were then transferred to the pontics, which were hollowed out to receive the implant abutments. Post type implants were then inserted (Fig. 10-108).

Interchangeable gold copings were placed over the implants (Fig. 10-109) and picked up with acrylic placed inside the holes of the corresponding pontics (Fig. 10-110). After the acrylic had been

Fig. 10-110. By placing cold cure acrylic inside the openings made in the pontics, seating the bridge, and allowing the acrylic to harden, the copings (arrows) become an integral part of the bridge.

Fig. 10-111. The prosthesis was cemented with oxyphosphate of zinc cement.

Fig. 10-112. Panorex of completed case. Bilateral subperiosteal implants are seen in the mandible 4 years after their insertion.