- His teeth had been extracted at the first treatment session due to severe uncontrolled periodontal disease.
- For the 4-month healing period he received an immediate denture.
- 4 implants were inserted into the mandible after 4 months following tooth extractions.
The fabrication of the permanent tooth repalacements (10 workdays)
This was the longest of all treatment sessions. Precision impressions were taken of the implants using closed tray impression copings. An impression was taken of the maxilla with oroplastic impression material (EX 3N Gold) in order to fabricate the most stable and most accurate denture. This material softens in response to mouth temperature and assists in the ideal edge contouring of dentures whilst the patient is making movements with their mouth. Following impression taking a gnathological treatment was due in which bite registration was performed with an articulator for the dental technician to see the appropriate joint position of the jawbones on occlusion and design the dentures accordingly.
During the framework trial fitting the finished bar is put in position, that is, screwed onto the implants to verify the accuracy of the framework.
Denture trial fitting is performed to verify aesthetics and proper occlusion of the teeth.
Our patient was content with the treatments, participates in regular check-ups and tartar removal, which is condition for warranty. A few weeks on, eating, speech and smile would be perfectly restored and self-confidence regained, and the patient would feel free to mingle with people. The first 8 days following hand-over of the finished work is a difficult period during which the patient should read out aloud, talk and eat so that the natural function of the muscles, tongue and the temporomandibular joint is restored at the earliest. This process usually takes two months.
It is supremely important to keep the denture clean. You are advised to remove it after each meal and clean it thoroughly. The implant and the bar too have to be cleaned thoroughly with a tooth brush and toothpaste, Super Floss and an interdental brush.
Implant tooth replacement need the same, if not more attention, care and follow-up as crowns and bridges retained by natural teeth do. Regular follow-up is also a condition for warranty. Oral hygiene and the longevity of the implants are closely related.
Picture of the implant deep inside the bone and the beautiful gum contour formed by the gingiva formers/healing abutments.
Closed tray impression copings inside the mouth by means of which precision impressions were taken of the implants.
Follow-up panoramic radiograph with the closed tray impression copings.
Function impression taken with a custom impression coping using oroplastic material Ex 3 N Gold of the edentulous maxilla
Closed tray precision impression of the lower implants
Gothic arch registration procedure with the asymmetrical arrow point clearly indicating an inhibition of the forward movement of the left mandibular condyle
Face bow transfer from the maxilla
The plastering of the upper master cast into the articulator with the help of a facebow transfer for the dental technician to see the position of the maxilla
Adjustment of the articulation of the master cast of the mandible into the correct joint position using the Gothic arch tracing
With the use of wax templates the length of the teeth and occlusal height are determined. The middle line, the position of the lips in a steady state and smiling position, and the width of the nose are marked
The finished wax templates following the adjustment of occlusal height, the determination of the middle line and smile line in the articulator
The bar designed for 4 implants and the artificial gum on the master cast.
During the denture trial fitting, teeth are embedded in red wax to examine aesthetics and the appropriate occlusion of teeth. At the denture trial fitting the dentist can move around the teeth at the patient’s request and can perform whatever slight aesthetic modification is necessary. Following the denture trial fitting the patient “nods in approval” and the dental technician may begin the fabrication of the permanent denture
Bottom view of the bar denture at the denture trial fitting with the dolder bar clasps
The finished upper metal plate overdenture (removable denture) with a unique rim finish
The permanent lower bar-retained denture for 4 implants on the master cast
Part of the bar of the lower bar denture on the gypsum cast
Bottom view of the finished lower bar denture with dolder bar retention
The finished upper full denture (false teeth) and the lower bar denture in the mouth:
Follow-up panoramic radiograph of the lower bar
Keywords: dental focus, foci, dental implant surgery, implant, periodontal disease, bar denture, implant-supported bar, gnathology, face bow transfer, Gothic arch registration, arrow point tracing, bite registration, framework trial fitting, denture trial fitting, precision impression, Ex 3N Gold, oroplastic impression material, dolder bars, full denture