The Fabrication of Two Maxillary Anterior Implant-Retained Crowns By: Hugo Relling In partial fulfilment of BTech: Dental Technology Peninsula Technikon

CONTENTS Patient History Patient History Patient Condition and Background Patient Condition and Background Clinical Treatment Plan Clinical Treatment Plan Dental Technology Treatment Options Dental Technology Treatment Options Dental Technology Procedures Dental Technology Procedures References References Acknowledgements Acknowledgements

Patient History Bridge Bridge 12-14

Patient Condition and Background Root canal on 14 1 Root canal on 14 1 Micro leakage in 14 Micro leakage in 14 Lateral Periodontal Abscess formed 2 Lateral Periodontal Abscess formed 2

Clinical Treatment Plan (1 st phase) 14 removed 14 removed 12 in good condition 12 in good condition Bridge separated Bridge separated

Tissue surgically sutured 1 : Tissue surgically sutured 1 : Prevent - any infection - ulceration - exposed tissue 1 st Phase… Reasons for transitional denture

Clinical Treatment Plan… (2 nd Phase) Implants placed Implants placed Bone collector used Bone collector used Stent used Stent used

Dental Technology Treatment Options Available options: Available options: - Cobalt Chrome Denture - Acrylic Denture - Implant-Supported Crowns

Cobalt Chrome Denture (Kennedy Class 1 Mod. 1) ADVANTAGES ADVANTAGES Excellent support Excellent support Durability Durability DISADVANTAGES DISADVANTAGES Expensive +/-R1100 Expensive +/-R1100 Discomfort Discomfort Not suitable as healing appliance Not suitable as healing appliance Must be well designed Must be well designed

Acrylic Denture 3 ADVANTAGES ADVANTAGES Inexpensive +/-R600 Inexpensive +/-R600 Comfortable Comfortable DISADVANTAGES DISADVANTAGES Must be cleaned regularly Must be cleaned regularly Increased risk of fracturing Increased risk of fracturing

Implant-Supported Crowns 4 ADVANTAGES ADVANTAGES Aesthetically pleasing Aesthetically pleasing Excellent retention Excellent retention Excellent support Excellent support DISADVANTAGES DISADVANTAGES Very expensive Very expensive

Left Untreated Consequences Consequences Drifting of teeth Drifting of teeth Aesthetics will degenerate Aesthetics will degenerate Discomfort Discomfort Lead to bad habits Lead to bad habits Maxillary arch will eventually collapse Maxillary arch will eventually collapse

Requirements of Ideal Prosthesis Aesthetically pleasing Aesthetically pleasing Comfortable Comfortable Durable Durable Financially viable Financially viable Conserve existing oral environment Conserve existing oral environment Concluded: Implant-supported crowns are the best and chosen option Concluded: Implant-supported crowns are the best and chosen option

Implants 2 Externally hexed implants used 2 Externally hexed implants used Length 15mm Length 15mm Diameter 3.75mm Diameter 3.75mm

Dental Technology Procedures Transitional acrylic denture Transitional acrylic denture - ball clasps between 25 and 26, 14 and 15

Dental Technology Procedure… (Standard procedure for temporary partial denture) Wax-up done and ball-clasps positioned Wax-up done and ball-clasps positioned Denture flasked Denture flasked Heat cure denture material used Heat cure denture material used Cured Cured Deflasked and polished Deflasked and polished Ready for placement Ready for placement

Dental Technology Procedures… Stent made Stent made

Cost Laboratory Costs: Laboratory Costs: 2 Implants R Acrylic DentureR Clinical Costs: Clinical Costs: Surgery= R17(Tygerberg) Surgery= R1932(Private) R17 per visit= R68(Tygerberg) R153 per visit= R612(Private)

References 1. M. Nevins, J.T. Mellonig. Implant Therapy Clinical Approaches and Evidence of Success. Volume 2. Carol Stream (IL): Quintessence Publishing Co, Inc; Stedman’s Medical Dictionary. 27 th ed. Maryland: Lippincott Williams & Wilkins; 2000.

References 3. W.J. O’Brien. Dental Materials and Their Selection. 2 nd ed. Carol Stream (IL): Quintessence Publishing Co, Inc; R.M. Palmer et al. Implants in Clinical Dentistry. New York: Martin Dunitz; 2002.

Acknowledgements Prof. Morkel Prof. Morkel Ms Nortjie Ms Nortjie Mr Mazema Mr Mazema Mr Steyn Mr Steyn Mrs Wright Mrs Wright Mr Motto Mr Motto Mr van Niekerk (interpreter) Mr van Niekerk (interpreter)