Fabrication of an Implant-Retained Partial Denture By Michael du Preez In partial fulfilment of BTech: Dental Technology

Contents History Clinical Treatment Plan Possible Technical Treatment Plan Treatment Option of Choice Laboratory Procedures Final Placement References

History 13 year-old Swelling in left area of mandible Possible malignant tumor

History Tumor removed Juvenile ossifying fibroma

History Mandibular bone loss Dentition loss

History Reconstruction Plate Two premolars and three molars remained

History Fibula free flap Segment of fibula is removed

History Part of reconstruction plate removed

History Fibula is removed Formed and attached 15

History Reconstructed Mandible Stabilized with plates and screws

Clinical Treatment Plan What type of implant? What can be performed with available bone? How many implants?

Clinical Treatment Plan Advantages Bone stabilization 12&9 Retrievability Improvement of function 13 Psychological improvement 10 Disadvantages Risk of screw loosening 11 Length of treatment plan 11 Multiple surgery Cost

Clinical Treatment Plan Biocompatible titanium Implant Abutment

Clinical Treatment Plan Implant is screwed or tapped in the bone 14&8 Tissue sutured closed

Clinical Treatment plan Tissue over implant removed 14 Abutment is placed on implant 14&8 Selected attachment placement 14

Possible Technical Treatment Plan Bar attachment 2&7 2 to 6 implants needed 14 Support denture 14 Relieves tissue 14 Best suited for cases of severe bone loss 14

Possible Technical Treatment Plan Ball and socket attachment 3&14 2 to 4 implants needed 14 Better suited for lower 14 denture Simplest way 14 Ball type insert fits in o-ring type attachments 14

Possible Technical Treatment Plan Screw-in fixed bridge implants needed 14 Non-removable 14 Need sufficient bone 14

Possible Technical Treatment Plan Cemented fixed bridge implants needed 14 Natural appearance 14 Easy to clean 14

Possible Technical Treatment Plan Magnetic attachment 1&3 2 to 3 implants needed 14 Magnetic keeper heads connected to abutments 6 Magnetic units incorporated in the denture 6

Treatment Option Of Choice Bar attachment 2&14 Most suitable 2 Less expensive than cemented fixed bridge 14 Less trauma on tissue 14 Mechanical retention 4 Best suited for cases of sever bone loss 14

Laboratory Procedures Surgical Stent 4 Guides and indicate implant position 4 Critical factor for ideal surgical and aesthetic results 5

Laboratory Procedures Preliminary impression 2 Special Tray fabrication 2 Master Cast

Laboratory Procedures Custom record blocks Wax setup Fabrication of bar attachment Processing and finishing of denture

Laboratory Procedures Final product 14 Clips incorporated in denture 14 Bar attachment on the implants 14

Final Placement Speech Aesthetics Mastication Self-Esteem

Thank you

References 1.Babbush C.A. Dental Implants, The Art And Science, London, W.B. Saunders Company, 2001: Hobo S. Ichide, E. Garcia, L.T. Osseointegration and Occlusal Rehabilitation, Tokyo, Quintessence Publishing Company, 1990: Jamanez-Lopez V. Oral Rehabilitation with Implant Supported Prostheses, Tokyo, Quintessence Publishing Company, 1998: White G.E. Osseointegrated Dental Technology, Tokyo, Quintessence Publishing Company,1993:31-43.

References 5.Taylor D. Clinical Maxillofacial Prosthetics, Tokyo, Quintessence Publishing Company, 2000: The Journal of oral impantology,vol12 no.1,1985, D’ Angelo J. Dr. Joseph D’ Angelo, date accessed: 15 September date accessed: 10 September , date accessed 15 September date accessed 10 September date accessed 10 September Davidoff S.R. The Dental Implant Homepage, implants.com, date accessed 7 September 2004www.dental- implants.com

References 13. date accessed 10 September 14.The dental implant projects, date accessed 10 September 2004www.implant4you.com 15. date accessed 9 September 2004