Case Study Presentation: The Fabrication of a Implant- Retained Mandibular Denture. Stèfan Schoeman In 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, 2 nd ed. Hong Kong: Imago. 2001: 241 – )D. Harold, Overdentures Made Easy, 3 rd ed. Londen: Quintessence Publishing Co Ltd. 1996: 105 – )K. Whaley, Muir’s Textbook of Pathology, 15 th ed : )Southern Implant Catalogue.

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