Mr Józef
Mr Józef came to our Materna Dental Clinic in Poznań for a consultation with Dr Tomasz Materna regarding prosthetic reconstruction of the lower jaw. The upper jaw was reconstructed with a denture on implants. Teeth no 34,35,37,44,47 were present in the lower arch.
During the consultation, a diagnostic interview was performed with the patient, an intraoral examination, photographic documentation of the current state of the dentition, a panoramic radiograph, a CT scan and an intraoral scan were all performed.
After thorough analysis of the medical records it was concluded that the extraction of the remaining teeth in the lower jaw was necessary.
The patient stipulated that he would not be able to tolerate a removable denture, hence a consultation with Dr Jacek Pawłowski, an implantologist, was recommended. During the implantology consultation, possible implanto-prosthetic options were discussed with both Dr Jacek Pawłowski and Dr Tomasz Materna. The patient wanted a comfortable and, above all, long-term solution to his current situation.
Before implantation
The patient opted for an extraction solution with immediate implantation and reconstruction with bone-forming material. The treatment plan presented implantation through an implant template using the MIS implantology system.
MIS implant system
Prosthetic work was planned on the beam for this purpose 6 MIS implants were proposed at sites: 32,34,36,43,44 and 46. Bone reconstruction in sites 34, 44 after tooth extraction.
Prosthetic work was planned for 12 sites using Cerkon Full Contour material in A1 colour with pink gingiva.
A temporary screw-retained prosthetic work on immediate abutments was fabricated.
Temporary work in the lower arch
Temporary work in the lower arch
With this solution, we fulfilled the promise of excluding dentures. Mr Józef was able to enjoy a wide smile and the gentle loading of the implants allowed for a longer integration time with the bone.
Furthermore, the raised compactness had a positive effect on the temporomandibular joint allowing the articular discs to be placed in their correct position.
Chewing function was regained and thus we restored incredible comfort for the patient.
Further integration into the bone without full loading allowed post-operative safety without displacement of the implants in the bone.
Mr Joseph’s next appointment was to try-in the cast.
Cast for try-in
Try-in of the cast
The appointment took place less than four months after implantation. The try-in allowed for a verification of the patient’s expectations after corrections to the provisional work were made. Corrections were made to the occlusion and canine guidance. Bar design was checked to ensure that there were no overloads in the bite or hidden stresses.
It is worth emphasising that the try-in is extremely important for both the dentist and the dental technician for the next step in the execution of the work. It allows the dentist to check the course of the medial line, the alignment of the teeth in the arch, check the height of the occlusion and bite and, most importantly, learn about the patient’s preferences and expectations.
Less than two weeks after the try-in, the final prosthesis was ready to be screwed in. Below is a video of the fitting procedure of the work made of Cerkon Full Contour material on a titanium bar in A1 with pink gingiva.
Take a look at the final result!
Final work with visible screw access holes
This solution allows for:
- Easy cleaning and good hygiene maintenance,
- Stability of adhesion,
- passive bonding of the outer layer (zirconium) to the beam reduces the failure rate of the work and reduces stress,
- no abrasion, as opposed to acrylic.
What appointments are necessary?
- Prosthetic consultation: tomography, pantomogram, photographic documentation, and interview with the patient.
- Implant consultation: interview, examination of the thickness of the alveolar and preliminary planning process of the implant treatment, intraoral scan.
- Surgical implant template planning by prosthodontist, implantologist and technician.
- Implant treatment using the surgical template guide.
- Postoperative follow-up.
- Loading of implants with temporary work.
- Implant uncovering (date to be agreed individually).
- Impressions for target work.
- Determination of occlusion height.
- Try-in (cast).
- Handover of the work.
- Check-up appointment.
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