Shan, S. Yu
| Shan, S. Yu |
Shan S. Yu
Nicole Deakins
Department of Preventive & Restorative Sciences, University of Pennsylvania School of Dental Medicine
Introduction
Implant supported fixed dental prostheses (FDP) are successful treatment options to replace missing teeth in partial or full edentulism. Recent data suggest that implant survival rates are approximately 90 to 95%, with high patient acceptance and satisfaction. In general, implant-supported FDP can be divided into screw-retained, cement retained or both. The main advantage of cement-retained FDP is esthetics while screw-retained FDP offer easy retrievability. The final choice of retention system is made after considering several clinical factors, such as retrievability, implant angulation, esthetics, and prosthetic complications. Common prosthodontic issues include screw loosening, porcelain fracture, loss of retention, esthetic concerns, and cement-related peri-implantitis.
Methods
This report describes the prosthodontic rehabilitations of two patients with partial edentulism that involved the use of implant-supported FDP. Both patients presented to PDM Honors clinic with missing maxillary and mandibular posterior teeth, seeking fixed dental treatment options. Implant supported FDP were treatment planned to replace patients’ missing posterior dentitions. Diagnostic wax up was completed on the patients' models, and used to make the surgical stent for implant placement. CBCT was obtained on the patient to evaluate their bone quality. Lateral sinus lift and bone graft were planned to achieve adequate bone level for future implant placement. At the meantime, both patients had collapsed bite due to the loss of posterior occlusion. Therefore, maxillary and mandibular interim partial dentures were fabricated to restore patients’ VDO at their centric relation positions and to maintain a stable occlusion.
Results
After 6 months of osseointegration, implants were ready to be restored. Provisional implant supported FDP were delivered to sculpt the gingival contour to produce a better esthetic outcome. In this case, cement-retained porcelain-fused-to-metal FDP were selected as the final restorations. Temp bond cement was used for ease of retrievability.
Conclusion
The long term successful clinical outcomes can only be achieved with scrupulous treatment planning. And the retention choice of implant supported FDP is influenced by implant angulation, esthetics, and retrievability. This case report discussed the treatment planning process of implant-supported FDP for two patients with partial edentulism.