PMC4628715_01
Panoramic radiograph of patient with two poor-prognosed mandibular teeth.
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After clinical and radiological assessments (Figure 1), considering the loss of the bone and labial support, two treatment options had been presented for the patient: implant supported overdentures or implant supported hybrid dentures.
Panoramic radiograph after implant insertion.
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Italy) were inserted according to manufacturer's recommendations. Implant locations were 15, 13, 11, 16, 26, 23, and 21 (Figures 2 and 3).
(a and b) Clinical view of the implants after surgical insertion.
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Italy) were inserted according to manufacturer's recommendations. Implant locations were 15, 13, 11, 16, 26, 23, and 21 (Figures 2 and 3).
(a and b) Gingival formers were fastened and the flaps were repositioned with interrupted 3.0 silk sutures. (c) The healing was uneventful for the following ten days.
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A coronally repositioned flap from the palatal soft tissue was achieved in order to facilitate a gain of attached tissue and tension-free closure of the flap around the healing abutments (Figure 4).
(a, b, and c) Wax-up try-in for determining intermaxillary vertical dimensions and the support.
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This setup is considered as the facial border of the future planned wax-up and it also helps the technician to construct a computerized design for this hybrid prosthesis which stimulates the final restoration (Figure 5).
(a) Occlusal and (b) frontal view of laser sintered metal substructure.
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In addition to the mechanical retention, chemical retention was provided by a proprietary bonding agent (GC Metalprimer II) (Figures 6, 7, and 8).
Occlusal view of the abutments (a) on the study cast and (b) intraorally.
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In addition to the mechanical retention, chemical retention was provided by a proprietary bonding agent (GC Metalprimer II) (Figures 6, 7, and 8).
(a) Occlusal view of metal substructure, (b) frontal view of metal substructure, and (c) metal try-in.
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In addition to the mechanical retention, chemical retention was provided by a proprietary bonding agent (GC Metalprimer II) (Figures 6, 7, and 8).
Computerized view of model and metal substructure.
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Implant at site 13 was found to be placed, tilted to the vestibular aspect during the first surgery, so this abutment at site 13 was cemented to the framework to provide a parallel path of insertion to the framework and to improve this implant's emergence profile (Figure 9).
(a) Occlusal and (b) frontal view of the first composite layer that is bonded to the metal substructure.
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After that occlusion was adjusted, the end result provided adequate contour to facilitate maintenance and healthy gingival tissues (Figures 10, 11, and 12).
(a) Frontal and (b) occlusal view for hybrid prosthesis.
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After that occlusion was adjusted, the end result provided adequate contour to facilitate maintenance and healthy gingival tissues (Figures 10, 11, and 12).
Occlusal adjustments at (a) lateral movement and (b) centric occlusion.
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After that occlusion was adjusted, the end result provided adequate contour to facilitate maintenance and healthy gingival tissues (Figures 10, 11, and 12).