PMC4461731_01
(a) Frontal and (b) orthopantomographic view of the case before treatment. The image of the primer copings on (c) cast model (d) and intraoral examination.
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Intraoral examination revealed that only 34, 37, 44, and 47 numbered teeth remained and all of them had crown restorations (Figure 1(a)). The radiographs were taken to evaluate the condition of the teeth to be retained for overdenture and the condition of the bone for implants (Figure 1(b)). Then, primary copings were casted using a nonprecious cobalt-chromium alloy and examined in the mouth (Figures 1(c) and 1(d)).
The image of the (a) temporary denture and (b) overdenture. (c) Intraoral view and (d) frontal view of the dentures.
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After the arrangements were evaluated intraorally according to phonetics, aesthetics, vertical dimension, and centric relations, the dentures were processed, finished, and polished (Figures 2(a) and 2(b)). After the primary copings were cemented with a zinc poly-carboxylate cement (Adhezor Carbofile, Spofa Dental, Jicin, Czech Republic), dentures were delivered to the patient (Figures 2(c) and 2(d)).
((a), (b)) The images of temporary denture with gutta percha filling material and (c) stone model that the estimated implant places were marked. (d) Orthopantomographic view of the case with gutta percha filled temporary denture.
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In second stage, 16, 14, 12, 22, 24, and 26 numbered teeth on maxillary temporary denture were drilled vertically and the holes filled with radiopaque gutta percha filling material (Figures 3(a)-3(c)). A panoramic radiograph was taken with this denture to assess the bone and the anatomic landmarks (Figure 3(d)).
(a) Orthopantomographic view of the case with dental implants. Intraoral view of implant abutments (b) and titanium framework (c). (d) The image of titanium framework with silicone index on the stone model.
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Semados Implants, Germany) were placed into 16, 13, 12, 22, 24, and 26 regions and the flap repositioned and sutures were placed (Figure 4(a)). Sutures were removed after one week from the operation and the temporary denture was adapted and relined with a soft relining material (Ufigel Soft, Voco GmbH, NY, USA) in order to be used during osseointegration period. After the appropriate fabricated titanium abutments were selected and mounted (Figure 4(b)), digitizing of implant abutments in the master model was performed with a digital model scanner (3 Series, Dental Wings Inc., Montreal, Canada). Then the marginal fit and occlusion of the main framework were also evaluated intraorally (Figure 4(c)) and the casts were transferred to a semiadjustable articulator. In order to lay the veneering material, silicone indexes were obtained from temporary denture (Figure 4(d)).
(a) Intraoral, ((b), (c)) sagittal, and (d) frontal views of the case after treatment.
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After the arrangements were evaluated intraorally for phonetics, aesthetics, vertical dimension, and centric relation, the dentures were finished, polished, and cemented with a zinc phosphate cement (Adhesor Fine, Spofa Dental, Jicin, Czech Republic) (Figures 5(a)-5(d)).