19 years Post op on Mandibular Overdenture

219 Rating(s).


Posted on By Maurice Salama In Full Arch & Dentures

1995. Patient presents with Flat Mandibular Anatomy and painful denture. Bicortical fixation with external hex Ice Self cutting implants from 3i were placed and restored with a combination of bar and locator attachments. Notice the tissue and radiograph bone levels at 19 years. Do we realize that All on Foru is not always needed? Mental Foramen to Mental Foramen placement with bicortical fixation of implants holds up well over time. Dr. Salama

framework
soft tissue after 15 years

prosthetic design
denture anatomy


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5 Comments

Hi Maurice;
The definition of excellence is quality work that withstands the test of time.
Team Atlanta is the best of the best for a reason.
gerald


Reply

Mo. Very encouraging to see implants doing so well at 19 years! Amazing bone level stability. I couldn't help but notice the "sleeper" implant. Was there more than one prosthesis? Nice looking case. Thank you for sharing.best regards. Chuck


Reply

Chuck;
Very astutue observation! There was a previous Hadar bar with clips in 1995 that the patient did not like very much. The next Prosthodontist and Lab decided NOT to use middle implant and simply place healing abutment. Their call but questions "how many implants" does it take???? to secure a functional prosthesis for 19 years. Also, thank you Gerald for the kind words.
regards Maurice


Reply

Great case and followup Dr.Maurice, compliments. Do you advice any protocols for lower anterior jaw bicortical fixation in such kind of cases? in terms of Number of implants, safety during osteotomy, etc.
For this case what will be your treament plan in 2014. Thanks for sharing this case. Ashok.


Reply

Ashik; Great question. I believe in the mandible you only require 3 implants well spread out and tripod based. Yes, you can get away with only 2 implants but I prefer 3 to avoid tipping of Prosthesis. I prefer a "splinted bar connector" with locator attachments on the bar not as individual unsplinted units. The literature says 2 implants and unsplinted locators but I say 3 and splinted for best longevity and biomechanics. Look at the bone at the crestal aspects after 19 years WITHOUT microtextured implants used? Dr. Salama


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