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Clinical Retaining patient


complete full upper and lower dentures fitted. The patient explained that he was not coping with retaining his lower denture. The patient has had dentures for six years after continually losing teeth over the past 20 years. He is married and is a retired chef. He smokes 20 cigarettes per day and does not drink alcohol. His medical history is unremarkable. At the time of attendance there


were no signs or symptoms of any TMJ dysfunction and no pain on palpation of the muscles of mastication. His dentures were set to a class 1 occlusion and he was comfortable with the bite and


satisfaction A


Abid Faqir presents a successful case of an implant-retained over denture in a patient unhappy with his current lower prosthesis


59-year-old male patient was referred by our in-house consultant prostho- dontist after having


overall tooth position. He had a low smile line. Intraorally his soft tissues were pink and healthy. The patient had an excellent upper denture and only wanted to consider treatment in the lower arch. A CT scan was carried out and assessed with denture markers. The patient had fairly good keratinised tissue left on the lower ridge however, ridge height was minimal. There seemed to be adequate bone volume to consider implant treatment. We looked at the various treatment options that were available. We dis- cussed the pros and cons of implant retained over denture and implant- retained fixed bridgework. We also talked about bar-retained or ball- retained. He opted for the over-denture due to cost and opted for a bar-retained as he knew of a


friend who had ball attachments and he seemed convinced that they don’t work as well. The patient decided on the following treatment plan:


1. Appointment with hygienist to optimise denture oral hygiene. 2. Smoking cessation advice. 3. Inform consultant prostho-don- tist of treatment plan. 4. Placement of two lower implants using the CT scan that had been taken and using the denture with markers.


5. After two months, take implant head impressions as well as replicating the lower denture with a reline over the implant heads. 6.Technician constructs bar on the implants and fits denture to this. 7.Wax try-in. 8. Final denture fit and removal and insertion instructions. 9.Regular reviews as with normal implant protocols.


The treatment was carried out Fig 1 Pre-op smile Fig 2 Retracted view


exactly as described above. Two NobelActive 13mm regular implants (torque to 45Ncm) were placed with a flap technique (crestal incisions with minimal envelope opening) and healing abutments. The surgery was


42 Scottish Dental magazine


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