Clinical
implant success Six of the best for
Dr Avik Dandapat BDS(Birm), MFGDP(UK),
Dip.Imp.Dent RCS(Eng) describes placing a screw-retained prosthesis based on six dental implants, in a 70-year-old patient unhappy with her current denture
T
he p a tient at tended our clinic in 20ıı. She was in her 70s and had recently lost
the upper retainer teeth on her partial chrome denture. She was extremely distressed with her new full upper denture and wanted a long-term solution.
History of complaint Over the last five years she had worn a partial chrome denture retained by three teeth. These teeth had progressively dete- riorated and were recently extracted by her GDP. They had added to the existing chrome denture making a very bulky and heavy upper full denture.
Medical history Apart from suffering from Bells Palsy and having a distinct lack of facial muscular function related to the left side, the medical history was unremarkable.
Extra-oral examination • TMJ appeared sound and no pathology detected on exami- nation • Lymph nodes: clear • Muscles of mastication: appeared normal and with functional limits • Facial muscles: exhibited atrophy on the left side and the reduced function of the following muscles: • depressor anguli oris • mentalis
• zygomaticus major and minor.
The most distinct element
we observed was when the patient smiled only the right side of the muscles used in smiling was functional. However, the patient was aware of this and under- stood that we would work in harmony with the current neuromuscular function. There also was an obvious
loss of maxillary bone and support to the soft tissues. A decreased OVD was also present. All of these issues were however corrected by the use of a well-constructed full denture replacing these areas and supporting the soft tissue.
Intra-oral examination Soft tissues were clear and free from any pathological signs. Dental examination found that the lower dentition was stable, oral hygiene was good and BPE no more than one. Heavily restored molars and another eight remaining teeth present.
Patient discussion After the examination, we discussed the various forms of treatment available with the patient and also potential levels of investment required. The options were as follows: ı. a complete upper denture 2. an upper denture retained
Continued »
Fig 1 Six DIO SM implants placed in the upper
Fig 2
Six DIO Multi-Unit screw-retained abutments placed
Fig 3 MediMatch framework try-in
Scottish Dental magazine 49
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