Implants
procedures Flexible
Simple prosthetic solutions in complex cases for a successful overdenture by Dr Emiliano Ferrari and Gianni Storni
P
rosthetic-driven positioning of implants allows both the technician and the dentist to rehabilitate patients with prostheses, while respecting
the basic rules of biomechanics and aesthetics. Due to insufficient bone tissue as a result of post extraction regeneration, or to the functional remodelling of the alveolar bone in tissue-supported pros- thesis wearers, it is not always possible to insert fixtures in the desired position or with the preferred inclinations without resorting to surgical treatment. In this case, the dentist is faced with
the possibility of performing regen- eration procedures of varying degrees of complexity. Another possibility is to place implants where there is sufficient bone available to manage the compromise with a suitable prosthetic device. In the case to be described, it was necessary to modify a new prosthesis in order to reposition implants presenting in an unfavourable anatomical situation without regeneration. The patient – female, 60 years old, non-
smoker and in good health – has worn a total prosthesis for many years. She had recently received two new prostheses to replace the previous ones. These pros- theses seem correct in terms of aesthetic appearance. However, poor stability was a concern. The patient subsequently changed her mind, choosing to proceed with implant insertion. Anatomical conditions appeared
compromised: the mandibula had severe bone atrophy in the posterior region and in the intraforaminal zone, complicated by severe skeletal Class III. During the initial phase of the surgery, a full thickness flap was lifted. After levelling the ridge, two
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