Clinical Report
Mandibular implant-supported fixed complete dental prostheses on implants with ultrashort and standard length: A pilot treatment

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Abstract

Edentulous patients may be restored with complete-arch implant-supported fixed complete dental prostheses (IFCDPs) on angled distal implants or on parallel implants distributed equally across the mandible to increase the area of support. A treatment is presented to introduce the clinical concept of providing edentulous patients with an implant-supported fixed complete dental prosthesison parallel tissue-level implants in the mandible with standard length implants interforaminally and ultrashort implants distally. A structured prosthetic approach was used for the tooth arrangement with a modified workflow as per the Biofunctional Prosthetic System adapted for static computer-aided implant surgery (s-CAIS) and computer-aided design and computer-aided manufacturing (CAD-CAM) of the screw-retained implant-supported fixed complete dental prosthesis. The concept offered advantages in challenging anatomic, surgical, and prosthetic conditions; providing distal nonangled abutments and implant platforms, which were straightforward to clean. If necessary, the prosthesis could have been easily converted into a removable overdenture using the existing digital prosthetic arrangement. Should implant removal be required, the extrashort implants can be removed with minimal surgical risk or morbidity.

Section snippets

Clinical report

A 65-year-old woman had been edentulous for 12 months and had been treated with mucosa-supported complete dentures. Her chief complaint was the inability to masticate comfortably because of her loose mandibular denture. She requested an IFCDP and new complete maxillary denture. She reported smoking 10 cigarettes a day but was otherwise healthy and not taking any medication. Initial prosthodontic and radiographic screening revealed favorable conditions for an implant-supported prosthesis (Fig. 1

Discussion

Promising concepts for optimizing patient comfort by combining a minimally invasive surgical approach with a fixed implant-supported reconstruction are underrepresented in the literature. The provision of 10 edentulous patients with a cross-arch fixed prosthesis has been described in a recent case series.10 Two 10-mm RN implants were inserted in the anterior area of the mandible and then splinted to 4 extrashort RN implants (4-mm endosseous length) in the posterior area of the mandible. The

Summary

The described treatment approach demonstrated the clinical feasibility of providing atrophied mandibles with IFCDPs supported by a combination of anterior regular and distal ultrashort tissue-level implants. This approach combined the advantages of a simplified prosthetic treatment concept: virtual prosthetic and surgical planning, s-CAIS, and novel CAD-CAM–supported complete-arch reconstruction. Thus, it may offer improvements when dealing with challenging anatomic, surgical, and prosthetic

Acknowledgments:

The authors declare no conflict of interest. All laboratory work was performed by Patrick Zimmermann (Zahnmanufaktur, Bern, Switzerland). Institut Straumann AG (Basel, Switzerland) provided the framework of the prosthesis free of charge.

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