Case 105 | The Award 2017 | Philippines

Case 105 | The Award 2017 | Philippines

 

Dr. Ricky Martin Llorca

ALL CLINICAL CASES

the case: female, 49 years old. complaining of loose denture and difficulty in mastication & speaking.

clinically: upper jaw-kennedy class 3 modification 2. lower jaw kennedy class 1 modification 1. old denture esthetically acceptable but poor in retention & function

radiographically:  upper anteriors with deficient residual ridge, posteriorly with extreme development of sinus with marked thinning ofthe alveolar process and the roots of the remaining tooth projects into the sinus. lower deficient residual ridge all over the edentulous area but with thick body of the mandible and enough height & clearance from the mandibular canal.

recommendation: upper jaw needs bone augmentation, a block graft for the anterior and bilaterral sinus lifting and grafting. since the patient is reluctant of invasive procedure.

instead we proposed a combination of fixed and removable denture to improved the functions and retention. lower jaw also needs bone augmentations if conventional implant and crown are to be planned but instead we proposed a lesser invasive and faster treatment which is the “all on four treatment concept”

treatment plan: 1st lower – cbct diagnosis, implant planning, restorations planning.

2nd lower – surgical guide fabrication, local anesthesia, implant placement surgery old denture relining.

3rd lower- 6 weeks healing, provisional fixed denture (Hybrid)

4th lower- pick up impression of implants, crown & bridge of the 4th quadrant try-in & installation of the final hybrid denture.

5th upper- crown & bridge preparations, Bridge try-in with precision attachment, bridge pick up impression, bridge and RPD try-in, bridge cementation and RPD installation.

results:  Denture esthetic on both upper and lower is achieved, stability and retention is remarkable.

most importantly the patient is satisfied in all aspects of the denture function.

1-pre-op

1-pre-op

2-pre-op stayplate denture upper & lower

2-pre-op stayplate denture upper &  lower

3-pre-op cbct

3-pre-op cbct

4-pre-op pseudo panoramic

4-pre-op pseudo panoramic

5-pre-op clinical

5-pre-op clinical

6-manual surgical guide

6-manual surgical guide

7-implant placement

7-implant placement

8-post implant surgery

8-post implant surgery

9- low profile abutment+ quickbridge aafter 6 weeks

9- low profile abutment+  quickbridge aafter 6 weeks

10-immediate provisional-lower

10-immediate provisional-lower

11-conversion of old denture to hybrid

11-conversion of old denture to  hybrid

12-trim & polishing of provisional hybrid

12-trim & polishing of provisional  hybrid

13-implant post-op pano

13-implant post-op pano

14-implant post-op cbct

14-implant post-op cbct

15-6 months post provisional

15-6 months post provisional

16- impression for final hybrid denture

16- impression for final hybrid  denture

17- OCR+framework of final hybrid

17- OCR+framework of final  hybrid

18-wax try-in of final hybrid +temp crown

18-wax try-in of final hybrid +temp  crown

19- finished hybrid-lower

19- finished hybrid-lower

20- installation of final hybrid-lower

20- installation of final  hybrid-lower

21- upper PFM bridge + male precision attachment +milling job

21- upper PFM bridge + male  precision attachment +milling job

22-RPD + female precision attachment +milling job

22-RPD + female precision  attachment +milling job

23- upper RPD + precision attachment in place

23- upper RPD + precision  attachment in place

24- lower hybrid denture in place

24- lower hybrid denture in  place

25- upper & lower prosthesis in place

25- upper & lower prosthesis in  place

26- post-op

26- post-op

27-post op happy

27-post op happy

28-post op 2 months later

28-post op 2 months later

29- chief complain

29- chief complain

30- testimonial

30- testimonial

Follow the contest also on our Facebook group!

 

Case 105 | The Award 2017 | Philippines ultima modifica: 2017-02-27T17:06:34+00:00 da Team Zerodonto

No Comments

Leave a Comment

Please be polite. We appreciate that.
Your email address will not be published and required fields are marked


Shares