An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case report

Prosthetic rehabilitation of patients with unfavorable-implant-position or problematic implant angulation is complicated. A completely-edentulous-patient with lower lip squamous-cell-carcinoma had undergone resective surgery twice. After radiotherapy of a total dose of 60cGy of 30 sessions for about...

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Main Authors: Mehran Bahrami, Roya Hashemi, Seyed Mehran Falahchai
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2017-10-01
Series:Journal of Craniomaxillofacial Research
Subjects:
Online Access:https://jcr.tums.ac.ir/index.php/jcr/article/view/174
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spelling doaj-b30f33e632c348738d362d00fc0c28902021-02-24T10:47:56ZengTehran University of Medical SciencesJournal of Craniomaxillofacial Research2345-54892345-62132017-10-0143An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case reportMehran Bahrami0Roya Hashemi1Seyed Mehran Falahchai2Dental Research Center, Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran.Dentist.Dental Research Center, Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran.Prosthetic rehabilitation of patients with unfavorable-implant-position or problematic implant angulation is complicated. A completely-edentulous-patient with lower lip squamous-cell-carcinoma had undergone resective surgery twice. After radiotherapy of a total dose of 60cGy of 30 sessions for about 3 months, moderate trismus was developed. Mouth commisurotomy was accomplished in order to insert three implants in the mandibular-anterior-region. Two distal implants were excessively tilted to achieve better biomechanical advantages and to obtain greater anterior-posterior- distance which made prosthetic rehabilitation of the patient challenging. In the mandibular-custom-tray a lingual “window” was designed to accommodate the open-impression-copings. Trial-denture-bases were tried-in. A putty index was recorded from arranged-mandibular-teeth. According to this index, a zigzag bar similar to letter “M” was designed using custom abutments. So that three ball anchors were placed on this “M-designed-bar” (MDB) more labial than the inserted implants to support the mandibular-implant-supported-overdenture. Using MDB permits teeth-set-up with minimal interfere with tongue function. The major disadvantage of this design is its inevitable-buccal-cantilever. Distolingual areas of mandibular tray were border-molded excessively in order to overcome this problem and to increase stability and also to reduce detrimental-lateral forces to implants. Key words: Dental Implants, Implant-Supported Denture Prosthesis.https://jcr.tums.ac.ir/index.php/jcr/article/view/174Dental ImplantsImplant-Supported Denture Prosthesis
collection DOAJ
language English
format Article
sources DOAJ
author Mehran Bahrami
Roya Hashemi
Seyed Mehran Falahchai
spellingShingle Mehran Bahrami
Roya Hashemi
Seyed Mehran Falahchai
An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case report
Journal of Craniomaxillofacial Research
Dental Implants
Implant-Supported Denture Prosthesis
author_facet Mehran Bahrami
Roya Hashemi
Seyed Mehran Falahchai
author_sort Mehran Bahrami
title An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case report
title_short An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case report
title_full An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case report
title_fullStr An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case report
title_full_unstemmed An innovative design in a mandibular overdenture with too-lingualy-inserted implants: A case report
title_sort innovative design in a mandibular overdenture with too-lingualy-inserted implants: a case report
publisher Tehran University of Medical Sciences
series Journal of Craniomaxillofacial Research
issn 2345-5489
2345-6213
publishDate 2017-10-01
description Prosthetic rehabilitation of patients with unfavorable-implant-position or problematic implant angulation is complicated. A completely-edentulous-patient with lower lip squamous-cell-carcinoma had undergone resective surgery twice. After radiotherapy of a total dose of 60cGy of 30 sessions for about 3 months, moderate trismus was developed. Mouth commisurotomy was accomplished in order to insert three implants in the mandibular-anterior-region. Two distal implants were excessively tilted to achieve better biomechanical advantages and to obtain greater anterior-posterior- distance which made prosthetic rehabilitation of the patient challenging. In the mandibular-custom-tray a lingual “window” was designed to accommodate the open-impression-copings. Trial-denture-bases were tried-in. A putty index was recorded from arranged-mandibular-teeth. According to this index, a zigzag bar similar to letter “M” was designed using custom abutments. So that three ball anchors were placed on this “M-designed-bar” (MDB) more labial than the inserted implants to support the mandibular-implant-supported-overdenture. Using MDB permits teeth-set-up with minimal interfere with tongue function. The major disadvantage of this design is its inevitable-buccal-cantilever. Distolingual areas of mandibular tray were border-molded excessively in order to overcome this problem and to increase stability and also to reduce detrimental-lateral forces to implants. Key words: Dental Implants, Implant-Supported Denture Prosthesis.
topic Dental Implants
Implant-Supported Denture Prosthesis
url https://jcr.tums.ac.ir/index.php/jcr/article/view/174
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