In this case report the treatment of a maxillary removable denture using patient, with fixed implant supported restorations, including simultaneous, same-day immediate loading with screw retained fixed provisional restorations is presented.
Method:
A 40 year-old female patient presenting mobile maxillary incisors and healthy right second molar was referred to our clinic with the complaint of tooth loss causing aesthetical and functional problems. A maxillary fixed implant supported restoration was planned. Anterior 4 implants were placed immediately after the extractions of maxillary incisors and to avoid maxillary sinus lifting, 2 angled implants were placed bilaterally to the premolar regions. Following implant placement, a simultaneous, same-day, complete-arch, screw-retained acrylic based provisional restoration was fabricated. After 3 months of uneventful healing period, custom made titanium abutments were prepared for four implants at the anterior region to avoid aesthetical complications at the lip line and standard multiunit abutments were used for the angled implants. The definitive metal-ceramic restorations were cemented with polycarboxylate cement.
Result:
The patient’s aesthetic and functional expectations were achieved immediately. At 3, 6 and 12 months follow-ups neither biological nor biomechanical complications were observed. No significant marginal bone loss was detected at one year follow-up.
Conclusion:
The major advantage of this treatment protocol is that the patient was maintained in fixed prostheses throughout the treatment by immediate implant placement and simultaneous same-day provisional restoration. Using angled implants to avoid additional surgeries also shortens the length of treatment period, thus a fixed, one piece restoration, supported by six implants is a satisfactory treatment option for such cases.