| Maxillary-
Completely Edentulous |
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Goal
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Presurgical Needs
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Considerations
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Restorative Options
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| Goal |
Identify
patient’s need for a removable or fixed prosthesis. This is critical
because a patient’s need will dictate the design of the prosthesis
and may affect the number of implants placed. For instance if the
patient’s chief complaint is dislike of the removable aspect of
the existing denture, then a fixed prosthesis must be planned.
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| |
| 1.
Mounted diagnostic casts
2. Presurgical
wax denture set-up
3. Surgical template
4. Plan for prosthesis
type and design, which will determine implant placement
5. Examination
of high smile line (which will affect the design and potentially
show metal if
ignored) without complete denture in
6. Radiographic
needs (panoramic/ CT scan)
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| Considerations
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[
Top ] |
The
position of the maxillary sinus often prevents posterior implants
without additional surgical procedures.
Some clinicians consider the edentulous maxilla the most challenging
restorative situation for implants.
For each patient, the clinician must consider the individual situation,
including:
a. Bone quality
b. Bone quantity
c. Maxillo-mandibular
relations
d. Parafunctional
habits
e. Opposing area,
occlusion, occlusal material (especially for the edentulous
maxilla)
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| Restorative
Options |
[
Top ] |
1.
Maxillary fixed-detachable prosthesis
A.
Definition: An implant-supported prosthesis that is fixed and not
removable by the patient. This prosthesis is retrievable by the
dentist by unscrewing the retaining screws.
B.
Design considerations:
1.
Number of implants
a.
At least four
b.
Ideally six or more
2. Design: acrylic-metal restoration
3. Design: ceramo-metal restoration
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Cosmetic
Dentistry
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