Case study 2 - Swissedent Style Implant Denture With A Fixed Screw Retained Implant Milled Bar

Presenting Complaint:
Patient has a removable F/F denture and would like implants placed in the maxilla and mandibular for a fixed prosthesis at Herts Dental Implant Clinic in Watford. The patients previous denture was loose, ill fitting and difficult to wear during function. The patient has had X6 OSSTEM ® implants placed in the lower arch and the success of the lower arch to determine the upper arch.

Diagnoses:
Bremadent was presented with this case that had X6 OSSTEM ® implants placed on various platforms and the patient would like the existing dentures to be copied exactly. We found the reason for the ill fitting dentures was a gradual procedure, as for most dentures wearers, the patient wanted a fixed solution rather than a removable and the only available option was screw retained implant bar dentures.

Treatment Plan:
The treatment plan given was to create a ‘Swissedent’ style prosthesis and a implant screw retained titanium grade 5 milled bar on the OSSTEM ® platform with a mirror polished fit surface. The mirrored fit surface would be 0.3 mm away from the soft tissues to allow for personal hygiene. The implants screw access holes on the LR3,4 would be angled and the screw access on the LR6, LL3,4,6 would be straight for better overall aesthetics. The Swissedent protocols would be used for aesthetics, hygiene and function whilst the screw retained implant milled bar would be used in conjunction for retention and reciprocation to create a aesthetic and functional prosthesis.

We accepted the case and prescribed the following treatment plan :

• Order lab analogues on the OSSTEM ® platform X2 Regular 4.5 and X4 Mini 3.5
• Special tray secondary impressions with bite registration
• Try in of prosthesis in wax
• Designed & Milled an Createch implant screw retained titanium grade 5 bar within the parameters of the tryin in wax with a mirrored polish fit surface 0.3mm away from the soft tissues with screw access angled correction of 20oC on the LR3,4
• Order screws for the various platforms with ASA screws for the angled corrections
• Try-in of the implant milled bar with a transfer of the wax try-in on the finished milled bar
• Provide a fixed Swissedent style prosthesis with screw access holes for natural looking aesthetics, hygiene and optimum function