Distal Extension Removable Partial Denture with implant-supported surveyed FPD

Situation

Patient Information

A 75-year-old male patient presented with hypertension and diabetes mellitus. The patient also presented with retained roots on #14, 13, 22, 23 which had been used as abutments for RPD. Remained 3 unit FPD on #12-X-21 was mobile, and all of the remained upper teeth were non-restorable.

Pre-operative View

Initial photos show that extraction of retained roots on #14, 13, 22, 23 was done.

Treatment Planning

- Distal Extension Removable Partial Denture for upper posterior teeth

- Implant placement on #14, 13, 11, 23, 24

- Implant-supported surveyed FPD on #14-13-X-11-X-X-23-24

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Implant placement & GBR on #13, 14, 23, 24 was planned.

All of implants are Neobiotech IS-II 4.0*10mm.

Allograft (ICB cortical) and collagen membranes were used for GBR. The autogenous bone was harvested using ACM drill.

Implant placement & GBR procedure on #23,24

Panoramic view after implant placement on #13, 14, 23, 24.

Uncovery of implants was done after 4 month.

Extraction of remained FPD on #12-X-21 & delivery of provisional restoration on #14-13-X-X-X-X-23-24 was done afterward.

Finally, implant placement on #11 was done. Since there was severe bone resorption on the labial side, implant was placed intentionally on the palatal bone

PA view of IS-II implant on # 11

Metal frame was cut and joined to get passive fitting.

Design of implant-supported surveyed FPD

Design of RPD

Prosthetic delivery

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Conclusion Implant-supported surveyed FPD can be used with removable partial denture in some clinical situation In this case, patient had been using partial denture and he didn’t have any complaint with his old denture. Moreover, the patient is old and has a medical problem such as diabetes. Therefore, Distal Extension RPD can be an alternative of extensive bone grafting & implant placement.

This presentation shows the treatment of a 75-year-old male patient presented with retained roots on #14, 13, 22, 23 which had been used as abutments for RPD. Remained 3 unit FPD on #12-X-21 was mobile, and all of the remained upper teeth were non-restorable. The treatment was plan to place implant on #14, 13, 11, 23, 24 and install implant-supported surveyed FPD on #14-13-X-11-X-X-23-24.