Case 29: Full mouth rehabilitation with Maxillary All on 6 and Mandibular PFM full arch prosthesis

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Case 29: Full mouth rehabilitation with Maxillary All on 6 and Mandibular PFM full arch prosthesis

 When the vertical dimension is collapsed and there are no posterior occluding teeth, a re-organised approach is needed to rehabilitate such situations.
A complete protocol involves:
1. Diagnostic impression and Facebow transfer, Centric record.
2. Full arch diagnostic mock up based on Pankey mann Schuyler's technique.
3. Establishing an ideal anterior guidance and occlusal plane restoration
In this case we had to complete the above three steps and then Implant planning was carried out for the maxillary arch which needed extraction of hopeless remaining maxillary teeth.
4. transitional Denture was fabricated after the Implant surgical phase and they were lined with soft-liner
5. After 5 months a hybrid prosthesis was fabricated replicating the occlusal scheme which was done during the planning phase.


The first phase involved the restoration of lower occlusal plane.






Once the lower plane is completed, the next phase involves the placement of 6 implants in the maxillary arch. The surgical phase for this case was carried out by a Surgeon and the case was referred back to me for the completion of the remaining prosthetic full mouth rehabilitation.

So an interim denture was fabricated to maintain the VD and the re-organised occlusion. 
During the Prosthetic phase for the implants, a Hybrid Prosthesis was decided for the maxillary arch, despite explaining the patient the advantages of a Malo-Bridge.
This prosthetic phase for the upper arch involves, placement of healing collars, Trayless splinted impression of the arch, Jig trial, Trial prosthesis and final prosthesis.
In this case there was labial access hole in the prosthesis which could have been prosthetically handle with a Malo bridge. That was a small limitation, however the lip profile made it less significant.










The entire prostheitc phase was done by me at Parasu Dental Hospital.Chennai

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