Case 32: Worn All on 4 Prosthesis- Making a new prosthesis

-
Case 32: Worn All on 4 Prosthesis- Making a new prosthesis

 Any acrylic hybrid prosthesis has its life as they are subjected to occlusal load and day to day wear. Normally a hybrid prosthesis on an all-on 4 or all on 6 will stay good for a period or 3-5 years. They will wear out over a period of time and requires a new prosthesis or relining the acrylic portion on the existing bar frame.

Here we have a case where the patient had undergone all on 4 in the upper and the lower arch had only 3 implants. Surprisingly they are holding good. We did advise the patient to go in for a malo prostheis with either Zirconia frame and Zirconia crowns or milled frame with PFM crowns, but the patient opted to go in for an acrylic hybrid again.

The sequence involved Removal of the worn prosthesis and a trayless impression with splinting of the impression post with pattern resin and the fit is tried again with a jig trial. Furthere jaw relation and trial is done followed by Final prosthesis torque. As per all on 4 protocols, Any abutment screw on an angulated multi unit abutment should be done at 15 Ncm. if it was a straight multi unit abutment then the torque is 35 ncm.

The sequence of the prosthesis fabrication is as follows in the following images.







 This case was done by me at Parasu Dental Hospital,  Chennai.

Comments

Post a Comment

Popular posts from this blog

Case 50: Full mouth rehabilitation-Digital Dentistry-Digital Smile Design of a patient with Amelogenesis Imperfecta.

-
Image
Case 50: Full mouth rehabilitation-Digital Dentistry-Digital Smile Design of a patient with Amelogenesis Imperfecta. Amelogenesis imperfecta is a developmental defect where the developement of enamel is affected. The condition may vary from simple white flecks of enamel hypoplasia to severe pitting with brown-yellow discolored teeth. Here is a patient who was a teenager and was emotionally & psychologically affected because of his unesthetic teeth. Reason is, he had amelogenesis imperfecta which was severe involving all his teeth with yellow brown discolorations along with pitting in the posterior teeth. Transforming smile and improving his psychological level can be achieved by first gaining the confidence and trust. This emotional dentistry can be fulfilled by Digital Smile design. As discussed in many of my cases, I use Adobe photoshop for my smile designing part. The very same day the patient walked in, photographs and videos were taken to plan the smile and re-enforce th
Read more

Guest Speaker 4: Photoshop smile design and Indirect laminate veneer preparation- 2 days hands on program

-
Image
Guest Speaker 4: Photoshop smile design and Indirect laminate veneer preparation- 2 days hands on program At Parasu dental hospital, we organised a 2 days Hands on workshop for a group of  10 dentists from varied specialities and GPs. The first day was kickstarted by Dr.Chelliah Venkataraman, the founder and Head of Parasu Dental Hospitals and the head of CVR dental Academy, Chennai. Day 1 of the program involved candidates learning about the basics of Dental Photography, The protocol to be followed for Smile designing using Adobe Photoshop and using Adobe photoshop for 2D smile designing. In-fact, I have written a detailed article on fabricating your own smile design templates which can be used for 2D designing, as a tool for patient education and treatment planning which can be seen i my earlier posts in my blog. So, day 1 was completed by candidates learning the protocols for Dental photography for smile designing as well as the use of adobe photoshop to create a smile design t
Read more

Case 48: All on 4 Maxillary implants+ Immediate loading+ Defintive Malo bridge

-
Image
Case 48: All on 4 Maxillary implants+ Immediate loading+ Defintive Malo bridge Another case of an immediate loading All on 4 maxillary prosthesis and after 6 months went ahead with a malo bridge made of milled Ti frame with PFM crowns. This patient had fixed prosthesis in the upper arch with multiple root caries which required extraction of all the maxillary arch teeth. The patient requested for an immediate denture or fixed prosthesis on the same day of extraction due to esthetic concerns. Phase 1: Involved a diagnostic impression and mounting & articulation along with cast modification in the maxillary arch for the fabrication of an interim immediate acrylic denture. This denture is used as an index and used for splinting the impression and conversion of the provisional denture into a fixed prosthesis. The entire surgery was done under local anesthesia. Total extraction was carried out followed by placement of two axial implants in the maxillary anteriors and angulated impl
Read more