Welcome to my August 2020 Newsletter Case Presentation
This newsletter describes in step by step detail the provision of an upper free end saddle partial denture in a patient with a high smile line and lower implant supported complete denture with suboptimal positioned dental implants.
This 75 year old woman was referred to me from her general dental practiioner.
Dental History and Concerns
An implant supported lower complete lower denture had been provided 4 years previously in the UK. This “no longer fixes to its anchors and is worn”. The upper partial denture was over 12 years old, having been provided in the USA. “Upper partial again worn and a little unreliable.”
Dental wish list
“Good eating teeth – and ones/teeth that I am happy to smile with.”
- The remaining natural upper 8 teeth had reduced but healthy periodontal attachment.
- The two dental implants (Astra) in the lower jaw had Locator attachments and appeared healthy. The implants positions were suboptimally positioned being over 30 degress divergant, resulting in poor fixation and increased wear of the Locator components.
- The upper and lower dentures exhibited suboptimal extension of the flanges and saddles. They had poor retention, support and stability.
- The patient had a high smile line showing the cobablt chromium clasps of the UR4 and UL3 during social interaction.
Apart from providing no treatment we discussed two solutions namely; fixed implant supported teeth versus optimally designed and made removable dentures. The patient chose to have removable partial dentures.
The clinical situation and treatment process is shown in detail below with photographs. I provided the clinical work and Rowan Garstang provided the technical work.
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