Modified fixed partial dentures for orthognathic surgery patients.
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Careful monitoring of tissue that had been the site of three previous surgical procedures was necessary, but the patient needed a functional, esthetically acceptable prosthesis. The Andrews bridge was selected because it combines the stabilizing qualities of a fixed prosthesis with the accessibility to the tissues of a removable prosthesis. The recurring nature of the verrucous carcinoma along with extensive tissue loss were additional factors in selecting this appliance. The final results satisfied all the criteria. The patient has been seen at regular follow-up visits for 2 years since the last surgical procedure and there has been no clinical change in the previously involved tissue. The patient has tolerated the prosthesis well and is satisfied with her appearance.
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PURPOSE: The aim of the present article was to describe the treatment planning for an implant-supported maxillary fixed prosthesis and the clinical procedure involved, including the laboratory fabrication sequence. MATERIALS AND METHODS: If patients request a fixed prosthesis to restore the edentulous maxilla, it is essential to decide as soon as possible whether this prosthesis design can satisfy the requirements of esthetics, phonetics, comfort, and function. Thus, the crucial clinical factors need to be checked during examination. Furthermore, the relationships between ideal implant angulation, available bone, and intended crown should be assessed using reformatted computed tomography. RESULTS: In patients with minimal bone resorption and limited intermaxillary space, implants can usually be placed in the prosthetically driven implant position for a fixed prosthesis. To evaluate and optimize esthetics, biology, and function, a fixed provisional restoration should be inserted for a 6-month diagnostic period. The ideal provisional then serves as a guide for the final restoration. CONCLUSION: If clinical and radiologic diagnostics indicate that an implant-supported fixed complete denture is feasible, meticulous presurgical planning, precise execution of implant positioning, and a progressive prosthetic treatment sequence are required. The ceramometal fixed implant-supported restoration can then be established in an ideally prepared and matured oral environment.
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