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    How to simplify overdenture treatment for today’s patients

    When it comes to dentures, function is just as important as form — so how do you make both happen?

    As the population range from 50 to 70 (Baby Boomers) years of age increases, the number of edentulous and partially edentulous patients will increase, since tooth loss and age are related. There are several reasons for the necessity of needing extractions leading to full-mouth edentulation, including neglect, severe wear, rampant caries, medications and poor health.

    Once converted to dentures, the effects of ill-fitting or non-retentive dentures become evident. Overdentures, utilizing small or traditional implants, offer one cost-effective solution that restores proper form and function to these patients.

    A patient in her early 60s desired implants placed in her upper arch for denture stabilization, since she had already experienced the benefits of an overdenture in the lower arch. She was so pleased with her lower overdenture that was stabilized by two conventional sized implants that she was now financially ready to have implant treatment in the upper arch.

    Case study

    Palpation and radiographic examination revealed a moderately sized maxillary ridge in the anterior portion (Fig. 1) that would only provide sufficient height and width for small diameter implants. However, in the posterior sections there was insufficient bone due to the pneumatization of the sinus cavities. All risks, benefits and alternatives regarding various treatments were discussed with the patient. After a thorough discussion of treatment options, the patient decided she would like to have four dental implants placed in her premaxilla region that would retain a metal-reinforced, palate-free maxillary denture.

    Fig. 1Fig 2

    Fig. 1                                                                                                          Fig. 2

    Using the CS 8100 3D (Carestream Dental), a CBCT scan was taken to accurately treatment plan this case to make certain that no complications would arise from the conservative non-flap approach of placing dental implants. Using 3DDX virtual assistance to precisely plan the placement of four 3.25-by-12 mm EngageTM (OCO Biomedical) dental implants in the anterior portion of the pre-maxilla area, a treatment plan was devised (Fig. 2).

    Fig. 3Fig. 4

    Fig. 3                                                                                                      Fig. 4

    Within a couple weeks, the CT-based pilot surgical guide (3DDX) was received in our office and tried in for verification of proper fit. The area was anesthetized and the sites for the implants was initiated with a 1.95 mm pilot drill through the surgical guide (Fig. 3) utilizing the AEU-7000 surgical motor (Aseptico) at a speed of 1200 rpm with copious amounts of irrigation. Paralleling pins (Fig. 4) were then placed in the site of the osteotomies to confirm the accuracy of the surgical guide.

    Ara Nazarian DDS, DICOI
    Dr. Nazarian maintains a private practice in Troy, Michigan, with an emphasis on comprehensive and restorative care. He is a diplomate ...


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