Upgrade From A Removable To A Fixed Partial Denture On Implants

Dental implants have become the standard of care and as dentists we need to not only be capable of planning them, but also to diagnose and treat them when there is something wrong with them, or with the prosthesis that they help support.  Sometimes the patient may feel uncomfortable, the prosthesis may require repair too often or is unable to function properly, and the general dentist needs to be able to find an appropriate solution to the problem.

The following article was published in 2012 by Dentistry Today, and shows a case that was seen in my office of a very nice lady that had been treated with implants and a removable prosthesis and was having problems.

Summary of case report
An initial examination and records showed a semi edentulous maxillary arch with four successful implants placed in 2001, in the anterior maxillary region, but not necessarily in the position of a tooth.

The implants were then restored with ball abutments for o-rings and an implant retained, tissue supported removable partial denture. This prosthesis was designed with two distal cantilevers; the larger of the two was on the right and measured 28 millimeters. This created an excessively large lever arm that made the prosthesis prone to fracture.  The lack of adequate interarch space for a removable prosthesis also made the thin acrylic material prone to fracture.
Other concerns with the case were the identification of the existing implants in order to purchase the required components to convert to a fixed partial denture, and the need to place additional implants.

I won’t go into the details of the process from treatment planning to completion , but they are available in the Dentistry Today article .

The patient has been functioning and comfortable for seven years now.

Below are before and after pictures of the case.

Old Partial Overdenture on implants

Fixed partial overdenture on implants

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