A procedure for repairing a fixed implant-supported complete denture

A procedure for repairing a fixed implant-supported complete denture
June 2005
Bill Abbo, DDS, Michael E. Razzoog, DDS, MS, MPH
The Journal of Prosthetic Dentistry Зѓў Volume 93 Зѓў Number 6
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One of the reconstructive choices for the completely edentulous patient is the placement of multiple implants and the fabrication of a fixed implant-supported complete denture. These patients experience an improvement in masticatory performance over patients who wear complete dentures.1-6
The fixed-implant complete denture consists of a metal bar with acrylic resin and denture teeth connected to implants by means of prosthetic retaining screws. Another method of completing the prosthesis is to apply porcelain to finalize the gingival and tooth structures. The original concept called for the metal bar to be waxed and cast in a gold alloy.7 Several manufacturers now offer a metal bar of titanium, either welded or milled from a single block. During fabrication of the denture, the metal must be treated with a bonding agent and a gingival-colored opaque material prior to the acrylic resin processing.8 This is done to enhance the adherence of the acrylic resin to the metal and to mask the dark metal color.
While such restorations provide comfort, function, and esthetics to levels that may not be obtainable with a conventional denture, maintenance and occasional repair are required. When fracture of porcelain or acrylic occurs, exposing the metal, the required repair may be complicated and expensive due to the need to remove the remaining material and reapply it to the framework. This article describes an alternative method of repairing the fixed-implant complete denture without replacing the entire gingival portion of the prosthesis. The patient described here presented with a fractured mandibular screw-retained fixed implant-supported complete denture. The fracture extended through the artificial teeth and gingival acrylic resin on the right side, leaving the titanium bar exposed (Fig. 1). Using this technique, there may be a color mismatch between the acrylic resin and the resin composite that might be of concern in some situations. However, with the increasing use of titanium rather than gold alloy for the fabrication of the metal substructure, the need for maintenance and repair is likely to increase.
References
1. Bakke M, Holm B, Gotfredsen K. Masticatory function and patient satisfaction with implant-supported mandibular overdentures: a prospective 5-year study. Int J Prosthodont 2002;15:575-581.
2. Slagter AP, Bosman F, Van der Bilt A. Comminution of two artificial test foods by dentate and edentulous subjects. J Oral Rehabil 1993;20:159-176.
3. Pera P, Bassi F, Schierano G, Appendino P, Preti G. Implant-anchored complete mandibular denture: evaluation of masticatory efficiency, oral function, and degree of satisfaction. J Oral Rehabil 1998;25:462-467.
4. Fontijn-Tekamp FA, Slagter AP, Van der Bilt A, Van't Hof MA, Kalk W, Jansen JA. Swallowing thresholds of mandibular implant-retained overdentures with variable portion sizes. Clin Oral Implant Res 2004;15:375-380.
5. Fontijn-Tekamp FA, Slagter AP, Van der Bilt A, Van'T Hof MA, Witter DJ, Kalk W. Bitting and chewing in overdentures, full dentures, and natural dentitions. J Dent Res 2000;79:1519-1524.
6. Jemt T, Book K. Prosthesis misfit and marginal bone loss in edentulous implant patients. Int J Oral Maxillofac Implants 1996;11:620-625.
7. Beumer J III, Lewis SG, Beumer J. The Branemark implant system: clinical laboratory procedures. St Louis: Medico Dental Media Intl; 1989. p.31-7, 157-67
8. May KB, Van Putten MC, Bow DA, Lang BR. 4-META polymethyl methacrylate shear bond strength to titanium. Oper Dent 1997;22:37-40.