Fabrication of a maxillary prosthesis using dental implants and an “overdenture” attachment. A clinical report

Abstract

A .%-year-old woman with controlled hypothyroidism and mild arthritis began treatment in 1971. The patient’s maxillary teeth and several mandibular teeth were lost as a result of periodontitis. A blade implant was placed in the mandibular right quadrant at that time. The region is still healthy and providing excellent support. The patient’s major concern was an inability to function properly with her conventional maxillary complete denture because of a chronic gagging reflex. She retained the denture with adhesive for many years. Intramucosal inserts were placed to eliminate the use of denture adhesives and minimize the patient’s severe gag reflex by improving maxillary denture stabilizati0n.l The inserts allowed fo:r removal of some of the acrylic resin on the palate, which reduced the gag reflex. The denture was well retained for 3 years, after which the underlying mucosal tissues became hypertrophied, inflamed, and irritated, resulting in the removal of the intramucosal inserts. The tissues were conditioned by use of a series of soft lining materials after minimal surgical revision. With the advent of the intramobile cylinder implants (IMZ), (Interpore International, Irvine, Calif.), osteointegrated dental implant system, a new maxillary prosthesis using dental implants was planned. Preoperative panoramic and intraoral radiographs indicated sufficient vertical bone height and proper bone pattern to accept endosseous implants (Fig. 1). To achieve stablility of the maxillary prosthesis over the IMZ dental implants, many different concepts were considered, including magnets, O-ring attachments, Ceka attachments, and the Stern ERA (APM Sterngold, Atteboro, Mass.) attachment. The ERA “overdenture” attachment was selected because of its resilient properties.