Abstract
Rehabilitation of atrophic maxilla still remains a challenge. Fixed implant-supported restorations have become more predictable in the last years; nevertheless, technical and biological complications still occur. Removable overdenture fully supported by a CAD/CAM titanium bar seems to be a viable treatment option for the rehabilitation of completely edentulous patients with a high degree of bone resorption. In these clinical cases, the soft tissues of the lower third of the face need to be respected, and a fixed-removable solution is the only option to have good hygiene control. Nevertheless, there is no consensus about the optimal number and position of the implants. A total of six adult patients were recruited and treated with an overdenture fully supported by a CAD/CAM titanium bar and low-profile attachment, screwed on four or six implants. A detailed step-by-step description of the procedures was presented. Overall, all the patients were successful treated with no relevant complications. With the limitations of this case series, maxillary implant overdenture fully supported by four or six implants seems to be a safer treatment option for the minimally invasive rehabilitation of atrophic maxillae, regardless of the number of implants.
Highlights
Rehabilitation of complete edentulous maxilla could be performed with several types of prosthesis.Among these, implant-supported restorations have become the most popular in the last two decades.alveolar bone resorption may require bone augmentation procedures before or at implant placement
A fixed prosthesis can be delivered with a crown or hybrid design, while a removable denture, or overdenture, can be designed only with a hybrid design
To increase the predictability of esthetic treatment outcomes, it was demonstrated that the space between the prosthetic crown and the implant platform should be filled with pink prosthetic material in order to fill more prosthetic space
Summary
Rehabilitation of complete edentulous maxilla could be performed with several types of prosthesis. To increase the predictability of esthetic treatment outcomes, it was demonstrated that the space between the prosthetic crown and the implant platform should be filled with pink prosthetic material in order to fill more prosthetic space To overcame these drawbacks, in patients with an altered skeletal maxillomandibular relationship and horizontal/vertical bone resorption (Cawood and Howell class IV, V, and VI), a minimally invasive overdenture fully supported by a computer-aided design/computer-aided manufacturing (CAD/CAM) titanium bar seems to be the gold standard [4,5]. In patients with an altered skeletal maxillomandibular relationship and horizontal/vertical bone resorption (Cawood and Howell class IV, V, and VI), a minimally invasive overdenture fully supported by a computer-aided design/computer-aided manufacturing (CAD/CAM) titanium bar seems to be the gold standard [4,5] This type of prosthesis can be successful delivered on only four implants, placed in the anterior area, which can be placed flapless (using a guided approach) or with a small flap. The aim of this case series was to report the two-year implant/prosthetic success and survival rates with four or six splinted implants placed in the maxilla to delivery an implant overdenture fully supported by a CAD/CAM titanium bar
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