Abstract
BackgroundOral rehabilitation of the atrophic mandible is, most of the time, a challenging procedure, especially in elderly patients with associated comorbidities.Case presentationThis clinical report describes the rehabilitation of an extremely atrophic mandible using an overdenture supported by four splinted implants, two of which are placed in the interforaminal region and the other two bypassing the inferior alveolar nerve at the level of the antegonial notch. A passive-fit bar structure splinting the four inserted implants was designed to compensate for mandibular flexure, to reduce the amount of strain on the implants, and avoid bone resorption and prosthetic failure. The 14-month postoperative cone-beam computed tomography (CBCT) and the clinical follow-up showed the bilateral integrity of the inferior alveolar nerve and the successful restoration of the atrophic edentulous mandible with a significant improvement in the patient’s quality of life.ConclusionsThe applied technique depicts several benefits such as a minimally invasive approach, reduced number of surgical interventions, reduced total treatment time, reduced treatment costs, and higher psychological acceptability.
Highlights
Oral rehabilitation of the atrophic mandible is, most of the time, a challenging procedure, especially in elderly patients with associated comorbidities.Case presentation: This clinical report describes the rehabilitation of an extremely atrophic mandible using an overdenture supported by four splinted implants, two of which are placed in the interforaminal region and the other two bypassing the inferior alveolar nerve at the level of the antegonial notch
The aim of this paper is to present a minimally invasive treatment option for the rehabilitation of extremely atrophic mandible using a bar-retained overdenture supported by four splinted implants, two placed in the interforaminal region and the other two bypassing the inferior alveolar nerve at the antegonial notch level
The literature is scarce on previous reported cases of extreme atrophic edentulous mandible treated with bar
Summary
Oral rehabilitation of the atrophic mandible is, most of the time, a challenging procedure, especially in elderly patients with associated comorbidities.Case presentation: This clinical report describes the rehabilitation of an extremely atrophic mandible using an overdenture supported by four splinted implants, two of which are placed in the interforaminal region and the other two bypassing the inferior alveolar nerve at the level of the antegonial notch. Compared to a maxillary denture, a mandibular denture has a base with a longer periphery and smaller contact area between the alveolar ridge and Filipov et al Head & Face Medicine (2021) 17:22 the denture base; fixed mucosa are frequently lacking. These anatomical features may have a negative influence on the successful use of a mandibular denture, causing instability due to insufficient retention, acute pain by overloading the mucosa, or even worse, by compressing the mental nerve, impaired masticatory function, speech difficulties, loss of soft tissue support, altered facial appearance, psychological impairment, and social limitations [3, 4]
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