Lip Support Research Articles

Evaluation of open-face maxillary complete denture for patients with prominent premaxilla: a crossover study.

The establishment of good facial esthetics is one of the main objectives of complete denture construction. Unfortunately, it may be the caused issue for patients having a prominent premaxilla due to excessive lip support by the labial flange of the maxillary denture. Open-face dentures (OFD) may suggest suitable prosthetic management for these patients. However, clinical evidence regarding the efficiency of OFD is scarce. A total of 38 completely edentulous participants having prominent premaxilla and skeletal class I Angle's classification were enrolled in this study. Each participant received a mandibular complete denture and 2 opposing maxillary dentures; conventional (CD) and open-face (OFD). On the day of denture insertion, the participants were divided into 2 groups; CD-OFD and OFD-CD where CD-OFD group was instructed to use the mandibular denture and the maxillary CD for 3 months and then to use the maxillary OFD for another 3 months after a wash-out period of 2 weeks. While group OFD-CD was instructed to use the mandibular denture and the maxillary OFD for 3 months then to use the maxillary CD for another 3 months after a wash-out period of 2 weeks. The dislodging force of the maxillary dentures was evaluated using the universal testing machine and the patient perception of retention, esthetics, and comfort was evaluated using the Visual Analogue Scale (VAS). Evaluation was carried out 1 day, 1 month, and 3 months after denture insertion. The Student t-test was used to compare the 2 maxillary dentures and the intervals for each denture were compared by using the ANOVA test with repeated measures followed by a Post Hoc test (adjusted Bonferroni) for pairwise comparison. The significance of the obtained results was judged at the 5% level (P value). The dislodging force and patient perception of retention did not show significant differences between the 2 dentures, while the perception of esthetics showed significant differences throughout the follow-up period. Perception of comfort showed an insignificant difference only at the 3-month interval. Open-face maxillary dentures can be a suitable alternative for patients with prominent premaxilla to achieve satisfactory retention, aesthetics, and comfort.

The Scalloped Surgical Guide as an Alternative to Flat Bone Reduction Guide in Full-arch Implant Restoration.

The goal of this clinical report was to present an alternative to traditional flat bone reduction guides, using a custom-designed 3D printed guide according to the future gingival margin of the planned dentition. A 61-year-old female with concerns regarding her smile appearance was presented. The initial examination revealed excessive gingival show accompanied by excessive overjet. The dentition was in a failing situation. The proposed treatment plan, relying on the sufficient amount of bone and keratinized tissue, consisted of re-contouring of the alveolar ridge and gingiva and placement of six implants and a FP-1 prosthesis after extraction of all remaining maxillary teeth. Digital smile design was completed, and a fully-digitally-guided surgery was planned. This consisted of utilizing three surgical guides. Starting with the fixation pin guide and continuing with the scalloped hard and soft tissue reduction guide and finally, the implant placement template. Following the surgery, the patient received a temporary restoration and on the 4-month follow-up, a new poly-methyl meta-acrylate temporary prosthesis was delivered. The patient's 7-month follow-up is presented in the paper. The report of this triple-template guided surgery indicated that digital 3D planning is a considerably predictable tool to properly establish and evaluate future occlusal plane, smile line, and lip support. Scalloped guides seem to be an excellent alternative to conventional bone reduction guides since they require less bone removal and improve patient comfort during surgery.

A case report of improvement in stability of dentures and lip support by increase of occlusal vertical dimension

A case report of improvement in stability of dentures and lip support by increase of occlusal vertical dimension

ORAL REHABILITATION IN A TOTAL EDENTULOUS PATIENT WITH INFLAMMATORY FIBROUS HYPERPLASIA: case report

Inflammatory fibrous hyperplasia or fissured epulis is a very common lesion in patients who use maladapted removable prostheses. It consists of a connective tissue overgrowth as a response to constant trauma in a specific area. Clinically, it is presented as an exophytic process or a well-defined elevation. It is generally, sessile-based and asymptomatic. Its consistency varies from firm to flaccid, with smooth surface or occasionally ulcerated, and its color is similar to the adjacent mucosa or erythematous. The most recommended treatment is surgical removal, however there are other methods such as cryotherapy, micro-abrasion and laser therapy. The aim of this work is to describe the stages of diagnosis and treatment, from the surgical technique for removing inflammatory fibrous hyperplasia to the patient's rehabilitation, with new prostheses. This is a case report of a 79-year-old female patient who attended the clinic at Faculdade Patos de Minas (FPM) reporting dissatisfaction with the loss of lip support and the aesthetics of her complete denture prosthetics. During the clinical examination, a nodular tissue growth was identified in the bottom region of the anterior maxillary vestibule’s sac. As a proposed treatment, an excisional biopsy was performed, confirming the diagnosis of inflammatory fibrous hyperplasia through histopathological analysis. After healing, new prostheses were produced, intending to meet the patient's requirements. The present study is expected to emphasize the importance of a thorough clinical examination, so that all changes in the patient are identified and, when necessary, perform a biopsy and histopathological analysis. In summary, it is essential to adjust or produce new prosthetic parts to prevent tissue trauma or cause negative consequences. The patient's postoperative period was uneventful, with favorable healing, and after the new prosthetic devices were put in place, function and aesthetics were restored.

Caregiver Experiences of Feeding Instruction for Infants Born With Cleft Lip and/or Palate

Purpose: The purpose of this pilot study was to attempt to describe how feeding education was provided to a group of caregivers of infants with cleft lip and/or palate and how they viewed the feeding experience. Method: Participants (n=5) were recruited from two Facebook support groups, Cleft Lip and Palate Support Group and Cleft Mom Support. The data were collected using Qualtrics™ software. The questionnaire consisted of eight demographic questions and seven topic-specific questions. The demographic questions included the exclusion and inclusion criteria. The participants of this study were required to be an English-speaking parent or a caregiver of a child under one year of age with non-syndromic cleft lip and/or palate. While six participants qualified, only five continued on to complete the topic-specific questions. Results: Four of five participants reported receiving feeding education from a speech-language pathologist, and all reported being provided follow-up care in regard to feeding. Three out of five participants mentioned the use of specific bottles in regard to the feeding education they were provided. Three out of five participants also described using Facebook support groups to acquire additional feeding information. Conclusion: This study helps to clarify the importance of speech-language pathologists’ role in cranio-facial teams as providers of feeding therapy to infants born with cleft lip and/or palate.

Determination of Labiopalatal Angulation of Maxillary Anterior Teeth Using Manual Method and Digital Methods: A Comparative Study.

The aim of the present study was to evaluate labiopalatal angulation of maxillary anterior teeth using Custom-made jig, Profile projector, and ImageJ computer software methods. The subjects for this study were selected in the age-group of 20-30 years having permanent dentition, including 2nd molars and bilateral Angle's class 1 molar and canine relationship. Recording the labiopalatal angulation in proximal view was carried out by using one manual method and two digital methods namely using Custom-made jig, Profile projector, and ImageJ computer software, respectively. Alginate impressions were made for the subjects, and the spatial relationship of the maxilla to the cranium was recorded using a facebow. The casts were mounted in a semi-adjustable articulator, and the articulated mounted casts with the mounting ring were transferred to the Custom-made jig, and angulations were measured in proximal view. Digital methods of measurement were recorded by using Profile projector and ImageJ computer software methods. Data were tabulated and statistically analyzed. In males, the mean labiopalatal angulation of maxillary right and left maxillary canines of Custom-made jig was 91.94 ± 1.47 and 91.70 ± 1.68, in Profile projector method 87.41 ± 3.75 and 87.58 ± 3.79, and in ImageJ computer software 84.23 ± 5.72 and 83.29 ± 6.74, respectively. In females, Custom-made jig was 91.82 ± 1.55 and 92.17 ± 1.84, in Profile projector method 86.70 ± 5.58 and 86.94 ± 5.57, and in ImageJ computer software 82.76 ± 6.34 and 83.05 ± 6.12, respectively. There was a very high statistically significant difference found between different methods. In conclusion, the values obtained in the digital methods (i.e., both the Profile projector and ImageJ computer software) were more accurate than the manual method. However, the ImageJ computer software was most reliable in comparison with the values obtained in Profile projector. The labiopalatal angulation of anterior teeth will act as a guideline in re-establishing the correct angulations and the anatomic contours of the maxillary arch to achieve the desired esthetics that provide adequate lip support and to restore the required functions.

Is Incisive Papilla a Good Landmark to Predict Clinical Outcomes and the Esthetic Perceptions of Edentulous Patients Treated with Implant-Supported Fixed Prostheses on Maxillae?

Purpose: To investigate the effect of incisive papilla on esthetic ratings and lip support for patients who are treated with implant-supported fixed prostheses on edentulous maxillae. Materials and Methods: A study population of 118 patients with maxillomandibular edentulism was identified. A self-administered questionnaire was used to evaluate treatment outcomes through a patient perspective. Also, clinical factors such as smile line, maxillary resorption, incisive papilla position, and lip support were evaluated. Results: Lip support has a significant effect on the facial esthetic scores of patients, while smile line and incisive papilla localization have not had a proven statistically significant effect on esthetic and facial esthestic scores of patients treated with implant-supported fixed prostheses on maxillae. Conclusion: Although the patients were diagnosed with disadvantageous clinical factors such as crestally localized incisive papilla, they still noted higher esthetic scores with their fixed prostheses. Factors that affect the esthetic perception of patients or their priorities should be investigated more to understand the reasons for patient satisfaction with prostheses.

‘Pillow technique’ to improve lip support in the context of zygoma implant rehabilitation

This study proposes a simple, off-the-shelf ancillary method for application in the dental rehabilitation of severe maxillary atrophy with zygoma implants, allowing simultaneous improvement of lip support in cases with a moderate lack of premaxillary projection. Three consecutive patients with an atrophic maxilla were evaluated retrospectively. All were treated with a fixed rehabilitation over four zygomatic implants and the pillow technique. The study variables included radiological assessment of the premaxilla volume, upper lip and perinasal soft tissue changes, clinical complications, and subjective evaluation of functional and aesthetic patient satisfaction based on a visual analogue scale. All of the zygomatic implants showed osseointegration. The survival rate was 100%. The immediate postoperative course was uneventful, and no surgical complications were noted at the follow-up visits. Radiological assessment of the premaxilla volume enhancement showed a final mean skeletal projection improvement of +9.4 mm, while the nasolabial angle decreased an average of + 0.6 mm. On the other hand, only small changes in nasal width were detected. Patient satisfaction with the functional and aesthetic outcomes at the 1-year follow-up was excellent. The pillow graft is an easy-to-handle technique that can be included in the armamentarium for moderately incrementing the maxillary sagittal dimension and enhancing lip support in the context of zygoma implant rehabilitation.

The Impact of The Labial Flange and Artificial Teeth on Lip Support in Elderly Patients with Maxillary Complete Dentures

Both maxillary complete denture’s labial flange and anterior artificial teeth play important roles in re-establish major support for the upper lip of elderly patients. However, whether the labial flange can be removed and still perceived as aesthetic remain unclear. Objective: To determine the perception of young adults toward the effect of a labial flange and anterior teeth on lip support of an elderly with maxillary complete dentures. Methods: A total of 64 young adults were recruited to evaluate the lip support for facial aesthetics of 30 full-face photographs in 3 different states: with an original complete denture (CD), with a flangeless duplicated denture and without the complete denture. They were rated using a Visual Numerical Scale (VNS) of 10, with 1 being the least attractive and 10 being the most attractive and repeated twice in random order. Soft-tissue profile analysis was performed to determine which facial anatomical landmarks were most important for lip support and aesthetics. Results: The overall VNS rating with CD (6.33 ± 0.58) was significantly higher (p < 0.001) than images with flangeless (5.58 ± 1.01) or without CD (5.23 ± 1.30). The landmarks that showed the most significant changes were in the subnasale area and NLA with original CD (p=0.060, p=0.072) and in frontal lip thickness with flangeless (p=0.082). There are strong correlations between subnasale and NLA and the mean total aesthetic VNS rating of images with CD, but not statistically significant (r=0.708; p=0.118, r=-0.835; p=0.078). Conclusion: The labial flange of a maxillary complete denture plays an important role in lip support and results in the aesthetic perception of the dentures wearer. The anterior teeth alone provide fullness to the lips, but not enough for labial support.

Restoration of Hybrid Prosthesis for Misplaced Implants – A Case Report

An implant-supported hybrid prosthesis is an acrylic resin complete fixed dental prosthesis and supported by implants might be a solution in extreme cases that the need of the restoration for esthetics, function, lip support, and speech. This clinical report aims to present the esthetic and functional prosthetic rehabilitation of a borderline case with implant-supported hybrid prostheses. A 31yrs old female patient was referred to the department of prosthodontics for rehabilitation of angulated implants. The intra-arch dimension of the patient was excessive and an insufficient peri-oral soft tissue support was observed. The clinical and radiologic examinations showed satisfactory implant health. After 3 years of follow-up, no functional, phonetic, or esthetic problems with the restorations were noted. This case reports suggest that implant-supported hybrid prostheses can be a reliable alternative treatment procedure when a porcelain-fused metal fixed restoration does not satisfy a patient's requirements for esthetics, phonetics, oral hygiene, and oral comfort.

Rehabilitation Of Anterior Maxillary Hypoplasia With Cleft Palate Using A Selectively Hollowed Complete Removable Prosthesis – A Case Report

Cleft palate is a congenital facial deformity that presents clinically with anterior maxillary hypoplasia, congenitally missing teeth, nasopalatal communication, anterior openbite and a constricted maxillary arch. Aesthetic and functional rehabilitation of cleft palate patient requires the use of a prosthesis that provides adequate support to the lip and reduces the problem of nasal regurgitation. This article describes the fabrication of a removable prosthesis that has been modified anteriorly by providing added thickness to the labial flange so as to increase the lip support. This flange has been hollowed out to reduce the weight of the prosthesis and also provides comfort and ease of use. The palatal plate evades nasal regurgitation and improves speech.

Interarch space assessment in edentulous patients rehabilitated with complete removable dentures using open-access software.

BackgroundThe interarch space is defined as the vertical space between the edentulous ridge and the occlusal or incisal aspect of the opposing arch. Measuring the interarch space in a patient requiring an implant-supported fixed prosthesis is crucial for determining the prostheses to be used in each clinical situation. Depending on the measurements and other factors, such as the need for lip support or pink esthetics issues, decisions about the most convenient type of implant-supported prosthesis can be taken. Analogic workflow to measure the interarch space can represent a time-consuming and expensive procedure that may lead to inaccuracies. ObjectiveTo describe a step-by-step protocol to measure the upper and lower interarch space with open-access software, starting from the digital scan of the patient's complete dentures obtained with an intraoral scanner. MethodsAn extraoral scan (using an intraoral scanner) of the existing complete removable prosthesis is required to assess the interarch space for making an implant-supported prosthesis treatment planning. If the existing complete denture does not fulfill the required functional and esthetic parameters, a complete interim denture, a wax trial denture, or a printed denture prototype should be previously fabricated. The antagonist arch and the intermaxillary record scan also need to be obtained. Finally, all STL files are imported into an open-access software for measuring the interarch space. ResultsOpen-source software can be used to measure the upper and lower interarch space from existing complete dentures following the step-by-step protocol outlined in this paper. ConclusionInterarch space of edentulous patients rehabilitated with complete dentures can be measured with a 360 degrees scanning of the existing complete denture and open-access software by applying the protocol outlined in this paper. Clinical relevanceThe clinician can assess and digitally measure the interarch space of edentulous patients requiring an implant-supported fixed prosthesis using an open access software.

Assessment of Mesiodistal Angulation of Maxillary Lateral Incisors: A Cross-sectional Study

Introuction: Idealistic prosthodontic treatment goals differ for different ethnic groups around the world. Dentogenic concept provides a quality of treatment and a more natural, harmonious and pleasing prosthesis as desired by patients. Providing natural and satisfactory aesthetics is especially important for anterior tooth prosthesis. Various degrees of crown angulation, have significant effect on attractiveness of smile. Aim: To study the degree of mesiodistal angulation of maxillary right and left lateral incisors in both genders of different age groups, to guide in the arrangement of teeth fulfilling the fundamentals by providing a functionally and aesthetically satisfactory denture. Materials and Methods: This cross-sectional study was conducted in Department of Prosthodontics at College of Dental Sciences, Davangere, Karnataka, India, from June 2012 to May 2015. A total of 500 patients with normal maxillomandibular relationship (250 males and 250 females) were included in the study and were divided into three age groups i.e, group A (21- 30 years), group B (31-40 years), group C (41-50 years). Clinical examination of patients was performed and dental casts of these patients were studied. A custom-made positioning jig was used to measure the mesiodistal angulations of maxillary right and left lateral incisors. The results were obtained by statistical analysis using paired-t test, One-way Analysis of Variance (ANOVA) and Tukey’s Post-Hoc tests. Results: The mean value for mesiodistal angulation of maxillary right and left lateral incisors in males was found to be 6.648±0.9889 and 6.704±1.0042 degrees, respectively. The mean value for mesiodistal angulation of maxillary right and left lateral incisors in females, was found to be 6.592±0.8296 and 6.580±0.8381 degrees, respectively. Conclusion: The mesiodistal angulation of maxillary lateral incisors was comparatively greater in males than in females and the variation in the angulation was slightly more for maxillary left lateral incisors. The values for mesiodistal angulations of maxillary lateral incisors can serve, as guidelines for the arrangement of teeth and help in achieving desired aesthetics, provide adequate lip support and restore required functions.

A Prosthetically Driven Approach for Immediate Dental Implant Reconstruction of a Maxillary Free Fibula Flap with the Aid of Virtual Three-Dimensional Planning and Intra-Operative Navigation

Objective: To describe a prosthetically-driven reconstruction of an edentulous atrophic maxilla and mandible using 3D surgical planning and intra-operative navigation. Methods: A twenty-eight-year-old male presented for reconstruction with fixed dental prostheses after a gunshot wound caused severe atrophy of the jaws and nasal deformity. His dentition was non-salvageable with insufficient maxillary bone for dental implant placement. To restore his midfacial deformity, reestablish upper lip support, and provide adequate bone, his maxilla was reconstructed using a free fibula flap. Dental implant placement is dictated by the planned prosthetic tooth position, and therefore the design of the maxillary reconstruction considered the necessary prosthetic space and the location of the planned prosthetics via Virtual Surgical planning. Intra-operative navigation confirmed the correct placement of the flap using surgical probe guidance. Results: Using our precise and prosthetically driven method, we were able to place dental implants to support fixed dental prostheses and correct the skeletal deformity in a single surgery. Conclusion: Traditional dental prosthetic design principles were applied to optimize functional and esthetic outcomes in a complex case of simultaneous maxilla-mandibular reconstruction. The use of 3D surgical planning and intra-operative navigation allowed us to shorten the treatment time providing a predictable and accurate outcome.

Workflow for complete dentures fabrication in three appointments: A dental technique

This technical report describes a novel workflow for complete denture fabrication designed to abbreviate the necessary steps for dental prostheses delivery by using a 3-appointment protocol in which preliminary impressions are made in the first session together with the registration of maxillary lip support, occlusal plane, and reference lines for tooth arrangement. A trial denture is fabricated with conventional or computer-aided design and computer-aided manufacturing procedures and is evaluated in the second appointment for esthetics, the definitive impression, and the maxillomandibular relationship record to provide precise references for definitive denture fabrication.

Clinical Evaluation of Surgical Orthodontic Procedure with Bone Grafts for Patients with Cleft Palate during Adolescence

Background: Cleft lip and palate is a congenital anomaly, presenting in a wide variety of forms and combinations. Successful cleft lip and cleft palate rehabilitation requires a multidisciplinary approach employing the skills of different specialists.
 Aims & Objectives: The aim of this paper was to present orthodontic preparation of patients prior to alveolar bone grafting & to review our findings in a group of patients treated by secondary and delayed bone-grafting procedures at our institution.
 Methodology: Thirty eight patients were examined for the type of cleft and the age at the time of examination. 10 patients were treated in our institution with presurgical orthodontics & operated by a delayed bone-grafting technique. Duration and type of expansion was noted at pre-operative, 2 months and 6 months. Crestal bone heights and the quality of the bone in the grafted areas was examined radiographically, along with presence of any fistulas.
 Results: All the patients demonstrated improved alar base and upper lip support, also better dental stability was seen in the region of cleft.
 Conclusion: All the patients included in this study appeared to benefit from the procedure with improved facial balance. In all ten patients the oronasal fistulas remained closed, hence was reported to be a success.

Morphometry and displacement analysis of the upper lips following maxillary full-arch implant-supported fixed prostheses: a 3D morphometric study

BackgroundWith the emergence of three-dimensional (3D) integration technology, analysis of soft tissue displacement and morphological changes after maxillary full-arch implant-supported fixed prostheses can be performed. The aim of this study was to verify the feasibility of the 3D integration method for constructing the relative position of the prostheses and facial soft tissue, evaluate the displacement and morphological variation of the upper lips after maxillary full-arch implant-supported fixed prostheses.MethodsTwenty-five maxillary edentulous patients were recruited in this study. At the time of final prosthesis delivery, the 3D prostheses data and three 3D facial profiles were integrated. After method validation, the 3D position changes of seven soft tissue landmarks were used to reflect the 25 upper lips. The variation of four morphological distances were analyzed to reflect the morphological alteration of the upper lips. Two pairs of dentofacial landmarks were used to analyze the sagittal relative position of the prostheses and soft tissue. The included patients were also grouped to determine the impact of sex, upper lip thickness, and length on lip support changes.ResultsThe average distance of the two matched relative reliable forehead regions was only 0.32 mm. The sagittal shifts of labrale superius (LS), stomion (STO), crista philtri left (CPHL) and crista philtri right (CPHR) were 3.44 ± 1.39 mm, 2.52 ± 1.38 mm, 3.04 ± 1.18 mm, and 3.12 ± 1.21 mm, respectively. With the exception of the decrease in the length of subnasale (SN)-LS, the length of cheilion right (CHR)-cheilion left (CHL), CPHR-CPHL, and LS-STO significantly increased. The two pairs of dentofacial landmarks had strong positive movement correlations along the sagittal direction. Patients with thinner and longer lips showed more lip support than those with thicker and shorter lips by a clinically insignificant amount.ConclusionsThe integration method of 3D facial and dental data showed high repeatability in constructing the dentofacial relative position. The linear equations reflecting dentofacial relative position could aid clinicians in evaluating the restoration effect and estimate the upper lip variation.

Treatment of Skeletal Class III With Extraction And Standard Edgewise: Case Report

Objective: This study was determining the skeletal, dental, and soft tissues changes is respons to camoflage Class III treatment. Methods: A male patient 14 years, 10 months with malocclusion of dental Class I and skelettal Class III, included crowding and crossbite anterior, overbite 3 mm, overjet -1,5 mm, maxillary midline shift to the right 2 mm and mandibular midline shift 1 mm. Treatment was extraction of maxillary and mandibular first premolar with standard edgewise appliance and retention of hawley retainer. After of treatment, correction of the crowding, crossbite anterior and midline, with dental relation class I, normal overbite and overjet is 2 mm. Results: This case is Angle’s class I malocclusion where sagittal interarch relationship is normal, it is preferable to extract in both the arches in order to maintain the interarch relationship, so was that extraction of the right first premolar of maxilla and mandibular. Conclusion: Careful management of the extraction space preserved normal lip support and facial profiles

Prosthetic rehabilitation of an adolescent with ectodermal dysplasia utilizing multidisciplinary approach: A case report

Ectodermal dysplasia (ED) is a hereditary disorder characterized by abnormal development of two or more embryonic ectodermal structures such as skin, nails, teeth, hair, eyes, and sweat glands. The main oral manifestations of ED include oligodontia, malformed teeth and, deficient alveolar ridges. Inheritance of ED is X-linked and expressed typically in males. This case report explains a multidisciplinary treatment of a 16-year-old adolescent suffering from ED with underdeveloped premaxilla, underdeveloped alveolar ridges, retained deciduous teeth, and thick fibrous frenal attachment. Prosthetics rehabilitation was done using removable cast partial dentures with lip support. It also enumerates the important role of a multidisciplinary approach in dental treatment, helping the patient’s healthy transition from childhood to adulthood. Dental professionals should be able to identify the oral features of ED and provide proper oral care (as early as 3–4 years) to restore the oral functional demands and esthetics.

Fixing the Removable: A Case Report

Various treatment options can be planned for a completely edentulous patient including implant fixed and removable prosthesis. But, the trident factors: mastication, phonation and esthetics should be given prime consideration while doing any dental procedure so as to achieve good prognosis. Though, prognosis dependsmajorly on the underlying residual bone as well as the mucosa,which helps the prosthodontist to determine the choice of a suitable prosthetic treatment option for a particular patient. Various studies over the past decade have shown the advantages of a mandibular implant overdenture rather than conventional denture - as the first treatment option for a completely edentulous mandible. An implant supported hybrid prosthesis is an acrylic resin complete fixed dental prosthesis and supported by implants might be a solution in extreme cases that the need of the restoration for esthetics, function, lip support and speech. Therefore, this clinical report aims to present the esthetic and functional prosthetic rehabilitation of a mandibular ridge with implant supported fixed prosthesis.