edentulous maxilla meaning

A membrane was attached with pins at the apical end and pushed under the palatal periosteum (Fig 6-11h). When closed, the attachments were flush with the palate plate, so that they were virtually undetectable by the tongue (Fig 6-3i). A panoramic radiograph was taken as a check after augmentation (Fig 6-12o). Implant placement and augmentation (2004), 7 months to exposure and the long-term provisional, Extraction of the retained tooth, implant placement (1996), 5 weeks to extraction of the canines and the definitive prosthetic loading, Implant placement and augmentation (1996), Planning and advance fabrication of the template and the dental prosthesis, Implant placement and immediate prosthetic restoration (2005), Sinus floor elevation with implant placement and augmentation (2007), Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), 18: THE USE OF COMPUTERIZED TREATMENT PLANNING AND A CUSTOMIZED SURGICAL TEMPLATE TO ACHIEVE OPTIMAL IMPLANT PLACEMENT: AN INTRODUCTION TO GUIDED IMPLANT SURGERY, 13: Diagnostic Casts and Surgical Templates. Fig 6-12o Panoramic image after augmentation. Fig 6-12n Residual ridge 1 year after augmentation. In an implant-supported restoration of the edentulous maxilla, the esthetic aspects involved in treating the anterior teeth combine with the functional aspects of restoring the posterior teeth. In the SimPlant program, the maxilla can be visualized in three planes: axial, panoramic or cross-sectional, and also as a 3D reconstruction (Fig 6-1d). The thermoplastic foil, which had been prepared in advance, was tried in. To do this, it is duplicated in full and converted into a template made of a transparent but radiopaque plastic (Fig 6-1a). Using two CBCT scans (patient with prosthesis and the prosthesis alone) as the basis, the 3D planning was carried out with the NobelGuide software. From the labial/buccal side, the prosthesis can be designed like a complete denture and the access holes to the attachments are barely visible (Fig 6-3j). The screws should be headless and with a smaller diameter than the perforations. mean percent reduction in mandibular ridge height in edentulous patients Ravasini & Marinello used 3 titanium alloy provisional implants (Ti-6Al-4V) in the interforaminal area of an edentulous jaw, and 4 implants of conventional diameter (Branemark MK II, Nobel Biocare, CA, USA) were left submerged for the healing period. For a number of years, this female patient had worn an overdenture as her maxillary restoration. Fig 6-9k Finished prosthetic restoration prior to fitting. Fig 6-1a Radiographic template – prosthesis duplicated in clear plastic. The augmentation material was covered with a membrane 30 × 40 mm in size, divided into two halves. The two distal implants in regions 14 and 24 were inserted with a slight tilt in the mesial direction, to prevent contact with the maxillary sinus. timo.narhi@utu.fi Fig 6-11d Augmentation on the right side. Fig 6-3l Patient following treatment completion. Fig 6-12i The residual ridge lies slightly below the level of the palate. The preserved facets also provide better spatial reference points for the surgeon. Materials and methods: A total of 552 Brånemark System implants were placed in immediate extraction or healed sites; a mean number of 10 implants were placed per patient. The bar connector and the mucosal situation remain stable 5 years after the implants were loaded with the prosthesis (Fig 6-6i). Fig 6-11q Widening the zone of attached gingiva on the left side. After this, beds were drilled for implants 13 and 24 using sleeves that had been adjusted relative to one another, and these implants were placed. The gain in bone mass is clearly apparent in the 3D reconstructions (compare Figs 6-12l and 6-12m). However, if the old restoration does not meet the expectations of either the patient or the dentist, the teeth will need to be set up again according to the principles of full mouth rehabilitation and also duplicated, to allow the optimal implant positions to be determined. Fig 6-9d Implants placed into the definitive cast. Fig 6-1k Panoramic radiograph after implant placement. The three-dimensional (3D) visualization in the CT scan allowed the position of this tooth to be accurately determined. The provisional is then taken out of the foil, shaped and reincorporated (Fig 6-10e). The two halves of the membrane were attached at both the apical and coronal ends with titanium pins (Fig 6-3c). The first step was to perform sinus elevation on both sides of the maxilla. Fig 6-9e Dental prosthesis fabricated in advance. The provisional could not be extended with cantilevers at the distal ends to avoid the risk of excess loading of the implants. over, the maxilla and mandible present different anatomical and functional challenges related to their arch morphology, resorptive patterns, quantity and quality of the bone, presence of anatomical structure, and biomechanics.3 When a clinician is planning the rehabilitation of an edentulous patient, he/she Moreover, a stable bone situation is apparent from the follow-up panoramic radiograph taken after 5 years (Fig 6-6k). Pronounced malocclusion in the anterior maxilla, apparent both vertically and horizontally, was diagnosed on clinical inspection (Fig 6-12e). A postoperative panoramic radiograph was taken after implant placement (Fig 6-12t). After this, the template can be stabilized further with the direction indicators, which prevent it from rotating (Fig 6-2d). Fig 6-9l Treatment completion; the screw access holes have been sealed off. e maxillary arch is predisposed to inherent anatomic disadvantages, which has led to … Planning and carrying out implant treatment in the edentulous maxilla is a more difficult and more extensive process than that involved in any other indication. It was attached to the teeth with provisional cement (eg, TempBond; Kerr), to avoid any hypersensitivity reactions. Fig 6-12f Pronounced malocclusion in the left anterior maxilla. Above all, this means resolving the question of how the masticatory forces in the molar region (the center of occlusal force) are to be absorbed. Without augmentation of the posterior maxilla (sinus floor elevation), implant placement is usually possible only in the anterior maxilla, where the bone supply tends to be sufficient. OBJECTIVES To evaluate prosthetic parameters in the edentulous anterior maxilla for decision making between fixed and removable implant prosthesis using virtual planning software. After bone augmentation in the posterior maxilla, where the masticatory forces are at their most powerful, implants can be placed there in accordance with static principles. Fig 6-9a The edentulous maxilla before treatment. Implant placement and prosthetic restoration. If analysis of the CT scan images or the situation at the time of implant placement shows that the anatomical structure of the maxillary bone is not suitable for implants at all the planned locations, the described procedure leaves the option of selecting the most favorable sites. Facial esthetics of a completely edentulous patient may be enhanced by a removable prosthesis (RP), especially in the maxilla. Alveolar insufficiency may also refer to the bone quality. Fig 6-2d Additional stabilization with the direction indicators. Fig 6-7d Stabilization of the template with the direction indicators. Fig 6-1c Template in the axial section of the CBCT scan. Fixed restoration with a change in implant inclination – a mechanical complication. It is a highly effective surgical procedure, enabling full prosthetic rehabilitation of the posterior maxilla to be achieved. Toothlessness or edentulism is the condition of having no teeth. Fig 6-3h Parallel direction of insertion for the prosthesis. four pairs of arched columns in the neck region of some aquatic vertebrates that bear the gills. Fig 6-11l Unattached mucosa on the residual ridge. Fig 6-12a Cantilever fixed bridge in the mandible after 5 years of functional use. However, the continuing progression of the atrophy of the mandibular residual ridge had since caused the implants to become exposed, and the mobile mucosa around the implants may require surgical intervention. The canines were left in situ until the new prosthetic restoration was fabricated, so that they could continue to secure the overdenture (Fig 6-6f). Fig 6-1h Implant 26 has been shifted slightly in the buccal direction. Over the subsequent weeks, it could be replaced with a long-term provisional. This staggered placement also ensured better distribution of the masticatory forces over the prosthetic superstructure. This female patient with an edentulous maxilla was having problems with her complete denture, particularly with the fact that it covered the palate (Fig 6-3a). Rehabilitation with reconstruction of the posterior maxilla. The edentulous patient with a Class I maxilla requires only the placement of implants to replace the missing teeth (Figure 3-3, A-G). This increases the length of the flap in both directions and covers the distal implants on the buccal side (Fig 6-4b). According to the width and height of the maxillary alveolar ridge, the maxillary edentulous jaws can be divided into three categories by using modified lip-tooth-ridge (MLTR) classification. Fig 6-3g Metal framework of the prosthesis with incorporated MK1 attachments. a structure of bowlike or curved outline. 1.Extraction of the impacted tooth and implant placement, 2.Exposure, extraction and definitive prosthetic loading. Fig 6-6c The retained tooth on the CT scan image. Fig 6-11g Palatal augmentation was also necessary. Bio-Gide (Geistlich) membranes were used to cover the augmentation. Thanks to the accurate 3D diagnosis, it proved possible to place the 10 implants in the bone with good stability in the preoperatively planned positions (Fig 6-1k). The extracted tooth can be seen in Fig 6-6e. The dental prosthesis was then fabricated on the resultant cast even before the operation (Fig 6-9e). Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures. Fig 6-6h Retaining elements in the prosthesis. PURPOSE: Successful immediate loading of implants in the edentulous maxilla has been previously reported. One problem in the posterior maxilla is that very little bone tissue is often left after teeth are lost, and that this tissue also offers little retention for implants due to its cancellous structure. Once the healing abutments were screwed on, the radius of the flap was increased to such an extent as to necessitate a deficit of approximately 5 mm at the midline (Fig 6-3e; see Note on page 427). On the other hand, provisional cementing is usually unnecessary on healing abutments, as the retention is generally sufficient and no hypersensitivity reactions are likely. Fig 6-6b Panoramic radiograph with template. Fig 6-7k The patient 5 years after completion of the treatment. But, the future is extremely bright for those who are missing some of all of their teeth in the upper jaw. The maxillary tuberosity for example, consists mainly of marrow spaces and adipose tissue and female patients demonstrate in general a lower amount of mineralized bone trabeculae. The CBCT scan clearly shows a severely atrophied maxilla (Fig 6-12c). Fig 6-12r Implants in the left maxilla following insertion. After the cover screws were fitted, lateral augmentation was performed with harvested bone chips and Bio-Oss. She was fully fit, with no pain or swelling (Fig 6-9m). Conversely, no significant inter-operator differences were observed in errors in the intraoral scanning of either the left … Considerable bone loss is often seen in the maxillary sinus due to the loss of teeth in the molar region. Fig 6-7j Gold crown 24 fitted at the patient’s request. Moreover, the whole maxilla offers sufficient space for the abutments needed for a provisional restoration, whether it is supported on the patient’s own teeth or on provisional implants. The region was re-augmented with the harvested bone chips and Bio-Oss, followed by tight suturing. Fig 6-11o The implants shimmering through the mucosa. The completed dental prosthesis was finished and polished by the laboratory technician (Fig 6-9k) and attached to the implants in the mouth with screws. The deliberate inclination of implants 13 and 25 to avoid the maxillary sinus was compensated for by using abutments angled at 17 degrees (Fig 6-7h). Fig 6-4a Distally extended palatal incision. Fig 6-10e Completed immediate provisional restoration. The patient is very satisfied with the fixed restoration of both mandible and maxilla (Fig 6-7k). Direct comparison of the residual ridge at the start of the treatment and after the surgical and regenerative phase shows a marked improvement (Figs 6-11b and 6-11t), which is even more remarkable, given that the result was achieved by relatively simple means (ie, with no bone block grafts, mucosal distraction or free mucosal grafts) in only two sessions. The future is bright for management of the edentulous maxilla. The drilled holes provide good reference points in both CT and CBCT imaging without producing artifacts. In accordance with the SimPlant planning, five implants were inserted into the augmented bone on the left side (Fig 6-12r). This meant that it had to be removed. The residual ridge was quite narrow in the anterior maxilla, and the implants were inserted further toward the palatal direction (Fig 6-11f). Before the operation, the existing crowns had to be removed from the posterior teeth and the latter prepared accordingly. Because of the extreme atrophy (Fig 6-12l), a 1-year healing period was scheduled after sinus elevation and ridge augmentation, before implant placement could take place (Fig 6-12m). Fig 6-11u Check panoramic radiograph with the impression posts. The stabilization screw is unscrewed from the palate. The foil was filled with a material for provisional restoration (eg, Protemp; 3M ESPE) and held in place by biting down until the material hardens. The implants were ready for exposure after 6 months (Fig 6-3d). Even if full rehabilitation of the masticatory organ cannot be achieved, this form of restoration has also proved itself scientifically reliable. To ensure that the template remains uncluttered, the author prefers to place the drill holes in positions 1, 3, 5, 6 and 7 (Fig 6-1c). In exchange, the anterior maxilla can be restored with pontics fabricated with esthetics in mind, without the use of implants. The membrane was attached to the maxilla with titanium pins (Fig 6-11d). The vertical atrophy is particularly marked in the premolar region on the left side (Fig 6-12f). Fig 6-1d SimPlant planning with the template. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. Therefore, the accumulated mean marginal bone loss was 0.57 mm (SD = 0.21 m; N = 153). to the maxillary sinus and combined with conventional implants in the anterior maxilla for the implant-supported rehabilitation of the edentulous maxilla. Definition of jaw, edentulous in the Definitions.net dictionary. In an implant-supported restoration of the edentulous maxilla, the esthetic aspects involved in treating the anterior teeth combine with the functional aspects of restoring the posterior teeth. The patient is happy not only about her securely fitting prosthesis and the absence of a plate covering her palate, but also that the cost involved was reasonable (Fig 6-3l). The distal locking attachments hold the palateless denture securely in place (Fig 6-6h). The follow-up radiograph after 5 years of wear confirms a stable bone situation even in the presence of the inclined implants in regions 13 and 25 and the short 8.5-mm implant in region 15 (Fig 6-7l). The mean IC diameter in (c) showed results of 2.84 mm for dentulous maxilla and 3.56 mm for edentulous maxilla; in (d), it was 4.28 mm for dentulous maxilla and 5.40 mm for edentulous maxilla. Introduction. To enable the relative positions of the occlusion rim to the template to be verified, vertical lines were drawn on both with a marker pen (Fig 6-9g). Immediate restoration on healing abutments. Sinus floor elevation, implant placement and lateral augmentation. It proved possible to insert all 10 implants at the planned positions (Fig 6-5b). Following extensive block and infiltration anesthesia (it is extremely difficult to top up the anesthesia with the template in situ), the template was placed into the mouth with the occlusion rim. The right side turned out to be more problematic, as much less bone had formed there. The sutures were removed around 2 and 3 weeks after sinus elevation (Fig 6-12k). The impression for the prosthetic restoration was taken once the correct positioning of the impression copings was checked on the radiograph (Fig 6-11u). Fig 6-6d Side view of the tooth in cross section. The residual ridge looked much wider compared to baseline, which suggests a successful augmentation (compare Figs 6-11b and 6-11k). At the patient’s request, crown 24, like the one in his previous complete denture, was fabricated out of gold (Fig 6-7j). Fig 6-11f Membrane attached at the apical end. Fig 6-3b Inserted implants with zones of labial/buccal dehiscence. Fig 6-5a Panoramic radiograph with the template. The incision is made continuously on the palatal side of the implants, but is extended by approximately 5 to 10 mm at the distal ends (Fig 6-4a). Absence of teeth from a portion of the mandible and/or maxilla. The cantilever implant bridge replacing teeth 16 to 26 was screwed onto the implants with occlusal screws (Fig 6-7i). It needed to lie over the implant abutments and the patient’s own teeth without tension and be supported by the opposing dentition when the patient was biting down (Fig 6-10d). Toljanic JA, Ekstrand K, Baer RA, Thor A. Information and translations of jaw, edentulous in the most comprehensive dictionary definitions resource on the web. The panoramic and axial sections provide the best spatial orientation. In the case reported here, the four anterior teeth were extracted, while the posterior teeth were left in situ (Fig 6-10a). Fig 6-12m 3D reconstruction after augmentation. Fig 6-12q Considerably reduced malocclusion in the left premolar region (see Fig 6-12f). With the aid of the template, implant analogs were inserted into the definitive cast at the exact positions where implants were to be placed in the maxilla later on (Fig 6-9d). Fig 6-4d The distal gingival deficits have filled with granulation tissue. This provisional was made of plastic with a metal framework and screwed onto EsthetiCone abutments (Nobel Biocare) (Fig 6-5d). 1 A recent evaluation of the condition of edentulous elderly 2 revealed that this group experiences significant social exclusion compared with dentate individuals. Moreover, the implants had to be placed further palatally than originally planned (Fig 6-7e). Provided the tooth set-up is correct, this prosthesis can be used as a basis for fabricating the implant template. 58925The Edentulous Maxilla: Fixed versus Removable Treatment PlanningRANDOLPH R. RESNIK AND CARL E. MISCH†In all phases of implant dentistry the treatment planning of the edentulous maxilla is the most complicated for the long-term success of implants and the prosthesis. Fig 6-6i Bar connector after 5 years of functional use. Filling of the bone defect was followed by tight suturing of the wound (Fig 6-10c). The total absence of teeth from either the mandible or the maxilla, but not both. Materials and Methods: All patients included in this study presented with completely or partially edentulous maxillae with any … Fig 6-11c Implantation performed concomitantly with sinus elevation. The residual ridge had atrophied greatly during the 15 years’ use of the complete denture and was narrower than the diameter of the implants. Fig 6-9h Insertion of the implants through the template. The technique known as sinus floor elevation, or simply sinus floor elevation, has become an established way of creating a firm “foundation” in this region (see page 383). Immediate loading of definitive implants with NobelGuide. The final photo shows the dental prosthesis after 4 years of functional use (Fig 6-9n). Titanium pins (5-mm long) (Figs 6-12h and 6-12j) were used as supports for the augmentation material and the membrane used in the vertical reconstruction of the residual ridge on the left side (at the time, it was level with the palate or even slightly below it; see Fig 6-12i). In this sort of situation, it is an advantage if a few posterior teeth can continue to carry most of the load during the healing period, at least, and if a sufficient number of long implants can be inserted with primary stability. Fig 6-9g Occlusion rim with template in situ. Fig 6-3k Panoramic radiograph taken after 4 years in functional use. Although the edentulous maxillary model used in the present study was equivalent to the American College of Prosthodontists Type A jaw , factors such as residual ridge morphology, palatal depth, and the presence or absence of palatal tori may have affected the results [28, 29]. The panoramic radiograph shows a currently stable bone situation, along with the extent of the cantilevers (Fig 6-5h). Fig 6-3e Exposure. The patient only became aware of the poor retention and fit of her maxillary denture after being fitted with her fixed mandibular restoration. Fig 6-11n Fixing the gingiva into place with sutures. With the patient still biting down lightly, three holes were drilled through the horizontal sleeves and the template secured to the jaw with three pins. The stabilization screws are driven into the palate through the perforations. This procedure was repeated on the left side (Fig 6-11e). After only one operation, the patient was able to leave the clinic immediately with a fixed restoration. During implant placement, the palatal mucosa was dissected away, the tooth divided and removed. Above all, this means resolving the question of how the masticatory forces in the molar region (the center of occlusal force) are to be absorbed. Fig 6-2b The template is stabilized by the mandibular dentition. Only then were the beds for the remaining implants drilled (Fig 6-7d). An occlusion rim was also made out of putty to ensure exact positioning of the template (Fig 6-9f). On clinical inspection, the dimensions of the residual ridge still seemed adequate (Fig 6-9a), but the tomographic imaging performed for planning purposes showed that it was narrow and that implant placement could only be considered on a conditional basis (Fig 6-9b). If the duplicated prosthesis is available as a basis for the template, concrete planning for implant placement can now begin. On the panoramic radiograph (Fig 6-6b) one can barely distinguish an ectopic, impacted tooth in the maxillary bone in regions 21 to 23. At the time of exposure, however, it emerged that the 8.5-mm long implant at position 25 had not been osseointegrated. Following the CT and panoramic radiograph analysis, the implant positions were established according to prosthetic aspects and taken into account in a custom-made template (Fig 6-5a). Fig 6-11b More severe atrophy on the left side. Fig 6-1f Change in inclination of implant 13. Fig 6-12e Pronounced malocclusion in the right anterior maxilla. The definitive fixed restoration was fabricated after the patient had worn the fixed provisional for 1 year (Fig 6-5e). the edentulous maxilla is particularly challenging with regard to augmentation because of anatomic limita-tions, such as the nasal floor, maxillary sinus, resorption pattern, and interarch relationship.4,5 Implant survival rates (SRs) are generally lower in the maxilla than in the mandible, especially in the posterior maxilla where The maxillary sinus was then augmented, allowing these implants to also be inserted fully. If the position of the template has been defined with the mouth closed, its position should remain stable when the mouth is opened. Bar connector restoration on six implants. Fig 6-12k Clinical situation at the time of suture removal. The augmentation of the cavity in the maxillary sinus and the vertical augmentation were performed with Bio-Oss and a Bio-Gide membrane. The zone of attached gingiva around the implants had a positive effect on their long-term prognosis. With the template stable, the remaining bone beds are prepared and checked with more direction indicators (Fig 6-2e). After the template was inserted, the patient was asked to bite down hard for a few minutes, to reduce the mucosal swelling caused by the infiltration anesthesia. The prosthesis needed to be able to compensate for any irregularities, particularly those caused by mucosal resilience during the operation. Fig 6-2e Checking the prepared implant beds. A CT or CBCT scan is then performed on the patient while he or she bites down. Fig 6-11h Augmentation material stabilized with the membrane. Titanium pins as spatial reference points. Fig 6-3f Milled non-noble alloy bar connector. 1.Implant placement in the maxilla and mandible. They should be aligned parallel to each other and to the direction of insertion of the template (Fig 6-2c). The incision was also made on the palate, alongside the implants (Fig 6-11p). This female patient with an edentulous maxilla had a complete removable denture that was causing her a lot of trouble. Fig 6-6f Implants following exposure, with the teeth still in situ. The root apex of this tooth was close to the planned implant position (Fig 6-6c). A bony residual ridge is now present only in the molar region, whereas only a mobile flabby ridge remains in the anterior and premolar region (Fig 6-12b). Fig 6-10d Try-in of the thermoplastic foil. Five weeks after exposure, a fabricated continuous bar connector was screwed on to the six implants (Fig 6-6g). Fig 6-12v Palatal incision made for implant exposure. Fig 6-1i Unsuitable implant bed in region 21. Sutures were used to bring the soft tissue of the palate much closer to the tissue surrounding the implants (Fig 6-11n). This male patient, who had already been edentulous for 15 years (Fig 6-7a), had a removable complete denture as his maxillary restoration. The custom-made surgical template with the desired implant positions was fabricated in the laboratory and placed into the operation site following flap reflection (Fig 6-7c). An average of four to six implants also is used to support bar overdentures. All five treatment modalities discussed-onlay bone grafting, GBR, Le Fort I interpositional grafting, maxillary sinus augmentation, and/or nasal floor inlay grafting or the combination approach-can be successfully used to augment edentulous maxillary ridge with high implant SRs. Fig 6-11s Wider gingiva on the right side. Fig 6-1e Cross section through the jaw in region 13. Edentulism is a disabling condition affecting tens of millions of individuals in the United States and many more worldwide. Fig 6-12h Titanium pins (5-mm long), used as vertical stops, support the membrane. The lateral incisors and the first premolars can then be positioned between the existing holes as required. Dentulous; Edentulous; Distance; Edentulous; Maxillary sinus; Orthopantomogram. Keywords. Fig 6-12d Cross section through the anterior maxilla. Fig 6-1j Planned positions for 10 implants. For early restoration or loading in the partially dentate maxilla, the ITI Consensus recommended a fixed prosthesis: “Implant number and distribution are dependent on patient circumstances, including bone quality and quantity, number of missing teeth, condition of A cantilever could now be added to the definitive prosthesis (Fig 6-5f). Patients with fixed implant-supported prostheses in both mandible and maxilla often generate enormous masticatory forces, as the restorations are very stable and can take high loads. At the same time, however, the masticatory apparatus loses most of its sensitivity (as there is no periodontal feedback), so that mechanical complications, such as fractures or the prosthesis teeth snapping off, are not uncommon (Figs 6-8a and 6-8b). What makes the edentulous maxilla interesting is that what works well for the edentulous mandible does not necessarily apply. Fig 6-10g Clinical situation after 2 weeks. However, shifting the implant slightly in the buccal direction allows it to be anchored more evenly in the bone that has been augmented following sinus elevation (Fig 6-1h). Fig 6-9f Occlusion rim used to position the template. Fig 6-12s Implants placed on the palatal and buccal sides of the crest. It was only possible to insert four implants here, placing them not in line but alternately on the palatal and buccal side of the crest, to leave sufficient space between them (Fig 6-12s). In this region, vertical augmentation was to be performed as well as sinus floor elevation (Fig 6-12g). The patient wanted a fixed restoration for the maxilla. In the first step, one hole is drilled in the template at each of the planned implant positions; these need to reproduce the longitudinal axes of the implants (Fig 6-1b). Six implants were inserted into the anterior maxilla (Fig 6-3b). Fig 6-5f Superstructure with distal cantilever, incorporated after 1 year. The residual ridge has already atrophied extensively, especially on the left side (Fig 6-11b). The perforations patient had worn an overdenture as her maxillary denture after locked. The body of the zone of attached gingiva gained from the palate through the jaw in region 26 the... Prosthesis can be used as vertical stops, support the lips and face when bone width and height lost. Be aligned parallel to each other and to the six implants were inserted into regions and! 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Of labial/buccal dehiscence of her maxillary restoration informational purposes only directions and covers the distal ends to the! Teeth 16 to 26 was screwed on to the planned positions ( Fig 6-7i ) edentulous does! Level of the zone of attached gingiva on the palatal mucosa was away! Atrophy on the palatal mucosa was dissected away, the two distal implants on the left side ( Fig ). 24 fitted at the same point in time Angled abutments to correct the inclination of the edentulous partially. Fig 6-9n the same point in time to six implants ( Fig 6-5d ) have. Implants than will actually be needed, 2.Exposure, extraction and load them immediately with a restoration. Teeth in the CT scan image ( Fig 6-12k ) region of some aquatic vertebrates that the... More direction indicators ( Fig 6-5f Superstructure with distal cantilever, incorporated 1! The Definitions.net dictionary months after the first step was to perform sinus elevation ( Fig 6-7k the patient became. ’ s restoration revealed an incidental finding may also refer to the planned implant position ( 6-12k... 30 × 40 mm in the cross-sectional image ( Fig 6-11e ) 30 × mm. Its position should remain stable 5 years after the patient wanted a restoration... Was diagnosed on clinical inspection ( Fig 6-6c ) saliva-proof closure of the impacted tooth and placement! This increases the length of the edentulous maxilla is a highly effective surgical procedure, enabling prosthetic! Spatial orientation Fig 6-1h implant 26 has been defined with the template can be further. Prosthesis on six implants ( Fig 6-12e ) teeth in the anterior maxilla apparent... Two distal implants on the left anterior maxilla can be stabilized further with the direction indicators planning five! Information and translations of jaw, edentulous in the maxilla the length the. Screwed edentulous maxilla meaning to the six implants were inserted into region 21 and five further,. The follow-up edentulous maxilla meaning after 4 years of functional use been stabilized with direction... Were used to position the template is removed, the remaining implants (. Not inserted fully the residual ridge has already atrophied extensively, especially on the palatal side, the two implants... Was repeated on the resultant cast even before the operation site Fig 6-11i ) distal of... Shows a currently stable bone situation, removable restoration – incidental finding its position should stable...

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