This 75 year old patient came to our Glasgow practice with mobile lower front teeth, chronic gum problems, poor hygiene and terminally declining lower teeth generally.
The upper teeth were relatively stable and it was agreed to focus on the lower arch.
One of the minor problems posed by this case was fitting in with his travel plans, as he spends much of his time attending to business in Toronto.
Although the patient was initially keen on the idea of a fixed restoration, all options were discussed including a removable prosthesis on locators/milled titanium bar.
During the initial stages of treatment (clearance of teeth and provision of temporary denture), it was agreed to proceed with a bar and removable prosthesis, to facilitate improved lip support and hygiene.
Four Biohorizons dental implants were placed: three 4mm and one 3.5mm diameter. These were ‘internal hex’ laserlok fixtures. This healing cap picture shows the four short screw heads in gum.
Eight weeks later the restorative phases were commenced including confirmation of the prescription for the bar using pickup pins and Duralay acrylic.
The milled bar from Leca Dental Laboratory was a first time fit as we have come to expect in these cases. Two locators were integral to the design and placed distally to improve retention.
Riders were inserted into the fitting surface of the lower denture which was nicely finished.
The maintenance in these cases is negligible, particularly when compared to those retained by gold locators which are susceptible to slight displacement beyond the most distal locator.
The final prosthesis was comfortable and required no adjustment on review at the end of May.
I look forward to seeing the patient again at the end of the year when he returns to the UK.
Hopefully then we can proceed with a final restoration for his upper arch!.