Restoration Of Maxillary Edentulous Jaws With Implant Fixed Denture:A Case Report

Objective:To investigate the application of oblique and axial implants in the treatment of edentulous jaws with severe maxillary distraction and to evaluate the initial clinical outcome of the denture restoration technique.Methods:A retrospective collection of 5 cases of implanted fixed dentures was performed in the Affiliated Stomatological Center of Zhejiang University School of Medicine from 2015 to 2018,including 2 cases of "ALL-ON-4",3 cases of 6 anxial implants.According to the preoperative dental specialist examination and CBCT imaging examination,a personalized implant restoration program was developed.Intraoperative selection of 4-6 Nobel Active implants in axial or oblique orientation,CAD/CAM after 3-7 months(Computer Aided Design/Computer Aided Manufacturing)Permanent fixation of implant-supported fixed dentures with pure titanium stents combined with polymeric porcelain restorations or porcelain-fused metal crown bridge restorations.After six months to two years,follow-up was performed to evaluate the effect of denture restoration.Result:① A total of 26 implants were fixed in 5 maxillary edentulous jaws,with no implants broken or implant failure.② The clinical follow-up of 2 years showed that the alveolar bone resorption of the implanted neck was less than 2 mm,and the alveolar bone resorption of the axial implanted implant was also less than 2 mm.There was no significant difference in the clinical repair effect between the two.The evaluation was all successful.When the length of the cantilever beam was controlled at 6-14 mm,no mechanical and biological complications occurred in the early clinical observation.③ Temporary prosthesis 4,no complications such as temporary denture fracture.5 pairs of permanent prosthesis(including 4 pieces of CAD/CAM cutting pure titanium scaffold and polymerized porcelain,1 set of porcelain fused metal crown bridge),no prosthesis shedding,breaking or failure after operation.Conclusion:① For edentulous patients with severe maxillary relationship,aesthetics and chewing function,which are severely absorbed in the maxillary alveolar bone,the“ALL-ON-4”and axial implants of 6 restoration program can obtain satisfactory clinical results② In the fixed fixation of the maxillary dentition,the implantation angle of the oblique implant at the back of the alveolar bone and the control of the length of the cantilever beam are the key factors affecting the therapeutic effect.③ The implantable fixed denture with CAD/CAM cutting pure titanium stent combined with polymerized porcelain restoration or porcelain fused metal crown bridge prosthesis has good initial clinical effect and low risk of mechanical and biological complications.