Edentulous Maxillary Arch Fixed Implant Rehabilitation Using a Hybrid Prosthesis Made of Micro-Ceramic-Composite: Case Report
The prosthetic treatment of patients with an edentulous maxilla opposing mandibular natural teeth is one of the most challenging endeavors that face clinicians. Occlusal forces from the opposing natural teeth may cause fractures in the maxillary prosthesis and also result in advanced bone loss of the edentulous maxilla. With the presence of extreme gagging reflex, the treatment may become more complicated. This article describes and illustrates the 2-stage surgical and prosthetic treatment of a patient with an edentulous maxilla opposing natural teeth. In the beginning, the patient was treated with 4 implants and a maxillary implant-supported overdenture. The extreme gagging reflex and the occlusal forces from the mandibular natural teeth obligated the team a second stage surgical and prosthetic treatment, which included increasing the number of implants after bilateral sinus lifting in the posterior maxilla and fabricating a maxillary fixed hybrid prosthesis made of micro-ceramic composite that yielded a satisfactory result.
Figure 1. Panoramic radiograph of the patient prior to the treatment. Figure 2. The view of the impression for fabrication of the maxillary overdenture. Figure 3. The intraoral view of the fabricated Hader bar tried. Figure 4. The view of panoramic radiograph 1 year after the delivery of the maxillary overdenture. Figure 5. The view of panoramic radiograph after sinus lifting and increasing the number of implants.
Figure 6. Intraoral view of the inserted implants. Figure 7. The prepared cast showing the 7 maxillary implants. Figure 8. Try in of the tooth arrangement. Figure 9. Try in of the verification index for accuracy. Figure 10. Intraoral view of the hybrid prosthesis framework. Figure 11. Final intraoral view of the hybrid prosthesis.
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