Dental Gypsum Verification Jig to Verify Implant Positions: A Clinical Report

Figure 1. (a and b) Wear of anterior teeth on existing dentures was present due to edge to edge occlusion. High frenal attachment, lack of keratinized tissue and ill-fitting mandibular denture contributed to gingival inflammation around labially angled implants. (c) Diagnostic dentures with adequate anterior tooth overlap were fabricated to meet patient's esthetic expectations and use for surgical guide fabrication. Figure 2. (a and b) Final impression and centric relation record utilizing mandibular surgical guide against Maxillary wax trial denture. Figure 3. (a and b) Verification jig was fabricated from dental stone on the master cast. One screw in one end of the jig was tightened to stabilize the jig while radiographs were taken to verify implant positions. Tissue around implant was healing after partial thickness flap procedure to gain keratinized tissue. Figure 4. Framework was tried-in intraorally to verify the fit. The milled framework had smooth surface and lacked mechanical undercuts which were necessary for acrylic attachment. Gingival tissue around implants healed uneventfully.

Figure 5. Mechanical undercuts were created with high-speed and a diamond bur before teeth were attached to the milled framework. Screw-access holes were blocked with putty before acrylic packing. Figure 6. (a through e) Occlusal and intaglio surfaces of the completed mandibular prosthesis. Treatment result with proper teeth set up. Screw access holes were closed with composite. The panoramic radiograph confirms complete seating of the prosthesis and shows some of the mechanical undercuts within the milled framework. Figure 7. (a and b) Treatment result at 6-month follow-up. Retrievability is one of the advantages of screw-retained prostheses. Tissue around implant looks healthy. There was some calculus on one of the distal abutments which was shown to the patient and explained the importance of oral hygiene reinforcement in that particular area.