Case details
Main demands: teeth shaking, unable to chew. Want to restore mastication, pronunciation, function and beauty.
Current history: the remaining teeth in the upper jaw are severely shaken due to severe periodontal disease. The teeth are missing and patients are reluctant to wear removable dentures for long periods of time.
Examination: 17, 16, 14, 24, 25, 26, 27, 36, 35, 45, 46, 47, missing, 15, 13, 12, 11,, 21,, 22, 23, 24, 37, severe periodontal disease.
 

Oral status of patients
 
Treatment planning
Treatment of periodontal disease first restored periodontal tissue health. Selective extraction was performed by implanting 14, 24, 35, and 45 implants to stabilize the vertical height of the tooth. The extraction was followed by 11, 12, 21, and 22 extractions, with 13 to 23 fixed temporary dentures with 13 and 23 abutments, and 11 and 22 bone conditions for better dental implants.
Prior to the manufacture of 13-23 temporary dentures, 13 and 23 were treated with deliberate root canal therapy, 13 by grinding, 23 by 14, 24 by implant failure, 14 by 24, and by implanting a implant at 15 sites to increase endurance. Because of the failure of the implant in the 14 place, the bone defect is serious, so the angle of the implant is more like the buccal slope in order to obtain the initial stability.
It was hoped that the patient would implant more than one in 25, but refused because of economic considerations. Finally, with Medentika’s M-base abutment, correct the angle of the, and finally make screw retained hybrid prostheses.
 

Patient condition (further deterioration)
 

Original X ray film
 

Dental implant
 

Dental implant
 

Temporary teeth
 

Impression
 
 

Second temporary teeth and intraoral photographs
 

Second temporary teeth and intraoral photographs
 

At this point, 14 teeth because of too far outside, worried about gingivitis, change design, with two stages of internal and external links!
At this point, 14 teeth because of too far outside, worried about gingivitis, change design, with two stages of internal and external links!
 
Try on the prefabrication and occlusal design. At this point, the No. 14 tooth is externally connected.
 
Due to the established shape and occlusion, it was redesigned directly from the computer!
 
 
Using Aidite, Multilayer SHT, 30mm zirconia material make no porcelain full ceramic bridge!!
 
Multilayer SHT, 30mm zirconia material
No porcelain full ceramic bridge
 
 
Intraoral presentation after repair
 
 
After wearing take full bridge group X-ray photo
 
Analysis of technical difficulties
With the length of the tooth is too high, the general zirconia block at market ——25mm, cannot meet the needs of Case, at the same time, through the color of the aesthetic effect, so I chose to use the Aidite “Multilayer SHT” aesthetic repair of special materials.
Stability and axial changes in the lateral muscles of the tooth are also a concern.
13, 14 teeth location, bone partial lateral, taking into account the production of gingivitis, so choose the corner of the implant to make, virtually also increased the technical difficulty.
DT:Chen jiehan
Technical director, Darwin (Taichung) Dental Technology Institute
Taichung City Dental Association executive director
Chief editor of dental periodicals, Taichung
Taiwan ADT International Sculpture Competition Jury
Aidit aesthetics (Chengdu) School of education deputy chief executive.
 
Chen Yanwen (operative doctor)
Bachelor of dental medicine, Zhongshan Medical University
University of Washington advanced dental education
Member of the Chinese society of Taiwan
Member of the Taiwan branch of Asia renewable dentition Research Association