A Digital and Conventional Approach to the Rehabilitation of Totally Edentulous Maxilla with a Toronto Infrastructure Design Hybrid Prosthesis: A Case Report

Yıl 2022, , 166 - 171, 18.05.2022

Melek Sultan Kiraz , Pınar Çevik

https://doi.org/10.54617/adoklinikbilimler.1020864

Öz

Abstact: Implant treatment is performed to compensate for the loss of support, stability and retention in the treatment of partially or completely edentulous patients. In prosthetic restorations on implants, hybrid prostheses can be produced by designing different infrastructure designs with the help of digital and conventional techniques.
Case Report: A patient with a completely edentulous jaw applied to our clinic for an over-implant prosthetic restoration. In the anamnesis, it was determined that the first treatment of the patient was with a fixed implant bridge restoration, but the patient was not satisfied in terms of function and aesthetics. When the condition of the oral tissues, ridges and the position of the implants were evaluated, a hybrid prosthesis was indicated. The prosthetic infrastructure and superstructure design of the fully edentulous arch to be rehabilitated with a hybrid prosthesis was made by combining conventional and digital systems. The infrastructure design of the hybrid prosthesis was designed digitally through special software and the rehearsal materials were obtained digitally. After informing the patient about the final appearance of the prosthesis during the rehearsal stages, the permanent prosthesis was completed with the Toronto prosthesis design on the implant consisting of a metal-supported porcelain system.

Tam Dişsiz Maksillanın Toronto Altyapı Tasarımına Sahip Hibrit Protez ile Rehabilitasyonuna Dijital ve Konvansiyonel Yaklaşım: Olgu Sunumu

Öz

Amaç: İmplant tedavisi parsiyel veya tam dişsiz hastaların tedavisinde destek, stabilite ve retansiyon kayıplarını kompanse etmek amacıyla yapılmaktadır. İmplant üstü protetik restorasyonlarda hibrit protezler, dijital ve konvansiyonel tekniklerin yardımıyla farklı altyapı tasarımları tasarlanarak üretilebilmektedirler.
Olgu sunumu: Tam dişsiz çeneye sahip bir hasta implant üstü protetik restorasyonunun yapılması amacıyla kliniğimize başvurmuştur. Alınan anamnezde hastanın ilk tedavisinin sabit implant üstü köprü restorasyonu ile yapıldığı fakat hastanın fonksiyon ve estetik bakımından memnun kalmadığı belirlenmiştir. Oral dokuların, kretlerin durumu ve implantların konumu değerlendirildiğinde hibrit protez endikasyonu konulmuştur. Hibrit protez ile rehabilite edilecek tam dişsiz arkın protetik altyapı ile üstyapı tasarımı konvansiyonel ve dijital sistemler kombine edilerek yapılmıştır. Hibrit protezin altyapı tasarımı dijital olarak özel yazılım aracılığı ile tasarlanarak prova materyalleri dijital olarak elde edilmiştir. Prova aşamalarında protezin final görüntüsü hakkında hastaya bilgilendirme yapıldıktan sonra daimi protez metal destekli porselen sisteminden oluşan implant üstü Toronto protez tasarımı ile tamamlanmıştır.

Anahtar Kelimeler

İmplant-destekli diş protezi, Dental implant-kaide tasarımı, Protez tasarımı, diş

Kaynakça

• 1. Gonzalez J. The Evolution of Dental Materials for Hybrid Prosthesis. Open Dent J 2014;8:85–94.
• 2. Gönüldaş F, Yılık B. Tam dişsizliklerde hibrit protezler. Öztaş DD, editör. İmplant Üstü Protezlerin Yapım Teknikleri. 1. Baskı. Ankara: Türkiye Klinikleri; 2021. s.34-42.
• 3. Carpentieri J, Greenstein G, Cavallaro J. Hierarchy of restorative space required for different types of dental implant prostheses. J Am Dent Assoc 2019;150:695–706.
• 4. Resnik RR. Misch’s Contemporary Implant Dentistry. 4th ed. Elsevier; 2020. p.1–1267.
• 5. Gopi A. Transition of a Misch removable prosthesis-5 to a fixed prosthesis-3: From a removable to a fixed complete denture. J Dent Def Sect 2021;15:144-7.
• 6. Kim Y, Oh TJ, Misch CE, Wang HL. Occlusal considerations in implant therapy: Clinical guidelines with biomechanical rationale. Clin Oral Implants Res 2005;16:26–35.
• 7. Krishnan V, Manju V, Thampi A, Kasthuri C, Krishnapriya VN, Krishnadas A, et.al. Prosthetıc Rehabılıtatıon Of Surgıcally Reconstructed Mandıble Wıth Increased Crown Heıght Space. JPID 2021;4:148-157.
• 8. Ameri N, Alikhasi M, Rezayani V. Full mouth rehabilitation with retrievable metal-ceramic implant-supported fixed prostheses for a young patient with atrophic jaws: a clinical report. Clin Case Reports 2017;5:1531–5.
• 9. Nematollahi F, Alikhasi M, Beyabanaki E. Restoring a post-traumatic partial edentulous mandible with the Toronto prosthesis: a clinical report. J Dent Res Dent Clin Dent Prospects 2018;12:135–9.
• 10. Egilmez F, Ergun G, Cekic-Nagas I, Bozkaya S. Implant-supported hybrid prosthesis: Conventional treatment method for borderline cases. Eur J Dent 2015;9:442–8.
• 11. Wittneben JG, Joda T, Weber HP, Brägger U. Screw retained vs . cement retained implant-supported fi xed dental prosthesis. Periodontol 2000 2017;73:141–51.
• 12. Javaid A, Ritu M, Manjit B, Ajay K, Himani B. Prosthodontic Rehabilitation of Edentulous Patient with Implant Supported Hybrid Prosthesis : A Case Report. Dent J Adv Stud 2019;122–5.
• 13. Kaur H, Bhatia V, Singh M BA. Full-mouth rehabilitation of screw-retained maxillary and mandibular hybrid denture. Natl J Maxillofac Surg 2020;11:146–9.
• 14. Alghamdi A, Al-motari K, Sundar C, Jansen JA. Dental implants treatment: Clinical indications. Alghamdi H & Jansen J, editors. Dental Implants and Bone Grafts.1st edition. Elsevier Ltd; 2020. p.23–42.
• 15. Montero J, de Paula CM, Albaladejo A. The “Toronto prosthesis”, an appealing method for restoring patients candidates for hybrid overdentures: A case report. J Clin Exp Dent 2012;4:e309-12.
• 16. Mohamed S, Emarah A. Three-dimensional marginal bone loss around implants supporting metal ceramic and metal acrylic screw retained hybrid prosthesis for rehabilitation of atrophied mandible. a cone beam radiographic study. Egypt Dent J 2020;66:1687–97.
• 17. Qamheya AH, Yeniyol S, Arısan V. Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA. Case Rep Dent 2015;2015:841745.
• 18. Gönder A, Polat S, Demirdağ ED, Babayev N. İmplant Üstü Restorasyonlarda Artık Simanın Tespitinde Kullanılan Klinik Uygulamalar. ADO Klinik Bilimler Dergisi 2021;3:222–8.