Dr. Mahmoud El Homossany
Full rehabilitation of upper arch
ALL CLINICAL CASES
A Female patient 60 years old presented to clinic after removal of benign tumor from the mandible. The surgeon has replaced the defective bone with a fibula bone graft. After 1 year 4 implants were placed in the graft.
Implants exposure was made and a Customized healing abutments were used because the available healing abutments were always buried under the mucosa after short period.Ti bases and PMMA were used.
Closed tray impression technique was made using size1 stock tray. Indirect transfer copings were used. Limited mouth opening was a challenge.
Verification jig was cut and joined inside patient mouth.
Cad Cam design of the bar was made and milled out of wax. Then ball attachments were added using surveyor.
Metal try in of the bar was done and passive fit was assured.
Waxed try in was made and a little over contouring was made to support the lower lip.
The misalignment of the upper teeth was a challenge, that’s why a decision to make the final denture of acrylic resin until full rehabilitation of upper arch.
Implant exposure
Impression
Healing abutsments
Verification jig
Verification jig
Splitting the jig
Cad cam design of bar
Wax pattern of bar and ball attachments
Bar on cast
Bar with ball and sockets
Before insertion of bar
Intra oral view
Intra oral view of the bar
Waxed try in
The denture
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