maXillary FiXEd prosthEsis with a substruCturE/ suprastruCturE dEsign: a CliniCal CasE

Clinical Assistant Professor Joanna Kempler, DDS, MS Department of Endodontics, Prosthodontics and Operative Dentistry, Baltimore College of Dental Surgery, Baltimore, MD, USA. 3460 Old Washington Road, Suite 102, Waldorf, MD, 20602, USA. e-mail: [email protected] this article describes a clinical case in which a moderately compromised maxillary arch is restored with a fixed implant supported prosthesis with a substructure/suprastructure design. the prosthetic rehabilitation of the edentulous maxilla can be achieved using different types of prostheses, including removable implant-retained, implant-supported, or fixed implantsupported prostheses. the treatment performed is presented step-by-step. the prosthetic design is discussed in detail and compared to other types of fixed implant supported prostheses. advantages and disadvantages of this type of design are also presented. the substructure/suprastructure design is indicated when the prosthesis must replace both soft and hard tissues. although it involves multiple steps and it is costly, the substructure/ suprastructure design represents a great alternative to any removable prosthesis and provides patients with great esthetics and function.