Prosthodontic Procedures for an Implant-Supported Maxillary Full-Arch Fixed Prosthesis Opposing Mandibular Implant- Supported Fixed Prostheses

The maxillary full-arch implant-supported fixed prosthesis represents a challenge due to the structural limitations of the existing premaxillary ridge and maxillary sinus. Prior to initiating implant treatment, it is critical to consider the necessary clinical and laboratory procedures needed to obtain an optimal level of patient and clinician satisfaction. Consideration must be given to establish a comfortable, cleansible prosthesis with a stable, harmonious occlusion that also meets esthetic and phonetic requirements. A 56-year-old female presented at the Graduate Prosthodontic Clinic at the University of Alabama at Birmingham to extract 4 mandibular incisors and the left mandibular first molar, due to advanced periodontitis. Steri-Oss root form implants (3.8-mm and 5.0-mm diameter) were subsequently placed (8 maxillary and 3 mandibular). To evaluate esthetics, vertical dimension of occlusion, and anterior guidance, screw-retained fixed provisional restorations were fabricated for both arches by means of a pick-up impression technique. Cement-retained definitive restorations were constructed and cemented using an acrylic/urethane-based provisional cement (ImProv). Occlusal contacts associated with protrusive and lateral movements were adjusted and oral hygiene instruction was reinforced subsequent to insertion of the prostheses. (Chang Gung Med J 2006;29(4 Suppl):76-84)