This section is to show you several examples of how one or multiple teeth can be restored by the help of dental implants. The individual examples are being signed with before and after photos. To start we need to classify the different available prosthesis. So you can have a better understanding of some cases we had performed.
It exists three main categories we need to distinguish for our purpose:
-Fixed prosthesis.
-Removable prosthesis.
-Fixed-removable prosthesis.
Fixed prostheses are, as its name indicates, fixed to dental implant and the patient can not remove them (though the doctor normally can). Within this category are one tooth repositions as well as multiple teeth. Fixed prosthesis are generally those most demanded for implants reconstruction, nevertheless, depending on each particular case, those can not always be the best indicated. Multiple teeth in a row are normally attached on a bridge, fixed to implants. Below several examples of fixed prosthesis are seen.
In this case, the patient is a 45 years old female with two congenital missing incisive. The patient used a removable prosthesis and she decided to have implants placed for a better comfort.
Patient with missing lateral teeth
Once implants were placed sutures were removed ten days after the surgery. The procedure to expose the implant head was performed one month an a half later and for the positioning rather of a healing abutment or a temporal crown, designed to shape the gum to grow around the future prosthesis.
X-rays with implants placed
The provisional crowns were left for approximately eight weeks before taking final impressions for prosthesis or definitive crowns.
As soon as tissues have a favorable condition, a final impression is taken with the aid of specialized components for the transference of the impression, which are connected to the analogous implants to record the implants position. The analogous implants are metal components that duplicate the exact position and the neck morphology of the implant fixings such as it is in the patient’s mouth.
Then the laboratory technician elaborated the abutments that are going to attach the implant fixing into the mouth by mean of screws. The crowns are cemented on the usual abutments.
The screws are then connected to the implants by mean of a torque value to fix the components on the implants. This preview is too important to prevent a future screw loosing.
Finally the access is sealed to the screws and the porcelain crowns are cemented.
Final photo with the crowns on the implants
The following case, images from a 35 years old patient are shown, who lost her central and lateral teeth of the maxilla. The patient wanted a fixed prosthesis with a high aesthetics. We will next show you the sequence of this treatment.
Patient that lost central and lateral upper teeth
X-ray with the implants placed
Healing screws placed on the implants
Final crowns on the implants
Rehabilitation Final photo
Here we show a patient woman that is 47 years old. She present severe periodontitis. Periodontal treatment was made. Most of the teeth in the bottom we save them with the periodontal treatment. All of the upper teeth the patient lost them because the teeth present to much movility.
Patient that presents severe periodontitis
Initial x-ray of the patient
As me mention the patient severe periondontitis and me had to do sinus lift elevations of both sides to place the dental implants.
Implants placed in the upper and lower
X-ray with the implants to placed
We had to wait 8 months due the sinus lift elevations to place a fixed porcelain prothesis.
X-ray. Implants with final prosthesis
Final results
Final results
The previous examples show that a fixed prosthesis supported by dental implants looks very natural.
There are many other ways to construct a fixed prosthesis for implants; nevertheless, the general concepts remain being the same.
Removable prosthesis is attached to implants in the way that allows the patient to remove them at any time. This means that these prosthesis are supported on implants to give them retention like they are supported on soft tissues. As it was previously mentioned, one inclines more for a fix restoration, though in certain compromising situations this type of dentures must be elaborated, that can enormously benefit the patient.
Below you can see again several examples of removable prosthesis for implants.
Here, we present a 65 year old patient, who told us that his low denture moves and hurts as he eats and speaks.
Initial photo of the patient
Four implants were placed to give him greater retention to the new denture, in addition five transitional implants with the aim that the patient could use a provisional denture during osseointegration time of permanent implants. The osseointegration time was one and half month.
X-ray with the implants placed.
After six weeks over the implants retentions caps are place to provide greater retention to the denture avoiding the movement when speaking and eating.
Retention caps placed on the implants for a greater prosthesis retention
Prosthesis with perforations for a greater retention
Final photo with the placed prosthesis
Fixed-removable prosthesis (partially fixed), are generally in a total mouth reconstruction for those patients that rather have one or both maxillas without teeth. This prosthesis is generally implant supported (with little or no tissue contact, such as a fixed prosthesis), although the patient or the doctor can remove part of the prosthesis for its hygiene, the prosthesis generally consists of two parts, a metal retentive one (some kind of bar attached to implants) that it is not movable and the other part where the teeth are, and its removable. This last one is fitted on the metallic part (connected to implants) and it remains connected to the metallic part by friction mechanisms and/or retentions clips. This is indicated in a better way on The following images.
The following patient is a 65 year old lady, who had no teeth in the maxilla and used a conventional total denture covering the palate totally. The patient wanted another prosthetic option because the denture’s palate caused her to feel nausea and also she lost food taste.
Missing all upper teeth
Seven implants were placed to make her a no palate denture, which is thinner and the palate remains free.
7 placed implants photo
These implants were attached by two gold bars to support the denture and to give greater retention.
Gold bars placed on the implants where the denture will be supported
Denture with no palate
No palate Denture with abutments for the retention
X-ray with Gold bar and low crowns placed on the implants
Denture placed in mouth without palate for a greater comfort
Final photo with the denture
Here we have another case of a 65 year old patient, who had 12 implants placed. Six of them in the maxilla to support a no palate denture and the other six in the back parts of the jaw to place a fixed cemented prosthesis.
Patient with removable prosthesis badly fit and antiaesthetic
X-ray with the 12 implants placed
Gold bars placed on the implants to retain the denture
Denture without palate for a better patient’s comfort
Acrylic Dentures without palate in mouth
Low implants left side
Final crowns placed on the low left side on the implants
Low right side implants
Final crowns placed on the low right side implants
Final photos with rehabilitation
The preview examples are a simple representation of the three different categories. It exists several ways to elaborate these prostheses with some differences from the shown ones; nevertheless, the concept remains the same. One factor to consider is that upper maxilla has to be designed according to the number of placed implants, due to the fact that the bone in the upper maxilla is not so hard as than the one of the jaw. Four to eight are considered adequate for a removable fixed prosthesis in the upper maxilla.
This patient is 59 years of age. The patient I present with severe periodontitis and most of the teeth were destroy. The majority of the teeth were conserved in the mandible. In the maxilla all teeth were extracted and seven implants were placed, to received a fixed prosthesis in porcelain.
Here we observed the bad conditions of the mouths patient.
Initial x-ray of the patient.
After two months when the implants integrate to the bone, we placed two fixed bars in maxilla where they are going to be cement the fixed porcelain prosthesis. In the jaw we observed the preparations of the teeth where the porcelain crowns were placed.
Here we show the bars in maxilla and the teeth preparations in the mandible.
Fixed prosthesis cemented to the bars in the maxilla
X-ray that shows the complete case already with the implants and the prosthesis.
Final photos with the fixed porcelain in both maxilla and mandible
