Converting a Denture to an Implant Supported Option

Vector 29

Offer the Conversion of Dentures to Implant-Supported Options to Your Patients

Implant-supported or retained dentures dramatically increase the stability and retention of a denture. Patients can speak, laugh, and eat with confidence, knowing their dentures will remain firmly in place.

This article focuses on the use of a patient’s existing denture as a scan appliance, designing an implant guide for guided surgery, and taking a reline impression through a denture.

  1. Scanning with an Existing Denture
  2. Designing a Surgical Guide
  3. Taking a Reline Impression Through a Denture
  4. Attachment Placement
  5. Patient Fitting

1. Scanning with an Existing Denture

1a. Preparing Radiographic Scans: The Existing Denture

For a fully edentulous patient, the existing denture often serves as the scan appliance. However, the suitability of the denture for this purpose is dependent upon several factors:

Fit and Seating: The denture must fit snugly without any movement, ensuring a positive seat. This is critical for the accuracy of the scan and the subsequent implant guide fabrication.
Occlusion: Proper occlusion is essential. Should the denture exhibit poor occlusion, equilibration is essential. Similarly, a denture that fits improperly requires a hard reline. A soft reline should not be used in this instance, as they can introduce errors in the scan, appearing as voids.

1b. Ensure an Optimal Fit:
Hard Reline: This method is recommended for adjusting the denture’s fit, ensuring it closely conforms to the patient’s oral tissue.

1c. Marker Placement for Dual Scans: Preparing the Denture

  • Markers and Placement: A total of six to nine radiopaque markers are recommended for this process. Markers should be placed on the pink surface of the denture, on both the buccal and lingual sides, avoiding areas that might interfere with the denture’s seating.
  • Scanning Protocol for Edentulous Patients: When scanning, it’s essential to conduct both in-mouth and out-of-mouth scans of the denture. The in-mouth scan captures the denture in full occlusion, a critical aspect for accurate implant planning. The out-of-mouth scan involves the denture alone. It is extremely important to ensure the markers remain in the same position in every scan you take.

 

1d. Special Considerations for Double Edentulous Cases

In cases that involve both upper and lower edentulous arches, the process requires a modification:

  • Marker Placement: Use a total of twelve markers, six per denture, to facilitate a detailed dual scan.
  • Scanning Process: This includes a preliminary scan with both dentures in occlusion, followed by individual scans of each denture. Ensure that the dentures are in full occlusion during the scan.

 

1e. Exporting and Submitting Scans
The final step involves the careful export and submission of scan files:

  • Single Arch Cases: Files should be named appropriately (e.g., “patient” and “appliance”) and submitted.
  • Double Arch Cases: Three separate folders should be prepared (lower, upper, and patient), named accordingly, and then submitted.

1e. Exporting and Submitting Scans
The final step involves the careful export and submission of scan files:

  • Single Arch Cases: Files should be named appropriately (e.g., “patient” and “appliance”) and submitted.
  • Double Arch Cases: Three separate folders should be prepared (lower, upper, and patient), named accordingly, and then submitted.

2. Designing a Surgical Guide

In the laboratory, the denture is converted into a surgical guide. A lab technician uses CAD/CAM software to create precision holes to integrate drill stops into the digital denture structure. Surgical sleeves are installed into the surgical guide in accordance with the chosen implant system of the clinician.

3. Taking a Reline Impression Through a Denture

3a. Removing Healing Abutments and Measuring Tissue Height: Once the implants have osseointegrated, healing abutments can be removed. Measure the soft tissue height around the implants before inserting the locator abutments.

3b. Placement of Locator Abutments: Once the area has been prepared, place the abutments onto the implants and tighten them using a hand driver. Confirm placement with a radiograph and torque to the implant manufacturer’s recommended value.

3c. Assembly and Adjustment: Place pickup impressions on the locator abutments and take a PVS reline into the denture.

3d. Impression for Laboratory: Send the denture reline to the laboratory for installation of the attachments.

4. Attachment Placement

The laboratory will carry out the reline process and return the denture to the clinic for the patient insert appointment.

5. Patient Fitting

Final Fitting: Upon receiving the denture from the laboratory, perform a final fitting with the patient. Adjust as necessary using PIP indicating paste to finalise the attachment processing.

post-img

March 20, 2024

Application of Computer Technology in Prosthodontics

Read More
post-img

December 11, 2023

Benefits and Reasons to Do a Diagnostic Wax-up

Read More
post-img

December 11, 2023

Orthodontic Treatment vs. Cosmetic Dentistry Procedures: Pros and Cons

Read More
post-img

December 11, 2023

Types of Computer-based Technologies in Dentistry and Their Applications

Read More