Restorative dentistry – case 3

Case overview

Replacing an unstable removable denture without implantation — lower zirconia crowns and an upper bar-retained denture anchored to the teeth.

• Starting point: A 64-year-old female patient did not find her removable denture stable, so she wanted a new restoration but did not wish to undergo implant placement. She had previously received an implant that had not been placed according to professional standards, so it had to be removed.
• Treatment plan: We planned zirconia ceramic crowns on the lower teeth. The upper implant had to be removed because part of it had entered the nasal cavity. Since the patient did not want a new implant procedure, we planned a removable denture stabilised with the existing upper teeth.
• Course of treatment: After preparing the lower teeth, we made metal-free zirconia ceramic crowns for every tooth. We then removed the implant from the upper arch along with a wisdom tooth that had remained in the bone. During surgery we prepared autogenous bone graft material from the wisdom tooth and used it to fill the site of the removed implant — faster healing, preserved bone volume, and a more favourable base for later implantation as well. She then wore a temporarily cemented restoration for 3 months. After 3 months a denture that could be retained with attachments on the remaining teeth was fabricated.
• Treatment outcome: The patient’s bar-retained removable denture is stable; the attachments hold with a precise fit — so she can chew and use the completed restoration without compromise.