Indication 5, Case 2

Edentulous mandible

Dr Gérard AOUATE, DCD , DSO. Paris, France
Dr David TIBI , DCD. Paris, France
Mr Claude VALTIN , CDT Paris, France

Implant-retained mandibular overdentures with immediate loading on 4 ITI SLA-surface 4,1 >< 8 mm connected with a Dolder bar.

	1 A 65 year old woman is reporting to our clinic seeking implants to stabilize her dentures.

	2 A 65 year old woman is reporting to our clinic seeking implants to stabilize her dentures.

	3 Radiograph reveals a partially edentulous mandible requiring extraction.

	4 The first surgery involves the extraction of three teeth as well as sockets debridement. Edentulous lower jaw.

	5 Four 8 mm SLA ITI implants are placed anterior to the mental foramina in position 34-44. After having checked that primary stability was excellent we decided to implement immediate loading. Transfer system in place (the « snap-on » impression procedure).

	6 Occlusal view. The abutments are spaced regularly to create room to the future three riders.

	7 At the completion of the surgery, impression-taking with synOcta prosthetics. The red positioning cylinders shows the dental technician that it is the red analog that must be used.

	8 Four synOcta abutments are placed on the four analogs for transoccusal srew-retained Dolder bar.

	9 The finished synOcta bar on the plaster model.

	10 Positioning the bar matrices.

	11 The Dolder bar is delivered with the original abutments. The SCS closure srews are removed and the synOcta abutments plus the bar positioned . The abutment srews are tightened using the SCS screwdriver with a minimal torque ( by hand ). At a later date, we will use a ratchet device with a tightening torque of 35N/cm.

	12 The Dolder bar is delivered with the original abutments. The SCS closure srews are removed and the synOcta abutments plus the bar positioned . The abutment srews are tightened using the SCS screwdriver with a minimal torque ( by hand ). At a later date, we will use a ratchet device with a tightening torque of 35N/cm.

	13 The bar in situ.

	14 Symmetrical and parallel implant placement in the edentulous mandible (OPT).

	15 Periapical radiograph . The SLA surface implant is embedded into the dense bone.

	16 Cleaning the bar with an interdental brush.

	17 Note the precise fitting of the gold coping on the implant shoulder ( left implants). At nine days soft tissues are not healed.

	18 Inner surface : three riders are mounted in the resin denture base.

	19 At 8 days, the prosthetic treatment is completed . Comparison of the patient’s preoperative and postoperative situation. After 8 days when the treatment has been achieved the patient can restart eating with confidence.

	20 At 8 days, the prosthetic treatment is completed . Comparison of the patient’s preoperative and postoperative situation. After 8 days when the treatment has been achieved the patient can restart eating with confidence.