Indication 5, Case 3 | ITI CENTER

Edentulous mandible

Dr. Dr. Dr. Christian Foitzik, Darmstadt (Germany)

	Model situation in the mandible at the time of prosthetic provision: Two-piece ITI full-screw implants inserted respectively in the regions 33, 34, 36, 43, 44 and 45 as the base for a purely implant-borne superconstruction.

	Specially, individually milled and distally extended one-piece bar, onto which a one-piece, easily removable - for hygienic considerations - bridge construction is attached.

	Removable bridge construction, as seen from the vestibular aspect.

	Bridge construction, as seen from the oral aspect.

	Maxillary implant position on the technical model at the time when the tooth replacement was manufactured. The implant positions are at 13,15,16, 21, 23 and 25. Due to poor anatomical relationships in the left maxilla, no other, prosthetically more favorable, position was available.

	Specially, individually milled, distally extended one-piece bar over the 6 ITI implants in the maxilla, onto which an easily removable bridge construction is attached.

	Frontal view of the bridge located on top of the bar in the maxilla.

	Removable bridge construction, as seen from the oral aspect.

	Individually milled bar after attachment in the mandible. The bar is directly screwed onto the ITI implants. Friction bars were used to improve the friction between the primary and secondary construction. The bar is manufactured in such a manner that hygiene is facilitated, and plaque niches are easily accessible for cleaning.

	Individually milled bar after it has been screwed onto the 6 ITI implants in the maxilla. To compensate for the unfavorable implant position in Region 11, the implant attachment was constructed toward the vestibular aspect, allowing the path of the bar to pass over the crestal ridge. The milled bar can be cleaned and hygiene is facilitated.

	Removable bridge construction in the patient's mandible. Due to the extensive soft tissue, the removable bridge construction could be manufactured in such a manner that it becomes rinsed by the saliva.

	Removable bridge in the maxilla. Because of the phonetic function, the edges of the bridge extend up to the gingiva in this area. With a conditionally-removable (fixed) bridge construction, there would have been considerable hygienic problems.

	Both bridges as seen from the chewing side. The width of the chewing area corresponds to the situation found in the natural bite. An extension toward the oral aspect, past the bar, was not necessary.

	Both bridges as viewed from the bar side. One recognizes the friction bars that have been inserted to improve the connection between the primary and secondary constructions.

	Final bite position of the purely implant-borne construction in the patient's mouth.

	Preoperative OPT

	Postoperative OPT