completely edentulous patient

Question 1

vertical dimension of rest

Answer 1

1) VDR - 3mm = VDO
2) head in upright position
3) constant through age

Question 2

do patients prefer fixed or removable prosthesis

Answer 2

1) fixed has more stability > mastication
2) removable is more cleansable, cost effective

Question 3

do patients prefer a maxillary implant overdenture to a complete denture

Answer 3

1) no indication to recommend to patients already satisfied with it

Question 4

who can benefit from fixed maxillary

Answer 4

1) psychogenic barriers to palatal coverage
2) gagging
3) anatomic limitations
—
1) 11-13 mm interocclusal space > bar splinted 4x
2) 8-9 > locator over 4x
*interocclusal space is from crest of soft tissue to polished surface of the denture

Question 5

manidbular complete denture or 2 implant overdenture

Answer 5

1) 10 year follow up
- increased chewing and comfort with 2 IOD
- less bone loss and
- patient satisfaction is clearly improved with 2 IOD

*STANDARD OF CARE

Question 6

2 IOD is?

Answer 6

1) implant retained, not supported
2) because it is also tissue supported

Question 7

where do we start

Answer 7

1) ALL are presented with 2IOD as the standard of care
$1000-$1500 total price
2) we compelte denture and then place implants, and then retro-fit that denture as IOD

Question 8

position of the teeth

Answer 8

1) S, F, and V sounds

Question 9

lost VDO

Answer 9

1) worn occlusal surfaces
2) loss of ridge
3) protrusion of the chin
4) is patient in centric

Question 10

VDO freeway space

Answer 10

1) VDR in relaxed position
2) VDO closed to occlusal contact
3) freeway should be 3 mm

Question 11

dual scan protocol

Answer 11

1) verify complete denture with rem pros faculty
2) use a #8 round bur to make 2 mm diameter holes, seal w pink resin
3) axium referral form and TP D036DL dual scan
- one with pt wearing, one denture on its own
4) digital workup in 3SHAPE IMPLANT STUDIO
5) send guide for fabrication D6190OD
6) surgery D6056OD
7) locator retrofit
8) may need alveoloplasty if interocclusal place is less that 8-9mm from tissue (11mm from bone)

Question 12

surgery

Answer 12

1) at 3 months, uncover the implants and place healing abutment
2) trim inside dentures so that the denture fit over the healing abutment
3) housing, insert which fits into housing, block out ring prevent bonding from getting into it

Question 13

follow up every 6 months

Answer 13

1) hygiene
2) reline
3) retentive elements wear out and come out
4) need to see these patients asap