Root Supported Over Dentures

8/2/2019 Root Supported Over Dentures

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James Pavlatos, DOS

Root-supported overdentures

This article provides

dentisls with an

overvlew 01 sorne

melhods and tools to

9< 1s ur e s uc c e ss with

root-supported

overdentures.

10 CDS R f .\ 'I Ii\ \' , ' ' ' 1 1 1 1lJ')tl

M~;ui('m~ wlth c:OnlJlku- tkllllll'\ .....are di.»;tlhfi('(! with the limit('d

rt"'IC'nllon 1100M.lbllu)' ot Ilwlr r~hc:tk:'1 Rapkl d(,lef'iorgtion of dK':¡J,·C'OIu

r i .¡~he' 'o()\U'CC: orlhe pl'óbkm \ 'c :nk<tl bcoe in me cd<'mu-

k)u) nundibk dncrior.no JI an I\Yf\IJt(' ann\d;1 rate Q , 01 mm ro O.~mm. In II

6'\"( ' . , . .01 ' pcñod. ltK bone jo...... H e ~ .. \ n1m '

The rcot-aupported overdentureItoot--suppon.t"d O"'n\XntUl'b nn ,aI\<, lhe probInm ~ b) .m cdrmt~

mmdiibk and nwdlb Tbb ;th('tNIIH 10C"rA"tKHt .&nd compklC' dalI~ ,.iD

~ d IC ' p.ulenf;, memion. 'iMJ¡¡I,,)llOd~.)ol."K"Cro dcnlUK ~I.

II,.iD~ peeerve d~ aht'Obr ~ """-1 ptncnl 00nc lose,

P('rlodonl~ ~t;ltUli..('ndodonck. polenU" I. pmhkm c;-oln«kntloo) aOOerarhygll(l)(' rnlbt be' ~-¡¡J~t('d wben _«Ih ..re "Ck\_ltN for w.t" u O\~rde:n(U~ abut·

mcnb.2 Long,-(C'rmI~riodonul ~II-<."C dvc.. nOI prttludC' mo~ paueees r r o mbdng c.1ItWJkbte.. fm rool·~.uPPU"ICll uH."1'\knhlrt" ....~ QÍ (('('Ih (roro pc.-r iodon-

•' lal dll<'.l.M' b u n e- u f che n u lo r rl." .I ~ )I l_ , (u r 0\ ...'\knlUI'O,

h Is tmpcrtam ro M'leel a I"Clalllahk ..bulmCfII tooth lh.:utus a hcaJth)' pcrt-

odomat prognQlob. l)erl(klul\llIl 1 r ~ : ;¡ II U C f U 1 1 1 < 1 "be reqaíred 1 0 retaín tI:('lh to rabuunems. 111Cmo r e rom :-I11)rMlrlCI,I" bUIIC, lh.,. 11l01't'~¡r.tblc Ihe abenuem

w UJ be 1 )10:'1 pocenll:ll ahulluCnlo; 1'\'<1"1",,¡tk¡~t 6 mm u( booe suppon. 'rhc

í'~aíxumem S)" 'SIl 'm 1.. an eS"ccpll.ln to 1111. ruk. :1..' 11requíres as lillle liS' mm

o( roer suppon:

, . « t h tlw h:a\'C cXlren~ h QrbO lu :d .. nd \'('nol <W!>pbcanml 2ft:' poot cbojas

fot O\'Ctdcnlurc ablAmcnt", Tmh "¡lh :& hro,)d tund oI21tadk':d ~:I 2ft:'mon:

dtSir2h1c t.Iun IMh \\ilh nllnlnul Slllti __C J JtlOfI;I\~ F'lIUt1'lL""1lh poor o r : t ] h)~nut'il be ardull)' n'2lUJI(l(l ~ a.ndi<bl~ lo r root "oUppOno.1 O\'ttden~

i'~hC Ihl'nP) l' 1fMiiOH.'d Inlhe: r«'fUnllon o( 2ft O\'n'denIUft:' 2bu!.

nliCnLIIL"o...~ldl ( cw- «1C'ftuon ot lhe- tooe In1MaI\('Obt riel#' 2nd ~ 2 hofkr.,.

1"1{< K ee 21UChn"l('nl Tht\ \\ 111;-'10\4O\ndttlILW rt1ttuJOn 2nd q21)i~ 1

8) m:linl2inin¡: lhe n)Ol IR Il' (,RHtOnmc.onl. ~(' p~ lhe heI¡:ht oIlh~

2h rotar rid¡tt.:and lhe J'If')fInQ('C'f'lt\(' qU;lhtlC"<> ot 1MprriOdOnt:l1~menl '

\l"hcn rn'uC1ion o( II'w:(Itnia' Cl"t".Mn0tt\.I" (lO "1lhin 1 mm oIltx rid~ae.1) Ihe CrOw,,"n'W)l...Iin ¡,(h:mgt'd 10(..~or ptriO(lonUIr, jn\-of\'nI :IIbuunt'TI"

Tbc' ' lW:C'CSS()( lhe 0\ ('nJt"nIUn.' h,ku:rmlnrtl in Iht: '('ln:1iOn 01 abUlmC:nI leeth

d u rin S lh e c ,l i: lJ C OI :" '¡" "OO 1rt '<1lnM: 'n lpbnnln .; t p h ,l . .. ..



FlCORE-Swllbtd r...k

I:ltIcb.mml(1.aa,.1.es1AlKbors.I . I IC).

Posicion cOm>idet2tions ínctude

delermining ucw n'an)' loolh :IIbuI·

menes sllould b e : ~2in(."(,I, and wnerel~"y $hOuld be 10C2lcd in che :ut.h le)

creare :1 dcsir.lble O\·cr<!,:nlurc. 'rwo

~bUlltlcnlS (usuallr C:lnjncS) are che

ruost rrequentl)' used l)()Silion,~ rOr an

overdenrore. lñrct; cr four :..1)ulnu:nlS

can \1IS0 be used, "'ilh 2bullnenlS

mose commoo.ly :tddtd In lile bicu$o

pi d cr CC:nlr.d incisor rq;;ion$.'

Zaag anchor systemThe Za::ll8anchor syswm provtdes

eesenuon aOOsl:tbmty (or (uUII.ndpar-

llal demures by ulilldng non-vital

eoots o C tccth. Thc Zaag sy~'i1em: 1

deslgnC'd Icr ditcCI ptacemem tmc

Ihe 1'001 whhoot a casI copfng ( f i g 1 J .l 'W :

1). Al! ~,1&romponents (Figurt:$ 2· ')

:'Ire uniquc:ly design<:d 10 be al (h<:

lowCSI vertical hdghl possiblc. '01111

Ie)w pOint o( conncclion ensures

dc(:rcascd StresS 011 Ihe SUPI)()r1ing

Slru"o.hl.rC$:m<! mOré ncxibility with

the pl;u:cmenl and design O( dcnturc

lcelh. Thi$ ~Icm i$ big.hl)' $0«C:5,.(uI. cvc;n wilh ,he m.inimum 0011<;Supo

pon o( (he rcm:ai.n.ing dcnlilion wilh

as Hule a$ S mm o( booc renuining in

che alveolar rldge,' The :I)'Slem i$

<kmonslr.tI~d in lhe case rcports prc·

lSC':nted In chis artlde (Flguml6-22).

Saving lhe que:stlon:tbk abuttneot:s

will re(Ju<X' bont:: l o : s l I u:socb.ted w¡th

eXtt:lCclon~ :lnd malntlltn the palk:nt's

FlGt:R.P.-CIlt"lIlIle (3..1......)

(q.1..t.it ,~lloCbort.. Ifl().

nG(RJI ~ IMIt (1.1_>

(~Ztsc A nch o" " 1 11 (').

pcriodomal ligamenc ptoptloceptor

qu:tlilics. When bcoe suppon I~ tost.

the rc:duelton o( rbe (OOI.h'S struceurc10 rbe levet or gin.giva and uunzsuon

o( ehc í'.ug anchor atl:lchmem will

gtc2I1)' íoceease the prohlbility o( suc-

cess. 1'hc 7...2S anchor ts seggested

an)' limé the prognosts o( an abur-

nleot lootll is doubl(uL

1I iSr«OOlnlendéd ro save as m:.aoy

eoois : : 1 $ po6$iblé 10 PI"C$en'C: the bone

sreuceure. RC)OISwith tbe grc:atCSt sUI)-

pon lIod most desit':lble l(tCation in

Ihe arch $he)ukl be $C.I ( .occc ,:d10 recetve

the att:lcblllcnt, Two ancbors wtu

prcvíde vcr)' S:Ui$(lICIOry reeeouon

:md good ~ubilil)'.

As I wrcte in :l prevtcus 2nicle.

-Root-supported overceotores gaín

thclr "''teolion aOO~lIbllh}' (roro the:

use or aU::tetunents, .....hich are simple

conO«'tOf'll c.-on.slsdng of (Vr.'0or more

pa.n.s.One pan eonnc.'Cts lO the toO!.

and lhe other pan lOthe o\'erocnlure_

A l C 2 c . h m c m s :an:: c.la.ssUlcd a s elther

re$iliel'H Ot nonrc:sillclll. A tcslllcnt

:ttt~hme:IU is one wllt:tc: Ihe prosth-c-

~l;;:lnm()\'Cup aM dowu or \'crtica1-J)' o\'er che abutlnent as Ihe p:atient

chc;w$., 'l'li$ aUoW$ Ihe proSthcsis le)

~mcinm2ximum cont:lCt with Ihe:

0,..11mucosa, It diSlributc;S Ihe load

O\'c:r the nutc:O$.l :mc , ! dir<;<:C$ il aw.ar

(rOnl lile :Ibutmcnl. 11 is :lIso m()~1

importan e (or ovcrdcnlurc all:l(;h·

IDC,nt .s 10 h:a\'C:¡ hingins mO liOn th :u

,xrmhs me prosthcsi,s lO rotJlCC e)\'cr

lh< abulmcnt ;md aüow 8«'~tt:rdi"I:

ccmpressíon o( lhe nlUCQS2. goor-sup

poned overcemure stecnmems arresiliem-Ihe)' are n o c . soIld aed ñgid

2S Ihe: no~siUCQl 1)'J)(';5. Aluc:hrrtc:nt

roe overdemures are gcnt'nll)' ur

Inltat:ldkulu (slud) I)'P<and are ron

neceed or retaJnt:d dl.rC!'CtJymtc tb•rnx-sta.ndln.g molSo.-

"1..: í'..:l2gaoehor. 2n intraradlcubtOt stud-type subgfngh'21 untversa

hingc teSilienl anacbment. 15 nO2ppropri:ue i(2 lot:tUy rl.g:id conaec

non i$ requlred or :1 load·bdti.ng s)tcm i$ indiCJlcd.'

Inén."2SC'<I wcnr areas on both pbs

ttc males and mcut (emalt:lI' 2110

longcr 21t:lehtncnt ti(e:. 'n\e $urgic-

slainkSS SIcc.1 ~ag (enlale iS coated

wirh lilllluum nilnle, which is 11lrc

cimcs h;¡rdcr Ih:m Ihe b.ase melal.

will nOI we:ar ,li! <luid:l)' 2S Olhe

:ltt:ldunent$..

'Ole í'.lL28male pivOts in itl!<pcrnu

n('nl mcl::&Jouslng to aUow (or (u.o

don up 10 15 <kg,rec . '$ (rom :ti p:tnJk

palh o( lo~nlon and can ~ changod

In 30 S(_'( ' ()nds when ncces.sa.t)·.'The í'.aag sta.ndard male comes

1\\'0 hcightS, th<: st.an<b.rd hc:lgbl. ,

nun (tigutc 4) 2nd lhc $hon t)'pc. 2.

mm abo\'c Ihe (c:malc (FIgure ,,), nl

sh(lrt eypc is tt..-COfllOlc:ndcd (Ot sim

tions when OCdusal spaeé Lo;'cl1' lim

hed.'

Tht; Za3A fema1c cOll1es in tW

S i ¡ r . c . : s . 111e:b:tS:; ~:aIW:l:trdc..'1uJkh:l$



2.~ primal')' db.mcer a .nd an (J'\"Cf"

aD cIb.Jn(ottt of 3.8 mm, Wilb .. dcpch

o( 4.0 mm(ri.lu~ }), Alwars dete,.

Jnin,e t.bt' spa« a'\'IJb.bk in tbe root

(or Iht st.lnd.Jtd ..be Z ....a (em.aJc.

$pi« tDlhl ~ Of u«cd ".0 mm.Tbe 7~..~ mlnlo(emalc" ha) 112.O-mm

di1mcIcr and an o- C'1'~ duncru . Ion 01j.j mm, with 11depth o( 2.' mm.

Dcccnninc the ~PKc ,&u¡bbk in thet1,)Qot (ur (he miflN>he 7•u . remak.

SpIa~ nlU)C C «(U ;I,I U f" exceed j,' mm,

Th e m f n i. 7. .:o j; ( atuc:hmenl I!I av,&jbble

ro ti l ¡nló \'1:"1')' Mn1111;IIt'nl or ttm,..ll

tnctscr roou:, or non·p:ar;aUeI abur-

mce t re em ,'

Placlng thestandard-size femaleMt'uure moumed .1ud)' C'a~1310Mt'"nnine Iht' ~pa«"'Jillbk if¡ thtrOO4 tOm:a\'e lhe ~ancbtd ..a.c 7~(t'"~k. Spatt mU,1 ~uaJ or cx~.. O mm in .."1Ckh It b he-.t 10 U~ lhc

$U.Ildatd <41 ' ( ' 7.üJt (tmak ~t

po~ibJe ~C'au,c o( 11, ',ronler,Jonger Ibllng ,.ale componenl.

Obaio 0('('tUS¡J r«Ot'ds ~ initi,at-

Ing ,ooch -.rnon ~ II!) •

Complttc 1M tndodorKk iIDd pcri-

odonllc prot."C'dUI'C'i P:lnW ~uctionof the l«eh $lnlpURo the endodonrJc

tt'ch.nk¡\k :lIld aliowli bcttcr ~ 10

the arul. Ikcoron:lIc wilh contplele

rnlued(ln or ~nvll:a.l tcc,h 10 wllhJn I

mm or lhe: Slnglva (11 Igurt' 19). 'nU ,'

í ' _ . 2 : t , ¡ ' J 0~C1) drill 15M ' U ' a.canlng andcrellllell an acc,¡r;He prt'pll!"¡llon ror

lh e í ' . A 3 . f ! : rcmak wiU. ou1 Ihe' n«d (or

!IpUOI hole < F l 8 : ' 1 1 ' C 2), Drl1Ia hole 10 : adepth whcre 11 full }60-de8~e

rece.lied ~~ahcr<rltcd on lhe

ocduSlJ surfxe ol the I " O O C . 'Th.i. ,,'ilI

2S.'lUIC fIrm and accutIle oo.in@ o( lhe•

remale and f'.tdIlUIlea propcr JUlAbuDt-ln aop ptn'Cftb d r iIlin I ~

lb< Whcn ~ lIw>

ooe:- aU:.Ichme:-nt b uo.<d. m ...ke Ihe

p«p&mkIm ., panOcl 10 od.I otbc : ros".,.,.-. Th< _ ........

have 10f'oIlow I~ c.o.d Ot~

01 tbc rcnuk C'OmponC'fll \\-W tinalt the

dc=gtu ot 1 ' O C 2 I 1 O t , : a 1 r'cewm oC lhe

nule anchOr) :u)IJ CQUJd contrlbute lO

u C O S R E \ ' l I IW A I ' I I 1 11 99 8

wprcmatute ""Qf' or bf 'c . . . . . . o( lhot

m » c s . Keep in mlnd Wl m e .;maIktaire Dlf .ni.fc:mak f IUIy be: me one 10 u,.t

whee pbdng 1MZug anchoh tn

~UJCU toOC.S. Whm ~ lhe~

panUd pose ., ahandk. 11') Inl~

mcuJ fanak 10 chedt: (01 :1 pNpn' 111

'rbe Rt.Sl lUQchm.en1 w[th a p.¡.nIklpose c:an be U5a1 a.;; a gukk lor pbdn.¡t

tbc CoIJcM1tls lIIttlk":hmm1 as p.;.r.l.lJclll.)

poss ib le_ 'rbe phollng lujt ol:aJe

aDoW 'S (or ~ I«way tn par:dklbm

(1' t1qttt$) berween multlple .. ... .en.

mems. xeep In mlnd atso, IIlll tnedo$tt 10 p:lr:llJeI lhe)' are , Ihe e:L!lleru

wrü be : rc r ure p:atletu IQ t ns er t r ne•l>tQ5IhesiS.

USiI'll; che p : tr :LUel p oS t 2 11a tUlndJe,

Partia! re.u.cnon

of ,he t ee rh s imp l if le s

,he endodon,ic

lechnique and allOM

b en er "",,< ss 10

lhe canal.

Ct'.mt':nt the:-metal (cm:tlc componen!

Itlto pillee, with a slrong (('<\In t('ln.

rorced gJllSSlonomet IIke Jl 'uStIPlu.s,

Some re'slor:ut\'e dentlSI$ wlll bond

lhe recuaJe ¡nlo tlle non·vltlll rool, b\u

~lher me.lhod 15aCCf:pllllble(PI.8"re8). ihe pllr:llld poSI ",111kcep Ihe

insick: or lhe í ' . . 2 3 J . l (("""maleele:!.1l .nd

free or cement. 11 is \'el')' impon.nc

tb2t thc: r oo c sw1 a ce fU rr ou n d ln g th<'

~ (c:uWc: be tinished ~n 10 (he'

cx.act b-dor k)-...-er cJun che lop 01lb< _ (J'igwe 9), Thb wW _

lb< Zu3 nuJc ...... "'"<rÚ1I >1«>-.•0 SC3C compkuty,

Rouod oIf aod poIhb che r o o c . Alt'(XI: úom cbc' DlCUl lbngC' tO the lb-

o!iU C. ~ cbe o;posaJ dmtln ~

bcc: b abo a«'t"pubie.) Afier ~tn'l(n.,·

lng thc Z:u.g ( cmaJe : and COtuoutl~

me tln:.tl toOt. !he dc:mbt ot the dc:m;¡¡1

laboralory can peccess abe ~ den'

tuee cap male attac.hmeol inlO Ihe

O\"Mkotun:. A cbair\s idc pick~ ol1he

maJe altad1mm1 (~ mc:thod) cm

be dOoc : Wben tbe pnicnt's c:xbcia¡

pro.thob ba " 'dW i l tiQg c t c: a r&n . '

A Zu3 Imp nuJc < < < > t > I n 8 )

(J'igwe 10) ond """"" Is .- 10 < lb<Indo"", mctbod of pbclng lb< nuJc

uuduncnl3 by me dental b.bot'.uory.

" VID)1 poI,.MIo:une:- Imptession nutro-

r I , a I ~uch lb EXOML""( by ce A.nkrlca

wUl cnll)' piel; up ehe Za ag ImptcS-

.Ion m,,1o (Flgun." 11),'

1( a new cverdenwee ts bctng

nI:uk, cake a prdlmln:aty impruslon

or the eceerurcus rldge Ilnd make Il

custcm 11'1)'.1'tep2~ rbe CUSI01n lr.ay

wlth :mlllchmcnt rccesSC:5lIInd pf'Qo

Ct'C(J 10 bordc:r.mold lbe U'2)'. Take !I

\'ln)1 po l )' SdOX2t lC ' imp res s iOn or IhC '«1cm \ibis riOf,tc 2nd prep:lt'C lOJCnd

h 10 lhe dental labor:uol'}'. J I ¡ , mtul

qJt~dlult tnOdd (em1k iS used b)' the

dmu.l bbota:torr u ~ 2I 'I2Jo Iln lhe

ma~ltr ca" 10 rcpliC2le 'he Zaaa

(mu.k inthe onJ ca,itr (figure: 12).

~nip a . 'ub.sHfuce mOCld renulC '

onlOeu-him~ male,m : . t . k i n . I

..ut'C' lhcy lIIK ('C)mpkcd)- $CIted Pour

Ihe m:l~ccr(aJI. incorpor:uing chC'

modd r c m a k in :10 t':DCt duptiation

o rthc ~tlon or the 1 . a : I 3 Cmaak in

t~p;¡t!ent. PI;tCC tbe Zaag ap mlk

wllh c:cnlcring slcc\'c !nIO each modcl

fcm:l.lc IInd proceS$ mc ckntu~. 1bc

Ot'nlcringsIee\-e ls ~mo\'C'd (rom lhemak component bdore dC'liverlng

Ihc flnlshed o\'ctdcnlurc 10 1hep¡lknt (}1g~s l3-lS),~

Changing the malelNog lhe roring 2nd sutinS tools., an)ion 1~malt (2n be ~bccdin

aboul )O $«'OI'Kls ..ithout remo\itlgany aa-,iic rroca tht o."'Crdeorurc.. l'bc'

colin! lool n a s into a -Str1i,bl h:bha.ndpiCc-e : . l»i.ng :a mcdium $pCcd

quiclJy c:orc out tbc nylon m*.. 1be

nrloo l'lU J c . ..iD be corcd out. k.nin¡J o dUn bmd ol pbMic: rw.tcri;&] in t h C '

('..p. UK an c-.xplorcr to rc:movC' chc

rcm.1nhl-l b;tnd or pla)tk auterial

M"ke ~urcthc ¡mide : oC .he cap b

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ttGlll6-{Ldt),_$!·,......,....t

(_.

....U1~)_" _

___ "" lItdI -. , ... -."t,. lit... ....., 6'QI (laIIt-laIMdMn.. .~

flnu&-(l,eft) ParalId poM" (<Me

_"*"'*-I boIIIl I td l. p o s i t l O C l ol roo..

fleru Hlpl) rc.aaeIUI~

.tuldlllM'llt (~.7,a1 AIIdIon.IIIIt)ofId>

rd1. 111roob.

flGOUIle-{ld) . . , r u . . . .(--' .).f'IQ .--u " .......... , ' - . , 1 ~, ; s:I .. (GC"_""_ _)"'1IIpra--

. . . . . . . . . . . . . .

nera Il-(Ltft)WGritlGJOIdwidl ... f I o .

,d_1Ie modd Jnnllk (....,.

nGllkllHlipl) c:o.pltkCI.nl11aty

O\trllmtUft. t :l in k l ll l \ 1('11'.

flClra I--Cid) c::o.,acu.1.adDaryO 'Im kw1w ............ ~ .....

. . . . _""-ulH .... re ,'T1t'~

.......... IIIk·,......~



nctUI6--(Lcft) M '! 'kw • •" " ' - _ _ .

«»mplncfy dt:Ir ~ JNppqt in"

iqDa:mt'fll RUk' T ' h o t tnbn8 1001 iS

U S C ' d 10 pI~a ~ l. ..ug nuJof' ¡ntO

lhe fDC'tal np Inkft 11~pla«mCcnt

iNk mio tMlipoIl~ cool Tbt taf.Ing 1001 wlll hOld 'he malof' wbue

delh-mng It 10 Ihe ..I,tu Whil(' eup-

J)Ofting tbcdtt\~. u se rc rm pt't'»Uft'10MUp tbc i"tpbttmomt nWt IntO lhe

mcal ap_ JI is m edw :Uc : :a I Iy tn.uncd

in al] uncieron :md w¡U noI puII OUt

Thc 2aag m2k c:an be changro 'lC'ry

quktl}' Wilhoul :dcering the OtfJtJnlll

01 ofthe O\~tdentun:'.'

nQ.u I~-(",,)Ma ""'""

_ _ .

1'1Cl!ItIIs-(ldl) ~ mltric

rd kM bdW't' ~tk ImItnINI o r

tee .

nGl:u 19-(ltlpt) ~1"OUkCl.et'dI

1Id0000~~L

f1Q._U lO-{Ltt),.~. ......_

...... - .....(-z.,.1.d~

'"'~rJQ:UU--( .... )(mp' lC!i n.

lar O'oC1*--t';dI: .l1li

(_ a... ~

' I e uu 'U-(tJt) ConIpktcd _d.iboular

r o o c " ' . 1 I f * 1 C d "'"*"...e (Kq);IOnt

OtIMlllIAb. alkMjto)_

Case report 1An 82-)t2t'Old fcm.dC'patitnl ""21$

ft'1imaJ fo f ao impbnt C'-mudon 2nd

coruullOlhon Shc: ~ three 1l'tlXiII:lt)

(<<"Ih1bc: muiIWy kfe.sccood n..;,la

l00lh hll4J been rct'iIOfN 10 s:llislllC'o

don and Ii.td exceüem booc: suppQn.



'rhe palien,'. chic( rompl.tnt w-udl21 there \Va) :. t~'<M.Inlt bridge ond-.cmuilbt) ~I an.IM : l IAd LlltnlImh ltul l.cpc ( .&IUnf i t otr 1bc muü-bt) pa.núJ dmt'-ft llI*d ~ 011lhe

riathl (V.)pid and btrraJ and kA XC'-QOd motu t«'lh 9t'bnt th~1_-0-";(

bñdkC' would r~1I off, WCJI,IX tbe~ antJ ~ bulldup _<b f'rxtumJ-.;thin ÜK' CnJWlb. the tnaJdIb.ry par-

to o dmtu~ would no c MOlfI.n plaCe,SomeUmc.'~ :&¡»llent prclK'nl3. ror

Impl;am" :md impl:lnc teConMruC.'tk:lnand yrt ~ M . m . p l í C . ' t ~llIdon ls C\ kknl. Iu1hb c as e. em c e che m:..xIJI;u')· l g t t 1 cus -pid:md la.cerallnClllOrlMh lud emcül t t

and l luccesst\11 endOd<Huk: t reatment .

lht- SOll . io n ~ 10 C'OI'''ln ..'t 11«()m1!ll'

tiofgJ ro()lI~lwont.'dO\'a\knlurcUslng .he"C lc:c1h 10 )Uppott lhe

7~ anchor <i) ' . . . cm lmdda;.plog theSttOnd mobt C1'ClI1«1he ",tenllon

and sublllcy ~ l O ! ' ~ muilhIy

OY«dc'nIUI't. 1'bc C'Onlnl.aIn-a1 2but.ment d.Jsp tr'ItN be ~ totJw kbracc's che dup a,g;all\)l tlte.,... dls-pbcuncflt dunns ln~ 01tbe O\W,

c:knnt« allxt'lmml) .......n the cWp-- lneft'«d\< l>ndntI - mb;oIlp-toenl 01 thr: a t t~hmC 'nc . 0IiXUf'S,. ~

bl,- ('au.tlnSt d:.malC 10 Ih" :nuch,

mmtj. 1'he cwp on thc ~ mobtchus necdnI a molal rot, and bucoJ200 lingu:ll br.lclng atm~ 10 po5i1ioc'1

•che::.1t;u;hn'lC'nl&COfT'CCtly (figure 1") .

The r'f:1C'nUonW',I,f ao ftood ch;u thep:lIienl could not teftlO\l(' Ihe ma;cij.

1 : ' 11" ) '()\'er'Ócnlul'e r O f ' thrtt d:i)'~ 1 I , I ' I c : t

insenión. 11,lllI~:&c.'Ommon ¡)tQblern

wilh oV('rt1t'ntu~ p:lllcnt$ ." d lime

rnU~l bt- ~pt'nl : 1 . 1 .h(' delh'cry appOint.m m c 10 gh'c lhotoupll'""-NC'IiOM unms«don a .nd ren~1 of lhe (,,~rdcn-tUtt' Follow.up apPOlntmeOl$ arelmpenth'(' b ..'di ÑnC'c the ovaden-

lu te b su ppo nt'd by ml .aOQ) ;L CatduI~..uIon 0\"Cf lhe ncxt)"al' or-l'IIo'O

and rchnJnt the O" ' t : tOaMun : r o r anyducrq».ndet an; rDOM Importanl,

Case report 2E.xtt:tctlon$ .nd mulll.Jty and

nundil)utu compkte ck:nlUI"C:)we~t'C)~I(,k;m1 ~ ;. It~·.unl<:mpl..n rOt :a

¡().p=ar-old \\'oman. The nw..ma :..ndtbe Mandible eaeh concllncd clght

t ec th . . ~itheoere paiodonuJ probo

Icms incach 1rd'\. Thc db.lnO~bort.bc l'tlUiIa ~'2:j2..) (oIIoolo~aU'':llon

of tcctb oos. ,. 1). 15.pcriodonu.l~ 00 the l " C I I ' I li n i n J t ttttb ~ ...

5,6. 11. 12;and:l. bonc' gnIt 00 aJlC-.J:tr.lction~j,e~ ror pm. . ) íblC' (UlUle

Imptam c.-onlSldetation~. 810,(;r.am(ORTHOVITA) W'.Jj lb(dlb che bone@nIt m:uc:ri:al llnd Cytopl;¡~ (INNO-VA) 2$ the bamet membeane. 'rneexísung :¡j.!(·unh permaneru brhJjlcwss sísc rt'tain('d.In the mandlble, teern nos, 26, 2'.

23 and 20 WCfe cxtr:acecd.Perlodontal surgety wac pcr(OrlU('don the n-:mainlng (c('eh nos lit, 17. II

Complere d i'W"os is

and lTeannenr planningare mosr imporrcnu{ar rhe .uce.ss o{

Ol feTde Juur e s .

:u'ld 21, roUOwed by endodonek lhc'r",P}', '('he cec:th were decoron;ued 10

witl'tin I mm o f lhe gingl\lll Crbl :andIhe Zo~8 anchor s)'lI'cm ror o,'('rd~ft.lun,:$ \Vas bónded ¡nlO caeh rooe. 'n'e~tllJ'ld.ard<:OOlpont'QCwa8 use< ! on thcrigbt ¡md Idt cuspld leeth. whllc ,hemiJú. : l nad tmcnuo wt'f'C pluut 0fI IheflJ'$l bkuspid lttth.

A mandIbuIat l "OOI<6UpponCld O \ ' e , . .

deneutC' was consu'\.tcc«t aM jntcn.C ' d . . whkh rc : suJ l t 'd 1ft opdmJ.l I'tIc .....

oona:od~,Akbougb tbc ~ fo r thi, C2)c

d ic I l'IOl :tppe2t prombinc: al f t n c . . c a n : - -

fui diagDosis and trntment pbnnlnlb t o u B h l aboul a ~c::uI\II tOOt'MIJ)'

poned O\·d\knl~. Irb tnQI)I In.por.12ftl (Ot rcslOr1lhc denl!.)O lO loo"bq'ond tbc : c : a . s y W:l) QuI whh c : : n r . a c -

t iOn 2nd c."Oroplcc:ek,UUA:.&.: u . a 1l)CC'ttbe ncc~:and ~irQ o r ,he p;¡tknL

Conclusion1 1 M " ·denturc (att- S)Yldtomc: ean be '

e:llminatoj .. ilh t'OOI-supponcd O\tt-

dmlUf\": thenpr. Compktc ~and lrellment pbtnoioJ: are IDO)IImporunl b- Ibc ~ 01 0\"Crdcno

IUro lbtOuab cardul ~kction o C

abucmcn( l 'OCJb. tbc : ~ cm beR'Uincd uKl )labilácd. Tbb altnn;a·U"'= tteltmcnt 10 e:xt:rxtion o(mtunl

Ic:rth :and oompk1c dcntUI'Q pfU'l.ido

if,fnter rt"lention, ~u.bWty, comfon,IMpt'O\'cd functlon, ~tbctiaand pbo-ncUe, roe the ¡»tknt, 'rbts rdath't'lrshnple tcdmJquc ror fabrlcatlcn ort()m~uppCnted overdentcres 1$(':.silrwühln (he sklU k'\'d or most genenl:&ndf'alor,nh'(' dentisu. Q

i»: "~11a1(}1i In frrl'_'(J/~pmttb Ir .

IJIlkJIlft'(¡;,bU. IL "nd lHu b«on~.(~ J.'"IbJl4nd rt'SI()rotI~.,impla'"

tk1t11J.'".ftw 10}'tW1lk Is " dJ¡JIom4Io f " ' " I",~ti<itrud ~ O/Oral1"'f*I-"~ 11MMA_"'"

iOdt1yOf~ .. .,.".,.."

_·" ' . ....- .A"" "" ".r '"I"",*",O-d.fI7l111td .~O*A........ ~ofOnll/~

/)Ir " ' , . 1 O s &.uotIN~of"'"

lII/ftOb 1..pItmI S h M I ? CIN&."'¡ '*-~tO_ ....namM~o/I~t DrIfthbJ', CmtruI Dtstrla.

. " , . , . . , , 1 O o r IbanJu 2mA~ II't4

tMVndido, Ct.. amiPuul Zuepp bit"V>nt/stt und t«hrrJall s.uppcw1. mMl

J(qstrm~ 1)c+~IWJl.Dboralo?". Chicngo.wNl~", ·Cor~·AA1ttJfor bis ~

tlsr.

I,P~vl;alOlJ. MlIn~,Ubul:umpbnl~"p.po"~(WCtdWIUtU" CDS Rc\'lew 1m:90, )2<9

2.Mon'O'W KM HatIdboot 01~c

O\'ff'dmtum. SI. Loub: ~1Qsby: 1":)7-4&j Zaal,Zctl AI'IC'bor Adnnecd

Gc:MftllOn T«bniquc: prodott eau . lOS

attO .tdriq_ pamph1ru.

4~da OO.EJ»lda PL " dink1l

eoqwboII 01 tI'wn"oo~ ...me-.CoolpnIdo::..w:. f.4.c 1992;I»}c"'62.""O

5 liaI> CA. J>ra,ip cumidcnciont Ior "'"*"".tJk pMWl ~ Cunpc:adCOc ' ldn f.dut" lSJt&';XI)I,."

Documents

Root Supported Over Dentures