When black or white is not the only solution Part 1

Page 1

14 april 2015

telescopicimplanttreatment

■ When black or white is not the only solution

– a telescopic implant treatment: Part 1 By Ulrich Heker, DTM Educational aims, objectives and outcomes ■ Educational aim: – to illustrate via a real life case study how multiple technologies can be employed to achieve a patient’s desired result ■ CPD outcomes: – to gain an overview of the specific issues that prevented the use of a standard approach to treatment – to illustrate how a team approach to a problem can achieve an ideal solution – to gain an understanding of the practical implications and techniques used to achieve a completely detachable prosthesis based on telescopic implants

Dentists are often faced with situations where black or white, prosthesis or implant, is not the only option. This is a case study of a telescope implant treatment (Kennedy Class 1) in the upper jaw of a female patient. Ulrich Heker (Master Dental Technician) describes the treatment of a UK patient with a completely detachable prosthesis based on telescopic implants, combining the best of both technologies to provide an optimal solution for the client at a reasonable cost.

(T = telescope with implant; x = missing)

the

technologist

Case history The patient presented a unique challenge for the dentist. The 55-year-old female had worn a classical gold/gold telescope prosthesis for many years. The original elegant work had evolved over the years through repeated extensions and relining. Finally, with a plate completely covering the palate, it had mutated into a full denture. The patient did not want to wear a full denture under any circumstance, so now implants appeared to be the only alternative.

However, from an oral surgical point of view, both sides were unsuitable for implants due to the lack of bone material. The patient had also rejected the necessary but expensive augmentation of the molar areas. Individual attachments were also out of the question, as the patient wanted a palate-free prosthetic solution. After thorough consideration, the decision fell in favour of a combination of implants with individual abutments and detachable, palatal bar-free telescope prosthesis. This was the situation:


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