Implant-supported fixed prostheses: Restoring vertical dimension in posterior mandibular atrophy
Introduction: The severe resorption of the alveolar ridge in the posterior mandible affects vertical dimension, centric relation, centric occlusion and anterior guidance.
Purpose: The aims of this case report were to assess the treatment outcome of tripoidal versus linear prosthetic configuration to minimize the strain, achieving occlusal stability.
Clinical Case Report: At UNAM, 3 Straumann SLActive implants were placed in severe posterior mandibular atrophy with a tripoidal prosthetic configuration (implants zones # 18, 19 and 20). Screw-retained provisional were made to achieve occlusal stability, modifying the vertical dimension in combination with interim prostheses in natural teeth and implants. The final prosthesis was delivered after 6 months of function using screw-retained mini-hybrid ceramic prosthesis with a mesostructure for the tripoidal implants together with e-max crowns for natural teeth and PFM crowns for implants in a conventional loading protocol.
Results: The modification of the vertical dimension occlusion made with a suitable diagnostic and treatment planning for posterior mandible atrophy provided a new centric occlusion achieving function and esthetics.
Conclusions: Posterior teeth should have equal intensity contacts that don’t interfere with temporomandibular joints in the back or the anterior guidance in the front.