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Henri Diederich

Dental surgeon, 114 av de la Faiencerie, L-1511, Luxembourg

The lady 58 years young wanted to change her look as her teeth were mobile in the mandible.

Her desire was also to receive a fast treatment out- come and not be without teeth.

Finance was also an aspect so we decided to do an overdenture.

Figure 1: Mouth situation before extraction.

Figure 2: Extraction was performed, bone was regularized and implants were inserted.

The choice of the implant was M 3514 which could be inserted between the extraction sockets in the remaining bone, initially, primary stability was brilliant, around 70 N/cm so all conditions were excellent to go for immediate loading.

4 implants were inserted and an impression with screwed transfers was taken immediately after the surgery.

Figure 3: Implants in place

Figure 4: Stitches are done and transfers are in place.

After this, the transfers were taken out and analogues were delivered to the lab.

A temporary bridge was done chairside and cemented on transfers, we used TRM.

At the next appointment a week later we tried the key and fixed the occlusion.

Figure 5: Impression after the surgery

Figure 6: Temporary bridge

Figure 7: Try in of the frame with bite

Figure 8: Lab model

At the next appointment, the milled barre in titanium was tried.

Inside the barre, the lab had used PCOM to get a perfect fitting to the implants.

Another week later the overdenture in peek was delivered the barre was screwed on the implants.

Figure 9: Before placement of the barre

Figure 10: The milled barre screwed on the implants

Figure 11: The overdenture in peek

Figure 12: Happy patient

Before

After

Conclusion

The same work can be done with ROOTT R implants but there I advocate going for delayed loading, 3 months.
You may do it with ROOTT C Implants:
The difference to ROOTT M implants is that getting the perfect fitting is more difficult and it may debond.
The screws are delivering very strong retention and as for this no debonding
Also a difference in price. The same prosthetic work with monoblock implants costs less ( lesser components).
So may also use P implants when bone quality is D3, D4 and you may mix ROOTT C , M, S, and P all depending finally on the bone quality.

Dr. Henri Diederich, Luxembourg