Implant-Supported Removable Partial Denture

A 73-year-old lady has an existing upper complete denture and a lower flipper.  A few days after #23 exfoliation, a 3.5x17 mm one piece implant is placed (Fig.1) and an immediate provisional is fabricated.  Later the lower flipper is remade.   The one piece implant and the provisional have been doing well for 7 months by the time Fig.2 is taken.

The tooth #28 has also been exfoliated for a few days.  A 4.5x17 mm two piece implant is placed (Fig.4, as compared to Fig.3 preop) and immediately loaded (Fig.5, taken 6 days postop).

Two provisionals #22 and 28 are dislodged several time while the implants #23 and 28 are healing, 9 and 2.5 months postop, respectively.

Next time the patient returns for recementation, take Alginate impression for both arches.  A base plate and occlusal rim for the lower will be made. 

When the patient returns for crown prep for #22, 23 and 28, take bite registration with the base plate and occlusal rim before removal of the provisionals.  Take another bite registration after prep using the first bite registration, the base plate and occlusal rim. 

When the permanent crowns are cemented, PVS impression is taken for the lower RPD.  Bite registration is taken using the same base plate and occlusal rim.

Xin Wei, DDS, PhD, MS 1st edition 02/02/2014, last revision 02/02/2014