Tooth loss can have a considerable negative impact on a person’s quality of life. Specifically, tooth loss will damage a person’s eating ability, nutrition, appearance, speech, and self-esteem. The current dental treatments for replacing missing teeth are dentures, bridgework and dental implants. This case was more complex than usual with diverging implants and the desire to have it screw retained. By using Astra Tech Angled Abutments we were able to change the path of insertion allowing both the upper and lorew prosthesis to be made in once piece. The upper is a Zircon Zahn full zirconia framework with ceramic built on the labial and buccal surfaces to ensure an aesthetic result. The lower is also screw retained, but in this case, it is high impact denture teeth with processed high impact acrylic over a milled titanium framework.
 The patient as presented before any work was undertaken |
 Divergence of fixtures shown with the guide pins in place |
 This images shows the angulation correction by using Angled Abutments |
 Working model showing the angulated abutment replicas. Note the abutment in position 22 is a TiDesign that has been customised to allow for a single path of insertion |
 Ti Temporary cylinders in place and the ‘blind’ coping on the 22 abutment |
 Ti Temporary cylinders and the ‘blind coping cemented into the Zr framework before insertion in the mouth. This allows for a metal to metal join as the prosthesis is screwed in place |
 Labial aspect of the final prosthesis on the model |
 Occlusal aspect of the final prosthesis on the model |
 Final prosthesis on the model articulated with the lower |
 Occlusal view of the lower screw retained titanium hybrid acrylic implant denture |
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 The final case at insertion – a full upper implant supported zirconia bridge with the titanium hybrid bridge on the lower |