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Clinical Case Report

Mandibular Implant-Retained Overdenture on a CAD/CAM-Milled, Parallel-Walled CrCoMo Bar

Arne Boeckler, Dean Morton

A 72-year-old male patient, partially dentate, presented with a request for a more functional and esthetic solution for his mandibular arch. He had lost his mandibular teeth over a period of more than twenty years due to a combination of periodontal disease and dental caries. He was not satisfied with his existing mandibular prosthesis, which was stabilized by his single remaining tooth 43. A pretreatment panoramic radiograph confirmed the absence of pathology. The patient was ambulatory, alert, and philosophical, and denied any health problems that would affect the dental treatment.

Surgical classification
Complex
Prosthodontic classification
Complex
Source
Treatment Guide 15
Purchase price
10 Academy Coins
CPD/CME
0.25 hours

Recommended content

General Risk Assessment

Patient-related Factors
Oral hygiene Fair
Compliance Good
Patient-medical Factors
Medical Fitness Healthy, able to undergo planned anesthesia and surgical procedure (ASA I)
Medications No medications that would negatively affect the surgical procedure and outcomes.
Radiation Treatment None
Growth Status Complete
Site-related Factors
Access Adequate
Pathology near the implant site None
Previous surgeries in planned implant site No previous procedures.

Surgical Classification

Surgical Complexity
Timing of placement Healed (Type IV)
Simultaneous or Staged grafting procedures Implant placement without adjunctive procedures
Number of implants > Three
Anatomy
Keratinized Tissue Sufficient (>4 mm)
Soft Tissue Quality No scars or inflammation
Proximity to vital anatomic structures Moderate risk of involvement

Prosthodontic Classification

Complicating Factors
Biological Screw-retained restorations with appropriate contours
Mechanical/Technical Absence of contributing factors
Planned contour of tissue-fitting surfaces Appropriate contours (hygienic - accessible for maintenance)
Prosthesis Factors
Prosthetic volume Adequate. Space available for ideal anatomy of the restoration
Inter-occlusal space Adequate. Capable to create an anatomically & functionally correct planned restoration
Occlusal Factors
Occlusal scheme User-defined occlusal scheme achievable
Involvement in occlusion Involvement
Occlusal parafunction Absent
Complexity
Loading Protocol Early/Conventional
Interim prosthesis Tissue or interim implant supported
Number of implants >2 (non-splinted) or ≥ 2 (splinted)
Timing of placement Healed (Type IV)

Esthetic Risk Assessment

Edentulous Esthetic Risk Assessment (removable)
Facial Support Desired tooth position provides sastifactory labial support
Labial Support Flange provides required lip support
Maxillomandibular Relationship Class I
Publication date: Dec 3, 2025 Last review date: Nov 26, 2025 Next review date: Nov 26, 2028

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