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Fabrication of a Co-Cr Precision Attachment in Association with a Zigomatic Implant

Fabrication of a Co-Cr Precision Attachment in Association with a Zigomatic Implant. Prepared and presented by Ruan S. de Jongh BTech: Dental Technology Student at Peninsula Technikon. Contents. Patient history Background information Possible treatment plan Possible technical treatment plan

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Fabrication of a Co-Cr Precision Attachment in Association with a Zigomatic Implant

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  1. Fabrication of a Co-Cr Precision Attachment in Association with a Zigomatic Implant Prepared and presented by Ruan S. de Jongh BTech: Dental Technology Student at Peninsula Technikon

  2. Contents • Patient history • Background information • Possible treatment plan • Possible technical treatment plan • Most suitable treatment option • Treatment option of choice • Laboratory procedures and final placement

  3. Patient History • 29 year old female • 1974 – complained about swelling • Tumour in right maxilla (Myxoma) • Myxoma appeared 1 year earlier • 2002 – Hemimaxillectomy • From midline including 2.2 —1.8 • Obturator made in 2002 by Ms Galloway • 4th year student in 2002 • Started with this current case

  4. Condition and background information • Currently tumor is removed • Patient’s maxillary right • Tumour was benign • Wearing obturator • Patient in stable and ready for advancements.

  5. Possible Treatment Plan • Hollow-bulb obturator • Already in existence • Co-Cr precision attachment • Osteotomy

  6. Possible Technical Treatment Plan • Cobalt chrome removable denture • Surgery (R 14 000 = 3h) • Anaesthetics= R 1 000 ph • Specialist = R 1 000 ph • Zigomatic implant ± R 8000 • Fabrication of attachment bar ± R 1 000 • Fabrication of Co-Cr appliance ± R 1 500 • Total cost adding up to ± R16 500

  7. Possible Technical Treatment Plan(continued) • Private hospital • Ward fee = R 500 p/day • Total cost = R 205 • Surgery = R 165 • Ward fee = R 40 (1 month) • I.D.S. pays for implant

  8. Possible Technical Treatment Plan(continued) • First visit • Impression • Surgery – placement of zigomatic implant • Healing time (± 6 weeks) • Second visit • Impression with analog in place • Construction of attachment bar

  9. Possible Technical Treatment Plan(continued) • Third visit • Impression with attachment bar • Co-Cr appliance is constructed • Fourth visit • Co-Cr appliance is placed • With 1st try-in • Fifth visit • Final placement of Co-Cr removable denture

  10. Most Suitable Option • Co-Cr precision attachment • Implant support • Improved stability compared to an obturator • Patient is ideal candidate • age • benign tumour • have retentive teeth

  11. Advantages Good aesthetics Very stable Reasonable cost Hygienic Superior strength1 Disadvantages Movement during function Retention diminishes with use Fracture - porosity1 Treatment Option of ChoiceCobalt-Chrome precision attachment

  12. Laboratory Procedures • First Visit • Cast of primary model • Changes are notified2

  13. Laboratory Procedures(continued) • Second Visit • Final model cast with analogs • Construction of Attachment Bar2 • Cast in Co-Cr • Worked off and polished

  14. Laboratory Procedures(continued) • Second visit (continued) • Plastic clips preferred (nylon)

  15. Laboratory Procedures(continued) • Third Visit • Construction of Co-Cr Precision Attachment1 • Duplicated • Co-Cr appliance constructed in wax • Invested • Cast • Sprues removed • Sandblasted • Trimmed • Polished

  16. Laboratory Procedures(continued) • Fourth Visit • Placement of Co-Cr precision Attachment • 1st try-in OR • Final placement

  17. References 1. G. Jenkins, Precision attachments. Removable Partial Prostodontics, Ch 6, Moscow:Quintessence Publishing, 1999: 78-80. 2. University of Pennsylvania Health System. Advances in Head and Neck Reconstruction. 2002: 132-143 3. D. Henderson, Major and Minor Connectors, 6th Ed. Removable Partial Dentures, Ch 4, Mosby Company, London. 1981: 20-39

  18. Thank You! Special thanks to: • Prof J.Morkel • Dr P.van Zyl • Ms Z.Nortje

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