Three-year outcome following same-day restoration of an edentulous mandible
Dr. Glen Liddelow
Australia
“The Trefoil system provides an outstanding option for the edentulous patient and will provide an affordable, quality solution.”
Patient: male, 77 years old. Hypertension, atrial fibrillation, medication - Warfarin.
Clinical situation: failing lower dentition.
Surgical solution: restorative solution includes a temporary maxillary denture and the Trefoil protocol for the mandible.
Restorative solution: New maxillary denture, Trefoil Bar
Surgery date: August 24, 2017
Total treatment time: 24 hours
Initial clinical situation
Edentulous patient with maxillary and mandibular dentures (left).
Mandibular residual ridge (right).
Initial clinical situation
Pre-treatment panoramic radiograph.
Surgical procedure
Preparation of the central implant site (left).
The central implant is inserted using the Positioning template (right).
Surgical procedure
The central implant is in position (left).
All three Trefoil Implants CC RP with 4.5 mm collar are in place (right).
Surgical procedure
The Transfer Abutments and a Temporary Abutment Non-Engaging CC are placed to construct the verification index (left).
Placement of the healing abutments. The site is sutured (right).
Restorative procedure
Master cast construction from verification index (left).
Verifying the fit of the Trefoil bar (right).
Restorative procedure
Fixation of the retentive mechanism can be either laser welding or resin. The bar shown here is laser welded (left).
Articulation of the bar to the opposing arch may be done in a traditional way using a wax rim on the bar or with a cut out duplicate denture prosthetic guide (right).
Outcome
Completed prosthesis with polished rounded intaglio surface to facilitate cleaning (left).
Delivery of the final bridge on the day of surgery. Occlusion is checked for even contact and anterior guidance. Accessibility for cleaning is verified and screws are tightened to 35Ncm. Access holes are sealed with teflonand composite (right).
Outcome
Post-op radiograph (left).
Patient’s smile following treatment (right).
Outcome
Abutments are perfectly in place at 3-year follow-up.
Outcome
Large amount of keratinized mucosa around abutments at 3-year follow-up (left).
Occlusal view 3 years after surgery (right).
Outcome
OPG 3 years after surgery (left).
Patient’s smile 3 years after restoration (right).
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Trefoil™The revolution in full-arch restoration.
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