Rehabilitation of a Patient with Screw-retained Milled Titanium Hybrid Prosthesis in the Mandibular Arch and Immediate Implant Placement in the Region of Maxillary Canine followed by Connective Tissue Graft and Immediate Provisionalization

Abstract

The continuous resorption of the edentulous mandible is the most common cause for the patients not being satisfied with con ven tional dentures. With the advent of dental implants, various remov able and fixed options can be provided to the patient for bet ter function, retention, esthetics and phonetics. The mandi bular implantsupported hybrid prosthesis ia a viable pros thetic option as it fixed for the patient and removable for the clinician. The passive fit of a hybrid prosthesis is a prerequisite for a successful prognosis, which can be achieved using the newer technology like computeraided design and computeraided manufacturing (CADCAM) milled titanium frameworks. The use of connective tissue graft to enhance soft tissue bulk around implants helps the clinician provide esthetically appealing outcomes. Immediate loading of the implants is the most preferred option for patients who are esthetically very conscious. Its provisionalization using screwretained prosthesis ensures a stable periimplant health as the extruded cement can be eliminated extraorally. This article presents the fabrication of mandibular implantsupported hybrid prosthesis with CADCAM milled titanium framework and connective tissue around imme diately placed implant with screw retained provisional prosthesis.