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Dr. Glen Liddelow

Three-year outcome following same-day restoration of an edentulous mandible

Dr. Glen Liddelow

Australia

Case courtesy of Dr. Liddelow

“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

 

 

 

Case courtesy of Dr. Glen Liddelow.

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Case courtesy of Dr. Liddelow

Initial clinical situation

Edentulous patient with maxillary and mandibular dentures (left).

Mandibular residual ridge (right).

Case courtesy of Dr. Liddelow

Initial clinical situation

Pre-treatment panoramic radiograph.

Case courtesy of Dr. Liddelow

Surgical procedure

Preparation of the central implant site (left).

The central implant is inserted using the Positioning template (right).

Case courtesy of Dr. Liddelow

Surgical procedure

The central implant is in position (left).

All three Trefoil Implants CC RP with 4.5 mm collar are in place (right).

Case courtesy of Dr. Liddelow

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).

Case courtesy of Dr. Liddelow

Restorative procedure

Master cast construction from verification index (left).

Verifying the fit of the Trefoil bar (right).

Case courtesy of Dr. Liddelow

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).

Case courtesy of Dr. Liddelow

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).

Case courtesy of Dr. Liddelow

Outcome

Post-op radiograph (left).

Patient’s smile following treatment (right).

Case courtesy of Dr. Liddelow

Outcome

Abutments are perfectly in place at 3-year follow-up.

Case courtesy of Dr. Liddelow

Outcome

Large amount of keratinized mucosa around abutments at 3-year follow-up (left). 

Occlusal view 3 years after surgery (right).

Case courtesy of Dr. Liddelow

Outcome

OPG 3 years after surgery (left).

Patient’s smile 3 years after restoration (right).

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