Éxito clínico de prótesis fija implanto-soportada y dento-soportada de arco completo con cantilevers distales, después de 4 años de seguimiento: reporte de un caso clínico

Abstract

Problem: The clinical success of implant and tooth-supported full- arch prostheses with distal cantilevers is uncertain. Objective: To evalúate, ¡n 4 years of follow up, the clinical success of an implant-tooth-supported hybrid prosthesis and fixed full-arch prosthesis with distal cantilevers in a partial upper and lower edentulous patient. Methodology: female patient aged 57 years presented to prívate consultation with partial edentulism bimaxilar generated occlusal instability and aesthetic alteration. After a clinical, radiographic and tomographic study, an ideal treatment plan and an alternative was determined; The patient agreed ideal forthe maxilla proposal: an implant supported hybrid prosthesis and the alternative proposal for the mandible: a fixed partial denture tooth supported inferior, both were designed full arch and type extensions cantilever lower distal to 7mm in length; after endodontic and implantology respective treatments, we proceeded to the manufacture of the two structures, in addition to restore function of the masticatory system greatly improved the aesthetics of the patient. Clinical and radiographic follow-up was performed at 4 years of installed prostheses, considering the following evaluation criteria: Radiographic: marginal bone leve! of the upper implants and teeth lower pillare, especially those closest to the distal extent and Clinical: survival of higher implants, the lower teeth, upper hybrid prosthesis and lower fixed partial denture, taking into account technical and biológica! complications. Results: Radiographic analysis demonstrated the integrity of peri-implant and peri- alveolar bone without bone resorption and cortical implants higher integrity pillare and lower abutment teeth. The clinical analysis showed absence of mechanical failures or biological both implants and teeth as well as upper and lower dentures after 4 years installed, revealing the clinical and radiographic success of therapeutic designed with distal extensions. Conclusión: Within the limitations of this clinical case we can conclude that the distal extensión type cantilever in full-arch prostheses, could be an option when rebuilding masticatory systems affected by the partial or total edentulism, after proper diagnosis and Proper planning of the case.