Implant-Supported over dentures

Implant Placement

Patient requested improved retention and stability of the upper denture.

Existing upper acrylic denture with reduced retention.
Adequate bone present at proposed implant sites, though thin bone noted at #11 and #13.
Pre-operative CBCT reviewed: No sinus perforation risk at #13 and #24 confirmed via sinus test.

Placement of five dental implants at #13, #11, #22, #23, and #24 to support and retain the upper acrylic denture.
Use surgical stent for guided osteotomy with freehand modification where indicated.
Modify upper denture with female housings for implant retention.
Provide oral hygiene and denture care instructions.

Local anesthesia infiltration administered to upper arch at implant sites (#13, #11, #22, #23, #24).

Patient draped and disinfected.
Osteotomy performed using surgical guide.
Sinus test performed for #13 and #24: negative for perforation.
Intra-operative CBCT taken to confirm positioning.
At #11, due to deviation from thin bone, flap raised and implant placed freehand.
4/0 Vicryl sutures placed at #11.
Implant at #23 also placed freehand after initial implant placements.
Five Dentium Slimline implants (3.0mm × 10.0mm) placed at sites #13, #11, #22, #23, #24.
Upper denture modified to receive BPF3 female housings using rubber dam isolation.
Denture relined and polished.
Patient instructed on denture insertion, removal, and hygiene.

Hemostasis achieved and patient stable.
Post-op CBCT confirms implant positions.
#13 implant noted close to sinus but no perforation observed intra-operatively.
Slightly reduced prognosis for #11 and #13 implants due to thin bone; patient informed and acknowledged.
Patient satisfied with esthetics and occlusion.