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Fabrication of a Co-Cr Precision Attachment with a Zigomatic Implant: Case Study by Ruan S. de Jongh

This project details the process of creating a Co-Cr precision attachment with a Zigomatic implant for a 29-year-old female with a history of maxillary tumor and hemimaxillectomy. The treatment plan, technical procedures, costs, advantages, and disadvantages are discussed, along with laboratory procedures and final placement. References are provided for further reading. Prepared and presented by Ruan S. de Jongh, a Dental Technology student at Peninsula Technikon, for a comprehensive insight into this innovative treatment option.

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Fabrication of a Co-Cr Precision Attachment with a Zigomatic Implant: Case Study by Ruan S. de Jongh

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  1. Fabrication of a Co-Cr Precision Attachment in Association with a Zigomatic Implant Prepared and presented by Ruan S. de Jongh BTech: Dental Technology Student at Peninsula Technikon

  2. Contents • Patient history • Background information • Possible treatment plan • Possible technical treatment plan • Most suitable treatment option • Treatment option of choice • Laboratory procedures and final placement

  3. Patient History • 29 year old female • 1974 – complained about swelling • Tumour in right maxilla (Myxoma) • Myxoma appeared 1 year earlier • 2002 – Hemimaxillectomy • From midline including 2.2 —1.8 • Obturator made in 2002 by Ms Galloway • 4th year student in 2002 • Started with this current case

  4. Condition and background information • Currently tumor is removed • Patient’s maxillary right • Tumour was benign • Wearing obturator • Patient in stable and ready for advancements.

  5. Possible Treatment Plan • Hollow-bulb obturator • Already in existence • Co-Cr precision attachment • Osteotomy

  6. Possible Technical Treatment Plan • Cobalt chrome removable denture • Surgery (R 14 000 = 3h) • Anaesthetics= R 1 000 ph • Specialist = R 1 000 ph • Zigomatic implant ± R 8000 • Fabrication of attachment bar ± R 1 000 • Fabrication of Co-Cr appliance ± R 1 500 • Total cost adding up to ± R16 500

  7. Possible Technical Treatment Plan(continued) • Private hospital • Ward fee = R 500 p/day • Total cost = R 205 • Surgery = R 165 • Ward fee = R 40 (1 month) • I.D.S. pays for implant

  8. Possible Technical Treatment Plan(continued) • First visit • Impression • Surgery – placement of zigomatic implant • Healing time (± 6 weeks) • Second visit • Impression with analog in place • Construction of attachment bar

  9. Possible Technical Treatment Plan(continued) • Third visit • Impression with attachment bar • Co-Cr appliance is constructed • Fourth visit • Co-Cr appliance is placed • With 1st try-in • Fifth visit • Final placement of Co-Cr removable denture

  10. Most Suitable Option • Co-Cr precision attachment • Implant support • Improved stability compared to an obturator • Patient is ideal candidate • age • benign tumour • have retentive teeth

  11. Advantages Good aesthetics Very stable Reasonable cost Hygienic Superior strength1 Disadvantages Movement during function Retention diminishes with use Fracture - porosity1 Treatment Option of ChoiceCobalt-Chrome precision attachment

  12. Laboratory Procedures • First Visit • Cast of primary model • Changes are notified2

  13. Laboratory Procedures(continued) • Second Visit • Final model cast with analogs • Construction of Attachment Bar2 • Cast in Co-Cr • Worked off and polished

  14. Laboratory Procedures(continued) • Second visit (continued) • Plastic clips preferred (nylon)

  15. Laboratory Procedures(continued) • Third Visit • Construction of Co-Cr Precision Attachment1 • Duplicated • Co-Cr appliance constructed in wax • Invested • Cast • Sprues removed • Sandblasted • Trimmed • Polished

  16. Laboratory Procedures(continued) • Fourth Visit • Placement of Co-Cr precision Attachment • 1st try-in OR • Final placement

  17. References 1. G. Jenkins, Precision attachments. Removable Partial Prostodontics, Ch 6, Moscow:Quintessence Publishing, 1999: 78-80. 2. University of Pennsylvania Health System. Advances in Head and Neck Reconstruction. 2002: 132-143 3. D. Henderson, Major and Minor Connectors, 6th Ed. Removable Partial Dentures, Ch 4, Mosby Company, London. 1981: 20-39

  18. Thank You! Special thanks to: • Prof J.Morkel • Dr P.van Zyl • Ms Z.Nortje

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