Abstract

A 69-year-old male patient reported to the UTHealth Prosthodontics with the chief complaint of decreased chewing efficiency and the instability with continuous use of his dentures. He was concerned with the functional efficiency of the dentures and not so much about esthetics. The patient was found to have a completely edentulous maxilla with a residual ridge morphology of minimal buccal vestibule and reduced hamular notch. The mandible had one root tip with a reduced residual bone height. The maxillomandibular relationship was Class III. Pt had a history of radiation in the head region with skin cancer of BCC, SCC, and Melanoma since 2008. Frequent attrition of the teeth may either be due to selfinduced excessive chewing. Treatment options offered

(1) denture or implant supported overdenture,

(2) denture or implant supported overdenture with metal occlusal surface, and

(3) implant supported fixed prosthesis.

Pt chose a two-implant supported overdenture with a metal occlusal surface for the mandible. Therefore, the denture with the metal occlusal was planned to address patient’s concern. It also improves the degree of masticatory ability and prevents the attrition of the teeth. This case report described a technique that uses custom made occlusal portions as the patterns for casting base metal occlusal surfaces. Metal has been reported to cause minimal wear to opposing occlusal materials. This technique is considered in cases where the prosthetic occlusion is in contact with enamel, composite resin, porcelain, metal, or a combination of such materials. Instead of individual units, a single joint unit is fabricated to improve the retention and provide easy finishing and polishing of the casting. This case report presents a simple and relatively inexpensive procedure for the construction of metal occlusal surfaces on complete dentures.

Keywords: Metal occlusal; Implant; Prosthesis; Overdentures

Abbreviations: BCC: Basal Cell Carcinoma; SCC: Squamous Cell Carcinoma; COPD: Chronic Obstructive Pulmonary Disease; TMJ: Temporomandibular Joint; VDO: Vertical Dimension of Occlusion; VDR: Vertical Dimension of Rest; Cr-Co: Chromium-Cobalt