Prosthetic solution for fixed full-arch maxillary prosthesis with implant divergent parallelism greater than 45°. A case report.

Abstract

A non-ideal implant position and angulation may bring about some technical concerns because the abutment prosthetic possibilities may fail to correct the implant angulation or its consequent prosthetic restoration insertion plane. This case report describes a prosthetic solution for fixed full-arch maxillary prosthesis with six implants (Bone-Level Regular CrossFit®, Straumann AG, Basel, Switzerland) non-satisfactory position in maxilla; one of the implants showed buccal angulation and a divergent parallelism greater than 45° in relation to the other five implants. To correct the implant angulation and the insertion bar plane, a screw-retained RC non-engaging gold abutment for bridge was used in five out of six implants, and a combination of a screw-retained RC CrossFit™ gold abutment for crown and a Screw Bloc System (CNG Soluções Protéticas, São Paulo, Brazil) was used for the right-hand-side anterior implant that showed a greater buccal implant angulation (>45°). A satisfactory outcome was obtained, which totally met the patient's expectations. Hence, the case was successfully solved with the avoidance of buccal insertion of the prosthetic screw and the consequent esthetic appearance loss of the fixed full-arch prosthesis.