:: Case Study 4

A 48-yr old Caucasian lady had a 3-unit bridge on the lower right side (Figure 11). After several years, it started to get loose at one end. It was impossible to remove the entire bridge without damaging it. As she preferred to reuse the bridge, time was allowed to pass with the hope that the other side would eventually loosen. Unfortunately, the underlying teeth became so badly decayed that they had to be extracted. Two implants (Figure 12) were inserted with much difficulty as there was hardly any bone left. Eventually, a new 3-unit implant-supported bridge was made (Figure 13).

Figure 11	Figure 12	Figure 13
Implants are normally placed parallel to each other in order to accommodate a bridge but the lack of bone in this case resulted in the implants being placed otherwise. Special components had to be used before the new bridge could be seated.

:: Case Study 5

A 46-yr old German gentleman lost all his upper and some of his lower teeth. He had been wearing dentures for many years and found them uncomfortable. His oral surgeon in Germany placed eight implants in the upper jaw (Figure 14). As he was on a round-theworld tour, he decided to have his upper teeth made in Singapore. Full-arch fixed implant-supported prostheses were fabricated and secured onto the implants by screws (Figure 15). He is now planning to do the same for the lower jaw (Figure 17).

		The implants were placed in Germany and the new upper bridge incorporating thirteen teeth were made in Singapore. The seamlessness in treatment over wide geographic distances facilitates patients’ mobility without compromising the standard of care during and after treatment.
Figure 14	Figure 15
Figure 16	Figure 17

:: Case Study 6

A 59-yr old Chinese lady constantly had problems with the many sets of upper dentures made for her. The pain and discomfort she experienced was due to trauma and bone loss arising from the bite of her lower natural teeth against her gums through the upper denture. Three implants were placed to support a special bar and denture attachment (Figure 18). The use of the bar significantly improved the retention of her new upper denture and prevented trauma to her gums. She is finally able to enjoy all the food that she likes (Figure 19).

Figure 18	Figure 19
A horizontal metal bar (left) connects all the three implants in the upper jaw. An overdenture (right) has an internal attachment that allows it to grip the bar for greater retention and stability. The overdenture can be removed for daily cleaning.