Maxillary prosthesis for patient with Sjogrens syndrome?

I am treatment planning a maxillary prosthesis for a patient who has had 5 implants placed in her edentuluous maxilla. They are approximately placed in the positions of both second premolars, canines and one roughly in the midline. The patient is 58 years old, her medical condition is unremarkable other than Sjogrens syndrome, which significantly affects her mouth. There is a 5-5 dental arch in the mandible.

My question revolves around what prosthesis will give the best result? I’m concerned with hygiene issues and tissue irritation with a fixed bridge or even a fixed bar to hold an overdenture. I believe in the KISS principle, and I’m leaning towards locators and a palateless maxillary overdenture. The implants are not perfectly parallel but enough that I think locators can work quite well. I know of issues regarding splinting vs non splinting implants in the maxilla, but what other suggestions do you have?

4 thoughts on “Maxillary prosthesis for patient with Sjogrens syndrome?

  1. Dorian Hatchuel says:

    Hi. Sjogrens causes dry mouth. Your concern is Hygiene. Placing locators implies full palatal coverage so that the denture is tissue and implant supported. If you leave the palate open you create a horse shoe shape and place stresses on the implants.
    A better example is a fixed-detachable denture. The bar is fixed and a milled Bar fits in the denture. This in turn is fixed to the bar but the patient can remove it herself.
    I recommend you contact Uzi at Uzi@nanomill.co.il and he will give you details. It’s a little more complicated to do but we’ll worth the effort. Both you and the patient will sleep better.
    Good luck.
    PS. Disclaimer: I have no financial interest in my answer. I don’t work for any company.

  2. Dennis Flanagan DDS MSc says:

    Locator support and retention can be successful if the off axial loading is controlled by the occlusal scheme. Zero degree or lingualized occlusion will OK. There needs to be a minimum of 5 implants in the maxilla, which you have. The palate can be removed. Since hygiene is an issue, a bar may be difficult to clean aa well as be unsightly. You don’t want the patient to show off his bar to his friends, this is not a practice builder. See Tarnows articles on this topic.
    Dennis Flanagan DDS MSc

  3. Dr. Bob says:

    The prosthesis should be planed before any implants are placed and then the implants placed to allow that prosthesis the be constructed. Implant restoration must be prosthesis driven. The Doctor and the patient should decide, before considering implants, what the final restoration will be. Some times a patient with implants in the mouth will present to the office. At this point the patient can be given options based upon the positions and sizes of the existing implants and then may evaluate the pros and cons of each reasonable option. The patient may want a fixed or a removable restoration. What is required to maintain the prosthesis may be a determining factor for the patient. Please involve the person who has to live with the restoration in these decisions.

  4. D Sampson says:

    I don’t see a problem with a fixed bridge on the five implants in a patient with Sjogrens Syndrome. We have many patients whee we have done a fixed hybrid prosthesis (All-on-4) style and they do quite well. There is minimal irritation of the soft tissues since it is completely loaded on the implants.

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Questions, Restorative.
Bookmark Maxillary prosthesis for patient with Sjogrens syndrome?

Videos to Watch:

Suturing in Guided Bone Regeneration

This video provides clinical tips for suturing techniques in Guided Bone Regeneration. In Guided Bone[...]

Watch Now!
Socket grafting with Collagen Dressing and Bond Apatite

This video demonstrates socket grafting with just bond apatite and a collagen wound dressing.[...]

Watch Now!
Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!
Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and[...]

9 Comments

Watch Now!
Placement of Implant Using EZ Devices

This video demonstrates the placement of a dental implant in the upper jaw using the[...]

Watch Now!
BonePen: Improve Positioning of Implants

A short video demonstrating close up the use of the BonePen Kit, a set of[...]

Watch Now!