Kenneth Case Study
| ARCHFull lower | IMPLANTS4 · AP spread | RESTORATIONNano-ceramic on Ti bar | WEAR MODEFixed · office retrieve |
A lower FlexOnX with four implants and no screws.
Kenneth needed a full lower reconstruction and he had the bone to support it. Four implants were placed with a deliberate AP spread and kept as parallel as the anatomy allowed. FRA abutments went in at surgery. After three to four months of healing he came back for a records appointment that looks, on purpose, like a careful denture workflow — then like a much more stable result.
The story
Spacers on the abutments. A master polyvinyl impression held to a crown-and-bridge standard. Vertical dimension recorded with a mush-bite and a simple facial measurement used as a check so the case does not come back over-opened. A wash on both arches so the bite does not rock. Midline marked. Ten days later, a 3D-printed try-in — one to evaluate, one the dentist can use as a prototype if needed. Vertical, midline, occlusion, and cosmetics signed off. Three weeks later, the definitive: a nano-ceramic overlay on a titanium bar.
The intaglio is the point of the design as much as the teeth are. The tissue surface is highly polished titanium so plaque has less to hold. Facial divots are milled so a Waterpik can flush from buccal to lingual between fixtures. Four FRA housings are picked up chairside. No screws in the prosthesis. Kenneth’s wear mode is fixed: he does not pop it out at home. The office does, on a six-month hygiene visit, and snaps can be changed without remaking the bridge.
What this case was built to do
- Use AP spread to get chewing stability on four mandibular implants.
- Make install and retrieval simple for the dental team.
- Give him a home-care path that does not depend on him seating a prosthesis every night.
- Deliver a fixed lower prosthesis at a cost that was actually reachable
“The fourth thing, and most importantly: we were able to give him a fixed prosthesis on the bottom at an affordable cost.”
— Dr. Mark Whitefield, case narration
FOR PATIENTS
IF YOU WANT YOUR TEETH BACK
This is what “real teeth again” looks like on a lower arch: you chew, you speak, the bridge stays put.
You do not live with a loose denture, and you do not live with screw-access holes in the teeth.
Cleaning is still the deal. Waterpik under the span every day. Come in twice a year so the team can take it off and see what you cannot.
FOR DENTISTS
IF YOU PLACE IMPLANTS
Mandible planning from the case: four implants can work when they are reasonably parallel (within ~15°) and AP spread is real. Five or six is the over-engineer when anatomy allows.
Do not chase steep angles. A modest divergence was restorable; the system is happier when fixtures stay straight.
Think denture workflow, execute like crown-and-bridge. FRA / locator-style housings, chairside pickup (Relines or acrylic), R.S.B. logic in the superstructure.
Design the slick intaglio and the Waterpik divots in the lab prescription — not as a hygiene lecture after insert.
Wear mode is a clinical decision: patient-removable or office-fixed. Kenneth was office-fixed.
