Journal of Dental Implant Research 2019; 38(1): 19-23  
Restoration of severe atrophic mandible with a few implant placement and fixed prosthesis: a case report
Han-Chang Yu1, Sang-Yun Kim1, Young-Kyun Kim1,2
1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam,
2Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
Correspondence to: Young-Kyun Kim, Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. Tel: +82-31-787-7541, Fax: +82-31-787-4068, E-mail: kyk0505@snubh.org
Received: December 31, 2018; Revised: January 11, 2019; Accepted: January 18, 2019; Published online: June 30, 2019.
© The Korean Academy of Implant Dentistry. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creative commons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
A minimally invasive method for a few implant placement and restoration can be considered in a patient with severe mandibular defect. A 59-year-old man had a severe defect in the left mandibular body, and implant installation was difficult. The patient preferred fixed prosthetic therapy rather than removable prosthesis and did not want extensive reconstructive surgery such as bone grafting. Therefore, four implants were installed, and a fixed hybrid denture with an all-on-4 cantilever was planned. During the treatment, osseointegration of #34i failed, and a fixed hybrid cantilever prosthesis was supported by three implants. Prosthetic complications such as repetitive screw loosening and fracture have occurred; however, the function is well maintained up to 7 years and 4 months. In patients with severe mandibular atrophy, minimally invasive implant placement with a small number of implants may be considered as an alternative.
Keywords: Atrophy, Implant, Fixed hybrid


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