A Digital and Conventional Approach to the Rehabilitation of Complete Edentulous with a Toronto Infrastructure-Designed Hybrid Prosthesis: a Case Report

Abstract

This case describes the prosthetic treatment of a completely edentulous patient treated with the "Toronto Bridge" technique, an implant-supported (all-on-four/all-on-five) hybrid prosthesis. A 42-year-old male patient applied to our clinic for aesthetic and functional problems. After clinical and radiographic examination, the all-on-five treatment concept for the edentulous maxilla and an all-on-four treatment concept for the edentulous mandible were planned. In the maxilla, two distal implants were placed at 30-45° angles, and three straight implants were placed in the anterior region. In the mandible, two distal implants were positioned at the anterior to mental foramina at an angle of 30-45°and two straight implants were placed in the anterior region. The digital impressions were taken, and the infrastructures and veneers were designed according to the "Toronto Bridge" protocol. The infrastructures and veneers were fabricated by milling zirconium blocks and cemented. The occlusion was rechecked for any interferences. This case report showed successful results for the all-on-four/five treatment concept "Toronto Bridge" prostheses at a six-month follow-up, and no complications were observed. This case report suggests that the implant-supported prosthetic treatment of a completely edentulous patient treated with the "Toronto Bridge" treatment technique provides esthetics, phonetics, oral hygiene, and oral comfort, which may be an alternative to an acrylic resin or porcelain fused metal fixed restorations.