• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.207-214
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• 2015

Due to the limitations of conventional removable partial denture prostheses to treat a cleft lip & palate patient who shows scar tissue on upper lip, excessive absorption of the maxillary residual alveolar ridge, and class III malocclusion with narrow palate and undergrowth of the maxilla, 4 implants were placed on the maxillary edentulous region and a maxillary removable implant-supported partial denture was planned using a CAD/CAM milled titanium bar. Unlike metal or gold casting technique which has shrinkage after the molding, CAD/CAM milled titanium bar is highly-precise, economical and lightweight. In practice, however, it is very hard to obtain accurate friction-fit from the milled bar and reduction in retention can occur due to repetitive insertion and removal of the denture. Various auxiliary retention systems (e.g. $ERA^{(R)}$, $CEKA^{(R)}$, magnetics, $Locator^{(R)}$ attachment), in order to deal with these problems, can be used to obtain additional retention, cost-effectiveness and ease of replacement. Out of diverse auxiliary attachments, $Locator^{(R)}$ has characteristics that are dual retentive, minimal in vertical height and convenient of attachment replacement. Drill and tapping method is simple and the replacement of the metal female part of $Locator^{(R)}$ attachment is convenient. In this case, the $Locator^{(R)}$ attachment is connected to the milled titanium bar fabricated by CAD/CAM, using the drill and tapping technique. Afterward, screw holes were formed and 3 $Locator^{(R)}$ attachments were secured with 20 Ncm holding force for additional retention. Following this procedure, satisfactory results were obtained in terms of aesthetic facial form, masticatory function and denture retention, and I hereby report this case.