This patient had few remaining lower teeth and was using a partial denture which had become increasingly difficult and painful to use. She had suffered severe bone loss in the back from denture use. She wanted to have a fixed prosthesis to allow her eat comfortably again and not worry about further bone loss. She was seen by Dr. H. Ryan Kazemi, oral surgeon and Dr. Flavio Rasetto, a prosthodontist, for evaluation and planning her treatment.
Because we had abundant bone in the front part of her jaw, it was seen possible to remove the remaining teeth, place several dental implants and restore her with immediate teeth, all on the same day. To precisely plan this treatment, A cone beam CT scan was obtained allowing us to reconstruct a 3-D model and perform virtual modification of the bone and placement of the implants. From this computer model, special guides were made to help Dr. Kazemi place the implants in the most precise positions. A temporary prosthesis was also prepared to be placed on the day of teeth extractions.
Under IV sedation, Dr. Kazemi extracted the remaining teeth and modified the bone to receive five dental implants. These implants were placed with aid of the surgical guide making sure they are placed in proper position and angle. Following placement of the implants, Dr. Rasetto placed the temporary prosthesis and secured it on the implants. Patient went home with a new set of teeth completely supported by the dental implants. She recovered within two days and was back to routine life in a very short time.
After three months of healing, the final prosthesis was delivered. This prosthesis, known as a fixed hybrid prosthesis, is supported completely by the implants providing absolute comfort in chewing and function. The prosthesis can not be removed by the patient but it can be easily cleaned.
What were the keys to her success?
- Why was immediate implants and teeth possible in this patient: This patient had adequate bone support for placement of implants on the same day and there was no infection or chronic inflammatory disease associated with the extracted teeth. Additionally, the implants were very stable, making it possible to immediately place the temporary teeth. Good bone, no infection, stable implants, and a balanced well-fabricated temporary prosthesis were the key reasons for supporting this treatment approach.
- An excellent prosthodontist working in collaboration with Dr. Kazemi- When replacing all teeth in a jaw, a very detailed treatment plan and strategy must be designed. It was through this team approach in implant dentistry with expertise of Dr. Kazemi performing all the surgery and mastery of the prosthodontist restoring the implants that we were able to achieve a great and predictable result.
- 3-D computer work up- With a dental CT scan (CBCT) and computer planning, we were able to precisely design the implants placement and delivery of the final teeth. This technology permitted us deliver the treatment with precision and safety.
- Proper implant positioning- The surgical guide is a must when planning for such a treatment. Implants must be in proper position and angle.
- Patient compliance with necessary follow up- Effective oral hygiene and routine dental exam and cleaning are the key to keeping healthy teeth and implants.