Case report
Patient with failing bridge upper left side #12-14 with significant caries and periodontal disease. A staged treatment approach was designed with plans for replacement of teeth #12, 13, and 14.
Treatment
- Extraction of teeth #12 and 14
- Site allowed to heal for 2.5 months to regenerate soft tissue and bone.
- Sinus lift bone augmentation using lateral osteotomy approach. An autogenous and allogeneic bone combination was used for graft material along with PRGF for enhanced tissue maturation.
- Site allowed to heal for 6 months.
- CBCT and optical scan done for implant planning. A 3-D work up was completed and a surgical guide was fabricated.
- Implants #12, 13, and 14 were placed using our surgical guide.
- Dental implants were allowed to heal for 4 months and then exposed with placement of appropriate healing abutments.
- Following 6 weeks of soft tissue healing, implant level impressions were done for fabrication of customized abutments and placement of final crowns.
Success factors:
- Staged treatment to achieve a healthy implant site before grafting stage.
- Proper site development with sinus lift bone augmentation to achieve proper height of bone
- CBT and optical scan for total implant planning
- A well-fabricated surgical guide
- Submerging of implant during healing as the grafted bone is most likely D4 quality
- Customized abutments and carefully fabricated final crowns.
Photos
