Case of the month - May, 2013

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Case of the month - May, 2013

  1. 1. My special thanks to Dr. Craig Renfer of Concord, CAfor his help with this Case of the Month. Manyyears after a motor vehicle accident and mandiblefracture, this patient presented with a failing, longspan fixed partial denture. The edentulous areadisplayed severe bone loss. Ridge augmentation tobuild full anatomic contours would have beendifficult. Dr. Renfer’s choice for a fixed-hybridprosthesis obtained an excellent functional andcosmetic result for this patient without extensivebone grafts or soft tissue augmentation.
  2. 2. LIZANO IMPLANT DENTISTRYCC: “My bridge anchor is broken and I want a new bridge”
  3. 3. LIZANO IMPLANT DENTISTRY54 y.o. maleMissing #23-26 (historyof MVA andjaw fracture)Fracturedtooth #22Limitedridge width(buccal-lingual)LimitedattachedgingivaModerategingivalrecessionModeratesmile lineand estheticdemandsFindings:
  4. 4. LIZANO IMPLANT DENTISTRYHow can we treatment plan this case?
  5. 5. AlternativesLIZANO IMPLANT DENTISTRYNo treatment (diminished prognosis for implantsin the future due to expected bone loss).Extraction #22Fixed partial denture supported by teeth.Removable prosthesis (with or without implants).Extraction of tooth #22 + 2 or 3 implants tosupport a fixed partial dentureAdditional ridge augmentation bone and/or softtissue grafting
  6. 6. LIZANO IMPLANT DENTISTRY
  7. 7. LIZANO IMPLANT DENTISTRY
  8. 8. Treatment SequenceLIZANO IMPLANT DENTISTRYSectionexisting bridge/ removabletreatmentpartialExtractiontooth #22Ridgepreservationbone graft(allograft)Cone beamscan /Anatomageplanning Reevaluate foradditionalbone and softtissue graftingImplantplacement (3)Implantabutments andrestoration
  9. 9. Extraction and ridge preservationLIZANO IMPLANT DENTISTRYRidge preservation bone graft (MinerOssallograft+ Cytoplast membrane)Severe bone loss buccal aspect of extractionsite
  10. 10. Anatomage treatment plan and computerguided implant placementLIZANO IMPLANT DENTISTRY
  11. 11. Anatomage treatment plan and computerguided implant placementLIZANO IMPLANT DENTISTRY
  12. 12. Anatomage treatment plan and computerguided implant placementLIZANO IMPLANT DENTISTRY
  13. 13. LIZANO IMPLANT DENTISTRYRidge augmentation graft indicated?
  14. 14. LIZANO IMPLANT DENTISTRYPlaced implants as follows:#22 site – AstraTech 3.5 x 13mm OsseoSpeed fixture#24 site – AstraTech 3.5 x 13mm OsseoSpeed fixture#26 site – AstraTech 3.5 x 13mm OsseoSpeed fixture

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