2. My special thanks to Dr. Craig Renfer of Concord, CA
for his help with this Case of the Month. Many
years after a motor vehicle accident and mandible
fracture, this patient presented with a failing, long
span fixed partial denture. The edentulous area
displayed severe bone loss. Ridge augmentation to
build full anatomic contours would have been
difficult. Dr. Renfer’s choice for a fixed-hybrid
prosthesis obtained an excellent functional and
cosmetic result for this patient without extensive
bone grafts or soft tissue augmentation.
6. Alternatives
LIZANO IMPLANT DENTISTRY
No treatment (diminished prognosis for implants
in the future due to expected bone loss).
Extraction #22
Fixed partial denture supported by teeth.
Removable prosthesis (with or without implants).
Extraction of tooth #22 + 2 or 3 implants to
support a fixed partial denture
Additional ridge augmentation bone and/or soft
tissue grafting
9. Treatment Sequence
LIZANO IMPLANT DENTISTRY
Section
existing bridge
/ removable
treatment
partial
Extraction
tooth #22
Ridge
preservation
bone graft
(allograft)
Cone beam
scan /
Anatomage
planning Reevaluate for
additional
bone and soft
tissue grafting
Implant
placement (3)
Implant
abutments and
restoration
10. Extraction and ridge preservation
LIZANO IMPLANT DENTISTRY
Ridge preservation bone graft (MinerOss
allograft+ Cytoplast membrane)
Severe bone loss buccal aspect of extraction
site
15. LIZANO IMPLANT DENTISTRY
Placed 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
