long (zygomatic) implants with 9 years follow-up
DESCRIPTION
Description of a case of atrophy in the upper jaw with long follow-up (9 years)TRANSCRIPT
Implant supported bridges in UJ and LJ with 9 years of follow up
With use of long implants in pterygoid zone
Situation
• Patient desires: fixed solution for upper and lower jaw
• diagnosis:– UJ: dorsally insufficient bone volume– LJ: enough bone volume
• Treatment plan– UJ: 4 standard implants and 2 long implants
with pterygoid anchorage– LJ: Implant supported bridge on 5 (6) implants
Chronology• 13/02/2003: Placement implants
– Upper jaw: (4RP,2pt) – Lower jaw (6RP)
• 28/07/2003: Second stage + failure implant 32
Intake
28/01/2002: Intake
28/01/2002: Intake
Implantplanning
UJ: Planning 4 RP and 2 pterygoids
UJ: Planning 4 RP and 2 pterygoids
Implantplanning
LJ: Planning 6 RP
Implantplanning
Dimensional data about the Safe® System
Dimensional data about the Safe® System
Treatment
Stereolithographic model with planned implant positions
Stereolithographic model with SurgiGuide with Mucosal support and Safe® System
Stereolithographic model with zygoma implant Insertion Guide
Stereolithographic model with SurgiGuide with Safe® System
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
Rubber stop for depth control
13/02/2003: Implant Placement in UJ and LJ
Second Guide for Placement of Long Implants
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
13/02/2003: Implant Placement in UJ and LJ
Postoperative check
Postoperative check
Postoperative check
28/07/2003: Second stage surgery
28/07/2003: second stage for the upper jaw
X
Implant 32 was lost at second stage
Final result Upper jaw and Lower Jaw
9 years follow-up
08/02/2011
08/02/2011: 9 years follow-up
08/02/2011: 9 years follow-up
08/02/2011: 9 years follow-up
08/02/2011: 9 years follow-up
08/02/2011: 9 years follow-up
Severe bone loss in the lower jaw
08/02/2011: 9 years follow-up
With a history of several crown fractures and bridge looseningAnd gradual breakdown of the bridge
08/02/2011: 9 years follow-up
08/02/2011: 9 years follow-up
08/02/2011: 9 years follow-up
08/02/2011: 9 years follow-up
Extremely asymmetric occlusion
08/02/2011: 9 years follow-up
Extremely asymmetric occlusion
08/02/2011: 9 years follow-up
Extremely asymmetric occlusion
What to do?
• Patient wants to change from restorative dentist
• A remake of bridge in the Upper and Lower jaw is needed
• After unscrewing the bridges, all implants were found to be stable
• What advice to give to the new restorative dentist ?