periimplantitis and narrow crest
DESCRIPTION
Case report of early bone loss around implants. Demonstration of the succesful retreatment using All-on-4 techniqueTRANSCRIPT
Situation
• Patients desires: solution for the lower jaw, chronic inflammation around 2 implants placed two years earlier
• Diagnostics:– Medical anamnesis: no medical problems, no medication
– Periimplantitis around the two implants in lower jaw
– Bad oral hygiene with plaque accumulation
– Sharp bony ridge with implant fenestrations (see Conebeam images)
Chronology
• 03/10/2007: Intake
• 03/10/2007: Removal of the implants, alveolectomy
• 26/08/2008: Placement AO4 delayed loading
• 01/12/2008: second stage surgery
• 24/02/2009: end result
• 07/06/2010 Follow-up > 1 jaar
Intake
03/10/2007
03/10/2007: Intake: chronic infection around both implants in lower jaw
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03/10/2007: Intake: chronic infection around both implants in lower jaw
Severe buccal fenestration of the implants causing periimplantitis and chronic gingivitis
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
Crest is too narrow
to place implants,
first an alveolectomy
is needed
Treatment plan
Treatment plan
• Removal of the 2 fenestrated implants
• Alveolectomy, healing of the bone
• AO4 , delayed loading, AO4 bridge
22/7/2008: orthopantomography, bone healing after removal of the 2 implants
Surgery AO4
26/08/2008
26/08/2008: Placement AO4
Location of the previous implants
01/12/2008: second stage and placement multiunit abutments
01/12/2008: second stage and placement multiunit abutments
Final result
24/02/2009
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
Follow-up > 1 year
07/06/2010
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
T-scan measurement of the maximal occlusion
07/06/2010: Follow-up > 1 year
T-scan measurement of the maximal occlusion
07/06/2010: Follow-up > 1 year
T-scan measurement of the maximal occlusion