Implant Dentistry Today No 14

Implant Dentistry Today 10 Pro Arch bi-maxillary prosthetic rehabilitation with Straumann BLT implants A clinical case report by Javid Taghizade , Russia Dental rehabilitationwith immediate implant placement and loadingwith temporary fixed dental prosthesis (FP-3 by Karl Mish). Initial situation A 67-year-old female patient presented a complaint on the unsatisfactory appearance of her teeth and low quality of mastication and food processing (Fig. 1 – 4). The patient also reported a decreased quality of life and social maladjustment. She expressed a strong unwillingness to wear a removable prosthesis due to an expressed gag reflex. Her medical records showed a history of periodontitis. Most of the remaining previously treated teeth presented with purulent discharge have a hopeless long-term prognosis. The patient recently recovered from an acute cerebrovascular accident and had hypertension under control. Clinical examination revealed partially edentulous upper and lower jaws with a total adentia in posterior regions. Treatment planning Considering the patient’s remaining dentition, a possibility would be to re- treat the multiple endodontically treated teeth and perform new fixed prosthesis. This intervention would also involve treating and controlling the periodontally compromised teeth, as well as the placement of dental implants in the posterior edentulous areas. However, the patient indicated no further willingness to go through extensive treatment time. She expressed a preference for replacement of the teeth with dental implants with a fully functional fixed prosthesis. After careful examination of the residual bone on the CBCT, I considered that high primary stability (and high insertion torque) could be obtained through the use of the Straumann® Bone Level Tapered (BLT) Implants. Furthermore, an implant- borne full-arch restoration could be undertaken using the Straumann® Pro Arch BLT concept. An immediate implant placement and provisionalization was chosen, to deliver immediate function and aesthetic appearance. Grafting with bovine deproteinized bone substitute was considered focally for dimensionally compromised bone sites mainly associated with the post extraction sockets. The following treatment plan was agreed with the patient. Total tooth extraction with a simultaneous placement of 6 Straumann BLT SLActive implants in maxilla and mandible. Placement of SRA abutments supporting the temporary fixed dental prosthesis was followed by the final prosthesis. Surgical procedure After atraumatic tooth extraction (Fig. 5 – 6), and levelling of the alveolar ridge, the Straumann BLT SLActive implants were inserted in the tooth positions 12, 14, 16, 22, 24, 26, 32, 34, 36, 42, 44, 46, while the SRA abutments (Fig 7 – 9) and protective cups were also installed. Bone defects were filled with autogenous bone chips (harvested during osteotomy preparation), followed by deproteinised bovine bone (Fig. 10). After suturing, a primary closure was achieved (Fig. 11 – 12). Fig 1 Fig 3 Fig 2 Fig 4 Fig 7 Fig 5 Fig 8 Fig 6 Fig 9