Periimplantitis and narrow crest

transcript

Luc@Vrielinck.be

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

Severe buccal fenestration of the implants causing periimplantitis and chronic gingivitis

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

• 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

Final result

24/02/2009

24/02/2009: Final result

Follow-up > 1 year

07/06/2010

07/06/2010: Follow-up > 1 year

T-scan measurement of the maximal occlusion

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