MANDIBULAR ANTERIOR TEETH REPLACEMENT WITH IMPLANT CROWNS

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STUDY CLUB CASE PRESENTATION: MANDIBULAR ANTERIOR TEETH REPLACEMENT WITH HARD TISSUE AUGMENTATION AND IMPLANT-SUPPORTED CROWNS:

STUDY CLUB CASE PRESENTATION: MANDIBULAR ANTERIOR TEETH REPLACEMENT WITH HARD TISSUE AUGMENTATION AND IMPLANT-SUPPORTED CROWNS Anthony J Reganato, DDS, MS Private Practice Periodontist West Suburbs-Chicago, IL “The Reganato Lecture Series” Sponsored by Woodlake Family Dental of Naperville, IL

CASE REPORT:

CASE REPORT PATIENT TREATMENT-PLANNED FOR REPLACEMENT OF TEETH #23-26 GP REQUESTS 2IMPLANTS (#23/26) FOR A 4-UNIT FPD PATIENT DESIRES ONE IMPLANT FOR EVERY TOOTH REPLACED HMMMM……DILEMMA???

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INITIAL PRESENTATION

Slide 4:

ATRAUMATIC EXTRACTIONS SOCKETS INTACT

Slide 5:

FDBA PACKED INTO EXTRACTION SOCKETS

Slide 6:

TEMPORARY COLLAGEN COVERING VICRYL SUTURING

TEMPORIZATION:

TEMPORIZATION TEMPORARY RPD IN PLACE

Slide 8:

1 WEEK POST-OP SUTURE REMOVAL PERFORMED AT THISTIME

Slide 9:

3 MONTH RE-ENTRY

Slide 10:

3 MONTH RE-ENTRY NOTICE MGJ… PATIENT DECLINED GINGIVAL GRAFTING OPTIONS

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PLAYING DEVIL’S ADVOCATE

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COULD 4 HAVE BEEN POSSIBLE…YES…SHOULD 4 BE DONE IN THIS CASE …NO!!!

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BEFORE AFTER

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POOR BLOOD SUPPLY AT MIDLINE, VERY DENSE CORTICAL BONE, MUSCLE ATTACHMENT/PULL, TEMPORARY PROSTHESIS, THIN CORTICAL PLATES, ETC. ALL PLAY A ROLE IN THE QUANTITY AND QUALITY OF REGENERATED BONE AT #23-26 SITES

Slide 15:

OSTEOTOMY PREPARATION

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POOR BONE QUALITY AT MIDLINE FDBA PLACED, THEN VERTICALS MADE, THEN MEMBRANE PLACED… NOT A RECOMMENDED SEQUENCE FOR GBR

Slide 18:

IMMEDIATE POST-OP COULD 4 IMPLANTS HAVE BEEN POSSIBLE??? NOT IF YOU WANT TO MAINTAIN 3MM INTER-IMPLANT DISTANCE SIGNIFICANCE: ~3MM = MINIMAL BONE REMODELING

Slide 19:

3MM IS NOT POSSIBLE 4 IMPLANTS ARE POSSIBLE

Slide 20:

PRE-OP IMPLANT SURGERY 2 MONTHS POST-IMPLANT SURGERY

Slide 21:

PRE-OP IMPLANT SURGERY 2 MONTHS POST-IMPLANT SURGERY

Slide 22:

2 MONTH RE-ENTRY WITH MIDLINE IMPLANT PLACEMENT

Slide 23:

BEFORE AFTER

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4 WEEKS POST-MIDLINE IMPLANT PLACEMENT IMPLANT TEMPORIZATION APPOINTMENT TISSUE TOUCH-UP PERFORMED BY GP WITH LASER

Slide 25:

SCREW RETAINED PERFORMANCE POSTS

Slide 26:

CEMENT RETAINED TEMPORARY FPD #23-26 ON SCREW RETAINED POSTS HMMM….

Slide 27:

IMPRESSION APPOINTMENT PVS IMPRESSION OF ENCODE HEALING ABUTMENTS MIDLINE TISSUE RESPONSE… FROM OVERZEALOUS LASERING… OR FROM INADEQUATE KG???

Slide 28:

CUSTOM ENCODE ABUTMENTS

Slide 29:

ACRYLIC JIG FOR VERIFICATION OF ABUTMENT ORIENTATION

Slide 30:

FINAL CROWNS

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FINAL PROSTHETICS

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FINAL PROSTHETICS

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BEFORE AFTER

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BEFORE AFTER

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BEFORE AFTER

THANK YOU:

THANK YOU CARNIVORE CHALLENGE “The Reganato Lecture Series” Sponsored by Woodlake Family Dental of Naperville, IL QUESTIONS AND DISCUSSION

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