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Case of the month - May, 2013

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This document summarizes a case where a 54-year-old male presented with a failing long-span fixed partial denture after a history of a mandible fracture from a motor vehicle accident. A cone beam scan and treatment planning software was used to place three implants to support a new fixed-hybrid prosthesis without the need for extensive bone grafts or soft tissue augmentation, achieving an excellent functional and cosmetic result for the patient.

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Case of the month - May, 2013
My special thanks to Dr. Craig Renfer of Concord, CA for his help with this Case of the Month. Many years after a motor vehicle accident and mandible fracture, this patient presented with a failing, long span fixed partial denture. The edentulous area displayed severe bone loss. Ridge augmentation to build full anatomic contours would have been difficult. Dr. Renfers choice for a fixed-hybrid prosthesis obtained an excellent functional and cosmetic result for this patient without extensive bone grafts or soft tissue augmentation.
LIZANO IMPLANT DENTISTRY CC: My bridge anchor is broken and I want a new bridge
LIZANO IMPLANT DENTISTRY 54 y.o. male Missing #23- 26 (history of MVA and jaw fracture) Fractured tooth #22 Limited ridge width (buccal- lingual) Limited attached gingiva Moderate gingival recession Moderate smile line and esthetic demands Findings:
LIZANO IMPLANT DENTISTRY How can we treatment plan this case?
Alternatives LIZANO IMPLANT DENTISTRY No treatment (diminished prognosis for implants in the future due to expected bone loss). Extraction #22 Fixed partial denture supported by teeth. Removable prosthesis (with or without implants). Extraction of tooth #22 + 2 or 3 implants to support a fixed partial denture Additional ridge augmentation bone and/or soft tissue grafting
LIZANO IMPLANT DENTISTRY
LIZANO IMPLANT DENTISTRY
Treatment Sequence LIZANO IMPLANT DENTISTRY Section existing bridge / removable treatment partial Extraction tooth #22 Ridge preservation bone graft (allograft) Cone beam scan / Anatomage planning Reevaluate for additional bone and soft tissue grafting Implant placement (3) Implant abutments and restoration
Extraction and ridge preservation LIZANO IMPLANT DENTISTRY Ridge preservation bone graft (MinerOss allograft+ Cytoplast membrane) Severe bone loss buccal aspect of extraction site
Anatomage treatment plan and computer guided implant placement LIZANO IMPLANT DENTISTRY
Anatomage treatment plan and computer guided implant placement LIZANO IMPLANT DENTISTRY
Anatomage treatment plan and computer guided implant placement LIZANO IMPLANT DENTISTRY
LIZANO IMPLANT DENTISTRY Ridge augmentation graft indicated?
LIZANO IMPLANT DENTISTRY Placed implants as follows: #22 site AstraTech 3.5 x 13mm OsseoSpeed fixture #24 site AstraTech 3.5 x 13mm OsseoSpeed fixture #26 site AstraTech 3.5 x 13mm OsseoSpeed fixture
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013
Case of the month - May, 2013

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Case of the month - May, 2013

  • 2. My special thanks to Dr. Craig Renfer of Concord, CA for his help with this Case of the Month. Many years after a motor vehicle accident and mandible fracture, this patient presented with a failing, long span fixed partial denture. The edentulous area displayed severe bone loss. Ridge augmentation to build full anatomic contours would have been difficult. Dr. Renfers choice for a fixed-hybrid prosthesis obtained an excellent functional and cosmetic result for this patient without extensive bone grafts or soft tissue augmentation.
  • 3. LIZANO IMPLANT DENTISTRY CC: My bridge anchor is broken and I want a new bridge
  • 4. LIZANO IMPLANT DENTISTRY 54 y.o. male Missing #23- 26 (history of MVA and jaw fracture) Fractured tooth #22 Limited ridge width (buccal- lingual) Limited attached gingiva Moderate gingival recession Moderate smile line and esthetic demands Findings:
  • 5. LIZANO IMPLANT DENTISTRY How can we treatment plan this case?
  • 6. Alternatives LIZANO IMPLANT DENTISTRY No treatment (diminished prognosis for implants in the future due to expected bone loss). Extraction #22 Fixed partial denture supported by teeth. Removable prosthesis (with or without implants). Extraction of tooth #22 + 2 or 3 implants to support a fixed partial denture Additional ridge augmentation bone and/or soft tissue grafting
  • 9. Treatment Sequence LIZANO IMPLANT DENTISTRY Section existing bridge / removable treatment partial Extraction tooth #22 Ridge preservation bone graft (allograft) Cone beam scan / Anatomage planning Reevaluate for additional bone and soft tissue grafting Implant placement (3) Implant abutments and restoration
  • 10. Extraction and ridge preservation LIZANO IMPLANT DENTISTRY Ridge preservation bone graft (MinerOss allograft+ Cytoplast membrane) Severe bone loss buccal aspect of extraction site
  • 11. Anatomage treatment plan and computer guided implant placement LIZANO IMPLANT DENTISTRY
  • 12. Anatomage treatment plan and computer guided implant placement LIZANO IMPLANT DENTISTRY
  • 13. Anatomage treatment plan and computer guided implant placement LIZANO IMPLANT DENTISTRY
  • 14. LIZANO IMPLANT DENTISTRY Ridge augmentation graft indicated?
  • 15. LIZANO IMPLANT DENTISTRY Placed implants as follows: #22 site AstraTech 3.5 x 13mm OsseoSpeed fixture #24 site AstraTech 3.5 x 13mm OsseoSpeed fixture #26 site AstraTech 3.5 x 13mm OsseoSpeed fixture