Conservative site management of a medically compromised patient

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Posted on By Maziar Tavazoei In Bone Grafting

First time posting here (have to self isolate myself for 2 weeks due to overseas travel, so trying to keep myself sane!).

Medically compromised 84 Y.O patient on wheelchair. Taking Xarelto amongst many other meds. Failed 3 units 11-22 bridge due to fracture of the abutments. She is not a periodontally compromised patient. Dentition is not in great shape but still functional. Due to polipharmacy and logistics issues offered removable partial denture but she declined. This case is not documented properly as I was not expecting for a favourable outcome.
11 was badly affected and in other circumstances I would have opted for a different approach but not for this patient. Tunnelled the site 11 (or 8 as per American colleagues) tucked a biogide membrane and grafted the site with bioss-collagene. The photos of final restoration were sent to me by my prosthodontist friend. Not a great aesthetic outcome but is what we could achieve in this case. I Welcome and appreciate comments and thoughts.

Initial presentation
Initial presentation

11
22


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3 Comments

I did not graft the site 22 that was actually more favourable initially (a bad decision!). 6 months later the site 11 looked much better than 22. Comparison of these two sites proves once again the post extraction changes in volume and how important is site preservation when indicated.

6 months post-op
11 vs 22


Reply

And implants. I had to graft the sites again, but was not challenging anymore.


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And restoration later on. I could not see the patient after final restoration as patient is on a wheelchair and organising transportation etc was a headache for her carer.


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