Edentulous Maxilla with Compromised Bone. Options? Part 1

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Posted on By Maurice Salama In Full Arch & Dentures

Patient presents with severe ridge atrophy and resorption in the maxillary arch. Options and solutions for your own practice? Dr. Salama

Thin ridge maxilla
Panorex Preop

CBCT 3D occlusal view
CBCT 3D frontal view


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4 Comments

Knife Edge Ridge and Pneumatized Sinus bilaterally.

Clinical view of Maxilla
Knife Edge Ridge


Reply

What is the final aim?
I would consider bilateral sinus grafts with placement of 6 implants 6 months later to enable hybrid restoration 4 months later. this would allow the patient to continue wearing prosthesis throughout treatment. If needed one could then graft anteriorly to enable further implants
Obviously zygomatic implants would be a consideration
If the patient was happy not to wear or be limited by a flangeless denture then one could consider full arch bone augmentation of some nature
Or one could use Dr Lee's palatal implants either to secure or temporise


Reply

Mo,

On the reconstructed panorex - difficult to see if you have any posterior bone in the sinus floor as we know with “paper thin” bone will not show on CBCT- for this could dictate treatment- weather you decide to to do bilateral sinus augmentation with biological modifiers - rhBMP2 etc or zygomatics- still need a floor- Anterior maxilla Khoury plates- ridge split with interpositional graft or sausage - Urban- could also consider grafting nasal floor-

I am believing that the mandible will also be treated
See you end of week....

Cheers,

Richard


Reply

Exactly the same as Barry Rimmer proposed.
Looking forward to see your case management!
Best
Snjezana


Reply

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