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full mouth reconstruction
Posted on 06.20.2012 04:34 PM
By Alireza Firouzeh
In Implants
Dear Dr Salama
This case is a 73 years old man with severe mobility of teeth no 10 and 11 in upper jaw and teeth no 23/24 25/26/27 in mandible.He also has vetical bone loss in both left and right side of maxillary and in posterior area of right mandible.what is your decision in restoring the dentition with implant support prosthesis???Do you believe in remaining the teeth no6/7/8/9 or not? what is the best treatment plan for the upper jaw??Do you think for achieving the better esthetic outcomes,these teeth have to be extracted??? In the lower jaw,do I need a vertical bone graft while I place my implants simultaneously using the tent technique with non resorbable membrane and fixation??
I would be glad hearing from you ASAP.
best regards
DR ALIREZA FIROUZEH
2 Comments
henry salama says on 06.21.2012 11:15 AM
A challenging but not unusual case. First, the main probable reason for the increased mobility of the anterior teeth is lack of posterior support to protect the anterior teeth and also off axis forces. Furthermore, to answer your questions & Tx Plan a case like this properly requires a great deal more information.
1)As to issues of esthetics, clinical intra-oral photos as well as facial showing lip position in full smile would be mandatory.
2) Generally, we prefer doing vertical augmentation in a staged approach before, & separate from, implant placement. However, a CBCT is required to decide on the important decision of choosing vertical augmentation of the lower right OR short implants.
3) Answers, to what teeth to save or extract will directly relate to decisions by you and your patient on a number of subjects, including esthetic requirements, finances and therefore whether you choose implant supported fixed or over-denture type final restorations. This will affect # of implants and splinting options.
Therefore, if you can share photos & CBCT info, maybe we can further explore the tx plan options.
Good Luck
zmpden2003 zmpden says on 07.02.2012 09:36 AM