To manage or restart?

156 Rating(s).


Posted on By Chirdeep Chandrakeerthi In Full Arch & Dentures

This 35 year old healthy lady presented with long due maintenance of her implant retained prosthesis. She had lost all her teeth at 15 years of age due to hypoplasia. She received her implants and prosthesis at an academic institution in the OMFS clinic. She had not had any maintenance visits for 20 years! Clinically, the implants are now outside the bony envelope perhaps due to the natural resorptive process over time. There is minimal attached tissue around the implants as seen in the clinical pictures. I removed her prosthesis and cleaned up, torqued the implants to 45 N to determine their stability and they are. Given the muco-gingival defects and lack of bony envelope around the implants, I feel like the construction is bound to fail in the coming years. Question to the forum: What would you do? Predictability of bone grafting around the existing implants? Soft tissue grafting to improve attached tissue? Explant and replace?




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5 Comments

Vesibuloplasty and FGG!! There is still great amount of bone available to secure implants and restoration. Dr. Salama


Reply

Check this link below http://forum.dentalxp.com/case/details/free-gingival-grafting-all-on-maxillary/7551


Reply

Dr. Salama, I viewed the case you recommended http://forum.dentalxp.com/case/details/free-gingival-grafting-all-on-maxillary/7551 The tacks would be a great additional option to secure the graft indeed. Since there is a possibility that one or more could get loose and drop off at some time with a possibility of ingesting/inhaling it, how would you control this possible situation? Thanks! Chirdeep


Reply

I use tacks and sutures. The tacks are 5mm long and engage deeply into the bone....


Reply

Awesome! Thanks. Will post pictures as it progresses.


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