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Other
treatment plan
Posted on 07.03.2012 09:31 AM
By Alireza Firouzeh
In Implants
Hi
This is a case I want to discuss about that.
He is a 73 years old patient that his chief complain is lack of enough dentition.In clinical examination I found some of teeth with moderate to severe mobility.Teeth no 10 and 11 in upper jaw have grade 4 mobility and seems to be extracted.On the other hand,in the lower jaw he has a same story with teeth no 23/24/25/26/27.In the panorex radiography ,especially in the right posterior region,a huge vertical bone defect is considered.To sum up, I want to know your treatment planning for this patient with implants.Do you think it is logic to save teeth no 6/7/8/9 or it is better decision to ext them.
I am waiting to hearing from all dentists to discuss about the case.
Best regard
ALIREZA FIOUZEH
5 Comments
Maurice Salama says on 07.04.2012 02:10 PM
Yes. I think you can consider saving some of the existing dentition.
Perhaps sinus lifts in Maxilla and vertical bone augmentation in lower right side utilizing ramus block or GBR.
Good luck
Dr. S
Alireza Firouzeh says on 07.09.2012 08:52 AM
thanks a lot for your comment
I extracted all six remaining teeth in maxilla and then I placed 8 implants distributing the jaw.In the right side I did closed sinus lift and 2 implants in molar and premolar areas and in the left side I prefered to insert two implants in the premolar areas and I escaped from performing open sinus lift because of his age.In the anterior segment,I inserted 4 implants in centrals and laterals sockets following my extractions and finally I grafted the canine sockets to preserve the bone.
But in the lower jaw yet I havenot done any surgury.I tend to perform vertical augmentation in the right side and waiting for 6 months and then I want to extract the 4 incisors and right canine and place 4 or 5 implants in this region .Is that my treatment plan suitable for this patient or not????
best regards
amir shirani says on 07.10.2012 08:27 AM
hello dear alireza,,in the radiografic photo of your patient distance between nerve and crest of mandible is good.you can use implant without bone graft ,but if you want best result,use block graft in bone loss area and after 4 mounts its ready for implantation
Bo Meng says on 07.08.2012 11:44 AM
Due to the patient is 73 years old, I think the treatment plan should be simple. The only desire of he is to eat food easily. So I think removable denture is more suitable. However, if he has a strong desire for dental implant, I think shot implant such as Bicon is perfect for him, with less surgery and better effect.
Ronald Goldstein says on 07.09.2012 10:37 AM
Allreza,
I cannot agree with Bo that a removable denture might be the best choice because the patient is 73 years old. I am older than 73 and I assure you I would NOT want a removable denture if implants could be done. Dr. Salama did one implant for me and I am so pleased I do not have to have even a fixed bridge. So I agree with your treatment plan and feel the quality of life will be so much better for your patient.