Noninvasive approach for maxillary &mandibular implants.

1 Rating(s).

Posted on By Wahib Moussa In Implants

Hello All
Patient is a middle-aged lady, suffering from fear & anxiety.
from any dental treatment.
Examination revealed, mobility of most the remaining teeth and heavy calculus deposits specially in the lower anterior.
The treatment plan:
Was extraction of 6,7,8,9,10,11, in upper arch.
Lower arch extraction of 26,25,24,23.
Insertion of 6 implants in the upper and 3 implants in the lower arch &Bone graft.
Flapless technique was followed, both arches were done in the same visit, acrylic partial dentures will be constructed for the patient.
Your comments and thoughts are welcomed.

Wahib Moussa, Thank You

1-Preoperative Case.
2-Preoperative CBCT & plan.

3-Extraction teeth & insertion implants .
4-Extraction teeth & insertion implants .

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Whilst we have implants in the tool bag, I think in this case I would air on side of caution . I would extract teeth and fit removable partial in the upper and possibly a Maryland type bridge in lower. then I would treat per and reappraise after 4 months. If per no better and patient unable to cary. out reasonable oral hygiene then further delay in implants. I dont think we are doing any favours to patients placing high end advanced dental work when at least adequate OH cannot be maintained especially in a nervous patient who may not return until she has problems with your work.


Dear Barry Thank you very much for commenting on the published, case. What you have said is great, and I believe is quite applicable in most of the situations. but in our situation here especially in Egypt, we have different attitude concerning bad oral hygiene, because most of the cases which comes for the dental treatment or implants, insertion had bad oral hygiene. Our policy is to motivate the patient, start educating him the importance of oral care. Second to demonstrate to the patient how he should utilize the investment done in his mouth from implants and keep safe third instruct him step by step on the oral hygiene and we have noticed a great progress in his condition this is factor number one. I also disagree in postponing the case or doing it in stages, because most of our patients come for implants, and they would like to have implants done. If we give him other options, possibility that. he may Refuse, insist or go to another dentist. Our policy is to keep him under regular checkup and recall system. We have cases with long term success over 27 years, we do have complications but not to many failures in the last 40 years. Thank you again, regards and respect …Wahib Moussa