Severe Mandibular Edentulism? All on Four? Part 2

408 Rating(s).


Posted on By Maurice Salama In Full Arch & Dentures

Patient completely edentulous with severe atrophy of posterior with nerve exposure over the ridge.
Thoughts on our plan? Minimal Bone Grafting, Nerve management including anterior loop and extension, possible nerve issues post placement, incision designs, prosthetic approach ALL on FOUR etc. etc. Just completed this case 1 year ago with Guided Surgery from CBCT 3D plan immediate loading ALL on Four and Titanium cadcam milled restoration and overlying acrylic teeth. Dr. Salama

impressions
lab prosthetics

seated case
Vestibuloplasty


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13 Comments

Mo. GREAT CASE! Do you have any plans for soft tissue augmentation? Would love to see a PO CBCT super-imposed over the original plan. Thank you for the update. Best regards. Chuck


Reply

Chuck; Thanks. We did a full Gintuit FGG with Vestibuloplasty. This gentleman lives in the Northeast and is maintained there....would love to see the post op CBCT and will share when I can. Mo


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Mo. Nice work in placement of Gintuit. Not as easy as it looks. I would also be interested to see how it holds up over time. Thanks again for sharing.Chuck.


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Maurice/Chuck, have either of you utilized ACDM for this type of vestibuloplasty? How does it turn out?


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Anoosh. I tried ACDM once. Bad taste, bad smell, bad result, and bad experience overall for both patient and myself. Didn't try again. Chuck


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Anoosh; I agree with Chuck regarding ACDM for this purpose. Dr. Salama


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Dr Salama,

Beautiful, i agree with chuck, i love the placement of the Gintuit here. Cant wait to see the post-op result here.

Thanks for sharing.

Ehab


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Wonderful Service, tough case. Is the screw access on the left on #21 or 20?, Occl on #19 I assume light?


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Between 20 & 21. Light occlusion 19.yes. See related posts Part 1 on top right of screen or go to link below;
http://forum.dentalxp.com/case/details/severe-mandibular-edentulism-all-on-four/1780


Reply

Maurice,

Hello from Dallas! You posted the gintuit ( are you getting from parent company now) after the seating of final prosthesis- did you do prior too?

I believe the max teeth are implants- is it imp bridges or similar to mandible and would you consider zirconia framework- ?


Cheers,

Richard


Reply

Richard; Gintuit prior to final restoration. Maxilla implants fixed hybrid also with cadcam milled titanium framework and acrylic teeth. Regards Maurice


Reply

7 years post op today on this case and still flourishing...because "tissue is the issue" and it's not the scan it's the plan"!!!


Reply

Old is gold Dr. Salama !!


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