The patient, a white 65 year old female, is a heavy smoker and a heavy drinker.
Previous dental care in the maxillary arch is failing; radiographs reveal no salvageable teeth, but adequate bone in the anterior maxilla to accommodate 13-15 mm. implants.
Sinuses are large, the posterior maxilla is ruled out as a site for implants, and she exhibits Class III skeletal occlusion.
Due to financial considerations, complex overdenture and a crown and bridge restoration were ruled out.
The final prosthetic design choice was a simple overdenture with a bar and retaining clips.
The use of four implants, for stability, was discussed. The patient’s smoking and drinking was significant as was the use of immediate implants.
The patient’s Class III skeletal occlusion and poor oral hygiene was afforded much consideration in the overall treatment plan. A discussion was initiated based on the complexity of the procedure and the predicted outcome of the treatment.
The patient was advised as to the problems associated with her smoking, drinking and poor oral hygiene. Following these discussions, she gave final approval for the proposed treatment plan.
The remaining maxillary teeth were extracted, implants placed, and an immediate denture was inserted. Healing was uneventful and six months later the implants were uncovered.
A bar was constructed and the final prosthesis was processed with four retaining clips.
The patient’s drinking was a problem throughout treatment in terms of her remembering the type of prosthesis that was being constructed. Ultimately, however, the treatment was completed to the patient’s satisfaction.
What this case study demonstrates is the powerful new world we have at our disposal as dental professionals. On my side, we have the latest technology to fabricate the restorations to make situations like the above a success.
On the other, we have dental professionals able to overcome someone with a torrid oral hygiene history to supply them with a comfortable, healthy smile.
Biterite offers a wide variety of solutions for implants, from cad/cam design to custom zirconia abutments.
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