PMC5102717_01
Clinical view at the initial appointment. Occlusal view of maxillary (a) and mandibular arch (b).
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The patient presented with a good state of general health with partial edentulism of the upper and lower jaw (Figure 1(a)) and with removable partial prostheses.
Panoramic radiograph from the initial examination.
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After clinical and radiographic analysis by panoramic radiography (Figure 2), poor bone availability in the maxilla and posterior mandible was observed and additionally a computed tomography was requested to plan the case in greater detail (Figure 3).
Computed tomography of maxilla. Distance between reconstructions: 3 mm.
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After clinical and radiographic analysis by panoramic radiography (Figure 2), poor bone availability in the maxilla and posterior mandible was observed and additionally a computed tomography was requested to plan the case in greater detail (Figure 3).
Maxilla 3D reconstruction in frontal (a) and occlusal view (b).
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Due to the extreme maxillary atrophy in the right side (including a radiographic image suggesting oral-antral communication), the indication for reconstructive procedures did not have a favorable prognosis as it can be also observed in the 3D reconstruction image (Figure 4).
Wide-short implants installed at the bone level.
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Due to a limitation of bone height in the posterior extremity, short implants were installed with a length of 5 mm and a diameter of 5 mm for the region corresponding to element 36 and of 6 mm for the 37 and 47 regions (Figure 5).
Abutments for multiple prosthesis installed during the surgery.
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Primary stability was also obtained in the mandibular arch and the heights of the mini conical pillars were selected (WS CM, Neodent Implante Osseointegravel, Curitiba, PR, Brazil) and installed (Figure 6) using a torque of 32 N cm.
Frontal view of final restoration.
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Subsequently, a ceramic trial was performed and partial fixed denture prostheses (FDPs) were installed using a torque of 10 N cm in the prosthetic screws (Figures 7 and 8).
Occlusal view of final restoration: (a) maxilla and (b) mandible.
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Subsequently, a ceramic trial was performed and partial fixed denture prostheses (FDPs) were installed using a torque of 10 N cm in the prosthetic screws (Figures 7 and 8).
Periapical radiographs at the prosthesis installation session in the mandibular arch: (a) right and (b) left side.
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The final periapical radiographic preservation (Figure 9) and 2 years of follow-up can be observed in the panoramic radiographic (Figure 10).
Panoramic radiograph at 2 years of follow-up.
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The final periapical radiographic preservation (Figure 9) and 2 years of follow-up can be observed in the panoramic radiographic (Figure 10).