Indication 3, Case 2 | ITI CENTER

Distal extension situation maxilla

Dr. Thomas von Arx
Department of Oral & Maxillofacial Surgery,
Kantonsspital Lucerne (Switzerland)

	Preoperative planning for the insertion of two ITI implants in a distal extension situation in the left maxilla. The 55-year old patient denied any sinus elevation surgery.

	Standard screw-type implants of 12 mm in regio 24 and 10 mm in regio 25 were installed after lateral incision on the palatal aspect and preparation of a mucoperiostal flap to the buccal aspect.

	As anticipated by conventional radiography (picture 1) and reformatted computer scans (not shown) peri-implant crater-like defects had to be augmented using autogenous bone harvested in the retromolar area in the left mandible.

	Bone grafts were secured by a titanium mesh which was fixed to the surrounding jaw bone using small bone screws. A submucosal healing of the implants was accomplished to enhance bone graft integration.

	Periapical radiograph 5 months after implant placement and simultaneous peri-implant augmentation.

	Upon implant recovery the titanium mesh and bone srews were removed. For peri-implant softtissue formation 3mm extension healing caps were mounted on either implant.

	Six weeks later two octa-abutments were inserted using the torque control device.

	The final prosthesis ( two connected porclain-fused -to - metal crowns) were seated by the referring dentist, Dr. Scacchi,Root / Switzerland.

	The final periapical radiograph demonstrates the exellent bone level around either implant with tight fit between suprastructure and implants.