Indication 7, Case 2 | ITI CENTER

Distal extension situation mandible

Daniel Hess, Dr. med. dent
St. Gallen / Switzerland
Alwin Schönenberger CDT,
Glattbrugg/Switzerland

	Panoramic radiograph of a 16-year-old female patient. Teeth 36 and 37 are retained due to anchylosis and horizontal displacement, respectively. As a result, the upper molars on the patient's left side are elongated.

	Clinical situation after completion of orthodontic therapy. Retention is ensured by the orthodontic appliance. At this time, the patient is 18 years old.

	Lateral view of the patient's left side. Teeth 36 and 37 have been surgically removed. Note the harmony of the occlusal line after successful intrusion of teeth 26 and 27. Implant therapy is indicated to stabilize the antagonistic non-opposed teeth.

	The alignment of the lower dental arch is perfect. An x-ray template is fabricated according to the envisioned prosthetic reconstruction. Two implants are planned in area 36-37

	Periapical radiograph of the prospective implant sites. Based on this evaluation, the placement of two 12 mm ITI full-body screw implants is possible. Tooth 38 will be extracted during implant placement.

	Radiographic control after implant placement. Surgery occurred according to the standard procedure for posterior segments.

	Lateral view of the two implants three months after implant placement. In posterior sites, a submucosal implant shoulder placement is not necessary.

	Clinical situation after abutment fixation. The implants are fitted with solid abutments. To date 1 single tooth gaps, small edentuluos spaces and free-end situations are most likely to be treated by cemented superstructures

	Impression making and fabrication of the superstructure was performed according to conventional prosthetic procedures.

	Premolar units are correctly sized for standard ITI implants. They allow adequate contours and appropriate inter-implant spaces.

	For mechanical reasons, neighboring units may be connected to each other. The absence of both occlusal and transversal screw openings, positively influences laboratory procedures and reduces treatment costs.

	Close-up view of the metal-ceramic restoration after cementation. The cement may be either provisional or definitive. Note the almost perfect integration of the two artificial crowns.

	Occlusal overview after completion of therapy. The previously shortened dental arch has been successfully extended distally.

	The peri-apical follow-up radiograph 2 years after implant placement documents good osseointegration and perfect marginal fit of the prosthetic superstructures.