Scholar Case 2

ITI Scholar Center:
University of North Carolina
School of Dentistry
Department of Periodontology
Chair: Dr. Ray C. Williams

Title:
Esthetic restoration of a failed maxillary dentition using 6 immediately placed ITI implants. A tissue-related flapless approach.

Introduction
A 45 year old female patient presented with a failed maxillary dentition to the Department of Periodontology, University of North Carolina at Chapel Hill, USA. Her major concern was the restoration of an esthetic smile and a functional occlusion. Clinical and radiographic examination revealed extensive restorative treatment in the past as well as loss of several premolar and molar teeth with a reduced vertical dimension of occlusion. Almost all remaining maxillary teeth were destroyed by secondary dental caries beyond crowns and fillings and had therefore a guarded prognosis. Her initially poor oral hygiene was significantly improved during the initial treatment phase consisting of supragingival plaque control, oral hygiene advice, and remotivation.

The alveolar bone crest height around the remaining maxillary teeth was considered sufficient for implant placement. After informed consent was obtained all severely destroyed maxillary teeth in this high susceptible caries patient, except the first molars, were extracted and 6 ITI Esthetic Plus Implants were immediately placed into the fresh extraction sockets. Extra care was taken during this flapless approach to place the implants in an esthetically ideal horizontal and vertical position for maximal preservation of the hard- and soft – tissue and to allow for an esthetically ideal restoration in this demanding patient. After 3 months of semisubmerged healing the gingival tissue was shaped with the temporary acrylic bridge for 8 weeks before the definitive PMF bridges were delivered. The patient was very satisfied with the restoration of esthetic and function in the maxilla. The mandibular restoration was postponed for treatment in the near future because finances were a concern.


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