Be prepared for the worst scenario From Bicon to Zygoma MKA Genk
Overview • • • • •
♂ 49 year old Severe periodontitis UJ and LJ Smoker ± 6 cigarettes / day Medically uncompromised Treatment plan: – Upper jaw; total extraction and implant treatment – Lower jaw: extraction 47 and periodontal treatment
13/12/2012
20/02/2013
Location 14
Location 12
Location 22
Location 24
Treatment plan 1 • • • •
Moderate/severe bone atrophy 4 x Bicon (4,5 x 6 mm) Delayed loading Fixed bridge (e.g. Trinia)
02/05/2013
At second stage failure of all implants
24/10/2013: failure all 4 implants
Complicating factors • Postoperative infection region implant 22 (R/ Clindamycin 3 * 300 mg/day) • Denture wearer, inadequate prothesis releive • 4 x mucosal perforation of healing plug • smoker
Treatment plan 2
X
CBCT Before retreatment
14
12
22
24
Treatment plan 2 • • • • •
severe bone atrophy Quad zygoma Immediate loading Temporary bridge After 12 months definitive bridge
Buccal fenestration of implant at 14
Placing 4 zygoma implants (Stella technique)
Showing the buccal bone defect after failure of the Bicon implants
09/01/2014: Radiographic check postoperatively
09/01/2014: Radiographic check postoperatively
09/01/2014: Radiographic check postoperatively