Periimplantitis and narrow crest Luc@Vrielinck.be
Situation • Patients desires: solution for the lower jaw, chronic inflammation around 2 implants placed two years earlier • Diagnostics: – – – –
Medical anamnesis: no medical problems, no medication Periimplantitis around the two implants in lower jaw Bad oral hygiene with plaque accumulation Sharp bony ridge with implant fenestrations (see Conebeam images)
Chronology • • • • • •
03/10/2007: 03/10/2007: 26/08/2008: 01/12/2008: 24/02/2009: 07/06/2010
Intake Removal of the implants, alveolectomy Placement AO4 delayed loading second stage surgery end result Follow-up > 1 jaar
Intake 03/10/2007
03/10/2007: Intake: chronic infection around both implants in lower jaw
Severe buccal fenestration of the implants causing periimplantitis and chronic gingivitis
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03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
03/10/2007: Intake: chronic infection around both implants in lower jaw
Crest is too narrow to place implants, first an alveolectomy is needed
03/10/2007: Intake: chronic infection around both implants in lower jaw
Treatment plan
Treatment plan • Removal of the 2 fenestrated implants • Alveolectomy, healing of the bone • AO4 , delayed loading, AO4 bridge
22/7/2008: orthopantomography, bone healing after removal of the 2 implants
Surgery AO4 26/08/2008
Location of the previous implants
26/08/2008: Placement AO4
01/12/2008: second stage and placement multiunit abutments
01/12/2008: second stage and placement multiunit abutments
Final result 24/02/2009
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
24/02/2009: Final result
Follow-up > 1 year 07/06/2010
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
07/06/2010: Follow-up > 1 year
T-scan measurement of the maximal occlusion
07/06/2010: Follow-up > 1 year
T-scan measurement of the maximal occlusion
07/06/2010: Follow-up > 1 year
T-scan measurement of the maximal occlusion
07/06/2010: Follow-up > 1 year