Plan2Smile case Report 6

Plan2Smile Case Report 06 Necessity of follow-up after implant treatment

Dr Luc Vrielinck, MD DDS Correspondence: Luc@Vrielinck.be Genk, Belgium

From Plan2smile to KeepSmiling • In our department follow-up is centered around three aspects: – Oral hygiene – Radiographic follow-up – Monitoring of the occlusion

From Plan2smile to KeepSmiling • In our department follow-up is centered around three aspects: – Oral hygiene – Radiographic follow-up – Monitoring of the occlusion

Oral hygiene • Around the implants • Around remaining teeth, paradental infections and periodontitis must be treated and monitored

Insufficient cleaning around ball attachements in the upper jaw

Insufficient cleaning below All-on-4 bridge in the lower jaw

Insufficient cleaning below overdenture bar in the lower jaw

From Plan2smile to KeepSmiling • In our department follow-up is centered around three aspects: – Oral hygiene – Radiographic follow-up – Monitoring of the occlusion

Radiographic follow-up • Purpose – Check the fit of all radiographic components – Determine bone level and diagnosis of periimplantitis

Check for misfits Bone loss induced by subgingival cement particles

Misfit of cemented crowns resulting in macrogaps

Misfit of the overdenture bar

Check for misfits

Misfit of the overdenture bar on zygoma implants

Check for unusual bone loss

Pronounced bone after 1 year, upper jaw with ball attachements

Check for unusual bone loss

Bone loss around implants 10-year function

From Plan2smile to KeepSmiling • In our department follow-up is centered around three aspects: – Oral hygiene – Radiographic follow-up – Monitoring of the occlusion

Monitoring of the occlusion • Contact distribution in maximal occlusion • Practically we use the T-scan for recording the occlusal contacts • Desired pattern and location of occlusal contacts depends on the oral situation of the patient and the prosthetic reconstructions present • Occlusion is checked at each recall appointments

Treatment with 2 Bicon implants in the upper jaw

No premature contact neither occlusal overcontact on the implant crowns

Check of the occlusion using T-scan

Check of the occlusion using T-scan