Retreatment after Failed Standard Implants by Luc Vrielinck
05/05/2011: Intake
05/05/2011: Intake
05/05/2011: Intake
05/05/2011: Intake
17
15
17
15 13
12
05/05/2011: Intake
22 23
25 26
25
26
05/05/2011: Intake
15
Chronology • 2000: Upper jaw was reconstructed using Lefort I advancement osteotomy and iliac crest bone grafts • 2001: placement of 8 standard Brånemark implants and fixed removable prothesis
• 2001 2010: – Chronic pain in the maxilla – Progressive bone loss around the implants • Referral to our Clinic in 2010
Medical antecedents • Surgical: – – – –
Cesarian Umbilical hernia Maxilla osteotomy & reconstruction & dental implants 2010 Multiple surgeries for recurrent maxillary infections around the implants (since many years)
• Medical – Hypercholesterolemia – Stomach ulcer
• Medication – Sipralexa 10 mg ½ co/day – Pantomed 20 mg 1 co/day – Diclofenac when pain
Diagnosis and differential diagnosis • Secondary bone resorption of the reconstructed maxilla • Periimplant bone loss and secondary infection (and/or vice versa)
Treatment Plan • Removal of all the implants and treatment of the bone infection • 3 months later: CBCT evaluation of the residual bone volume • If the patients wants: implants retreatment (probably with zygoma implants)
Situation after Removal of the Implants in the Upper Jaw 28/07/2011
Bone Analysis and Implant Treatment Plan
18
17
16
15
14
13
12
11
21
22
23
24
25
26
27
28
Planning
Surgical Treatment | Zygoma Implant Placement 30/08/2011
30/08/2011: Placement of Zygoma Implants
30/08/2011: Placement of Zygoma Implants
30/08/2011: Placement of Zygoma Implants
30/08/2011: Placement of Zygoma Implants
30/08/2011: Placement of Zygoma Implants
30/08/2011: Placement of Zygoma Implants
30/08/2011: Postoperative control
30/08/2011: Postoperative control
30/08/2011: Postoperative control
Planning for Nobelprocera™ Overdenture bar
Final 12/01/2012
Final result: 12/01/2012
Final result: 12/01/2012
Final result: 12/01/2012
Final result: 12/01/2012
Final result: 12/01/2012
Follow-up 2 year 30/05/2013
30/05/2013: 2 year follow-up
30/05/2013: 2 year follow-up
30/05/2013: 2 year follow-up
30/05/2013: 2 year follow-up
30/05/2013: 2 year follow-up
30/05/2013: 2 year follow-up
Follow-up 4 year 15/04/2016
15/04/2016: 4 year follow-up