Removal of infected teeth, dental implant surgery, fabrication of metal-ceramic crowns, screw-retained metal-ceramic crowns borne by implants
Treatment phase II – dental implant surgery
Male patient aged 55
Antecedents:
- Professional tartar removal and teeth polishing was performed due to a massive pile-up of sub and supragingival tartar.
- At the previous session 6 decayed and infected lower molars and their periodontal pockets were eliminated.
- The patient was handed over an immediate denture for the 3 months of healing.
Before
After
Second treatment following 3 months of healing: 3 workdays, the installation of implants
Following 3 months’ healing the bone was ready for the installation of implants. For a thorough planning of the site and size of the implants a CBCT (Cone beam computed tomography) scan was recorded to examine the bone mass in 3 dimensions prior to the intervention.
A CBCT scan allowing the bone mass of the jawbones to be examined in 3 dimensions, the site and size of the implants to be assigned and the path of the inferior alveolar nerve to be traced.
The height and width of the bone were ideal for the installation of implants. By securing 3 implants in each quadrant a stable bridge can be achieved. Since the stability of the implant exceeded 30 Ncm on installation the implant was covered with a healing abutment aka. gingiva former allowing the gums to heal into the perfect shape for the permanent abutment in the process of osseointegration. In the lower jaw bone a crucial nerve passes highlighted in pink in the CT scan. The dentist must accurately pinpoint the path of the so-called inferior alveolar nerve to prevent drilling into the nerve when drilling the bone which may cause permanent lip paralysis.
Follow-up panoramic radiograph with the lower implants and gingiva formers (healing abutments)
Following implantation, the provisional denture is relined with a soft material (soft reline). In the course of healing, remember to not only clean your natural teeth and provisional dentures thoroughly, but also the gingiva formers with a tooth brush.
The treatment can be resumed after 3 months’ healing with the fabrication of permanent replacements, viz. metal-ceramic bridges borne by natural teeth and lower implants. There is a time window of 3 months for selecting the type of implant crowns during which the patient can decide whether they favour a screw-retained implant crown or cement-retained one.