Implant treatment in a severe periodontitis patient

This treatment shows a patient with a failing maxillary dentition from advanced periodontitis and caries. A fixed, implant supported, maxillary immediately loaded technique was used by placing implants in sites selected for maximum initial stability, thereby avoiding the need for grafting procedures. Following periodontal treatment of the mandibular arch, the patient was seen for maxillary surgery which included extractions, alveolectomy and alveoplasty, implant placement, abutment placement, surgical impressions and occlusal registration. An autopolymerized screw-retained composite provisional (“overnight”) was fabricated so the patient could leave the office with fixed teeth. Prosthetic materials were delivered to a dental technician who fabricated a heat-polymerized, processed, screw-retained provisional restoration which was delivered 4 days after surgery by the restorative dentist. Healing proceeded uneventfully and the patient has not yet received the final restoration.