Moderate to advanced maxillary & mandibular alveolar defects secondary to lack of development due to congenitally missing permanent tooth buds. Unstable hinge axis secondary to lack of reproducable occlusion.

Initial panoramic radiograph.

Immediate postoperative radiograph - completed procedure: Removal of the exisiting teeth with placment of implants and immediate loading the maxillary and mandibular implants.

Definitive restoration.

0 Evaluation & Diagnosis
1 Treatment Planning
2 Progress & Completion
3 Follow-Up & Outcome

Patient cases:

Complete-arch treatments

(Edentulous)

Rehabilitation of an ectodermal dysplasia patient

Lead:

Edmond Bedrossian

Evaluation & Diagnosis

Maxilla: complete lack of permanent teeth with existing malformed central and lateral incisors.

Mandible: lack of permanent mandibular teeth with exception of the right and left permanent cuspids. Presence of composite defect, requiring a Procera Implant bridge.

Moderate to advanced maxillary & mandibular alveolar defects secondary to lack of development due to congenitally missing permanent tooth buds. Unstable hinge axis secondary to lack of reproducable occlusion.

Existing inaesthetic and non-functional maxillary and mandibular removable partial dentures.

Loss of vertical dimension of the facial soft tissues.

Lack of labial support and collapse of the paranasal region. Hidden maxillary transition line during maximum animation.

Initial panoramic radiograph.

Initial assessment: Patient presents with available maxillary alveolus in Zone 1 only.

Initial assessment: Patient presents with available maxillary alveolus in Zone 1 only.

Treatment Planning

Surgical protocol using 4 axial anterior implants and two posterior Zygoma implants.

Surgical protocol All-on-4® treatment concept.

Progress & Completion

Placement of the anterior maxillary implants following removal of the teeth.

Confirming the proper trajectory of the zygoma implant using the initial round drill.

Multi-unit abutment placed onto the zygoma implant.

Torquing of the Multi-unit abutment to 35Ncm.

Attachment of temporary titanium cylinders to the multi-unit abutments following suturing of the soft tissue.

Passive fit of the maxillary denture over the temporary titanium cylinder before luting the cylinders to the denture.

Confirmation of the proper angulation of the mandibular implants using paralleling pins.

Connecting the temporary titanium cylinders to the mandibular denture after placement of the implants and torquing of the abutments.

Immediate postoperative radiograph - completed procedure: Removal of the exisiting teeth with placment of implants and immediate loading the maxillary and mandibular implants.

Final panoramic radiograph.

Maxillary and mandibular Procera implant bridges for establishing a stable hinge axis, reproducable occlusion as well as esthetic lip support reproducable occlusion.

Maxillary and mandibular Procera implant bridges for establishing a Stable hinge axis, reproducable occlusion as well as esthetic lip support reproducable occlusion.

Maxillary and mandibular Procera implant bridges for establishing a stable hinge axis, reproducable occlusion as well as esthetic lip support reproducable occlusion.

Follow-Up & Outcome

Definitive restoration.

Questions

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Team members

Edmond Bedrossian

Implantologist

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