Doctor Peng Dong, the expert of tooth implantation in Peking University International Hospital and president of Beijing Hedu Stomatological Clinic Co., Ltd
Medical Case Report
| Sex / Age: Male/76 |
|
| First Visit: 07/05/2015 |
Implant Surgery: 18/09/2015 |
| Others Surgery (GBR…):18/09/2015 |
Final Restoration: 05/03/2016 |
| First Recall: 24/03/2016 |
|
| Chief Complaint: Missing a lower anterior teeth, the patient seeks implant restoration. |
| Consideration(s):GBR |
CASE OUTLINE
The lower teeth 2, 1, 1 and 2 were extracted due to looseness three months ago. The patient is in good health with no other surgical contraindications. Oral examination: Lower teeth 2 and 2 (lower left central incisor and lower left lateral incisor) are missing, with significant alveolar bone resorption, and the mucosa shows no signs of redness or swelling. Teeth 3 in the lower left and lower right regions, as well as teeth 2 in the upper jaw, are free from caries, not loose, and the gums show no signs of redness or swelling. The upper and lower front teeth exhibit a deep overbite of Class II. Overall oral hygiene is good (one week after periodontal scaling), with no calculus, stains, or soft plaque. Significant gum recession is evident. CT scan shows that the width of the alveolar bone for tooth 2 in the lower right region is 5.0mm, with a bone height of 15.2mm, and for tooth 2 in the lower left region is 4.5mm, with a bone height of 15.8mm.
TREATMENT PLAN
For both lower right and lower left teeth 2, conventional implantation of C-Tech implants (Model: ND-3009) will be performed, along with simple bone grafting during the same procedure. After five months, impressions will be taken, and an oxidized zirconia porcelain bridge will be permanently placed for final restoration.
TREATMENT
1、Collect blood before the surgery to prepare CGF.
2、Under routine electrocardiographic monitoring, place disinfectant towels in the lower right and lower left quadrant. Administer painless local anesthesia to the areas. Make incisions along the crest of the alveolar ridge for lower teeth 4, and additional incisions inside the grooves for lower teeth 3. Carefully reflect the gingiva, observing significant alveolar bone resorption. Use large round burrs to smooth the bone surface.
3、Precisely position the C-Tech implants (Model: ND-3009) in the lower right and lower left teeth 2. Use a pilot drill to reach the working length and gradually create tapered boreholes measuring 2.6*13.0mm. Implant the C-Tech implants and secure with closure screws, applying a torque of 20N for each. Cover the implants in the lower right and lower left regions with bone graft, membrane, and CGF membrane on the buccal side. Suture the site tightly, and apply sterile gauze rolls for hemostasis. Instruct the patient on post-operative care, including a 5-day course of oral antibiotics and rinsing with chlorhexidine mouthwash four times daily for two weeks.
4、Remove sutures after 10 days, confirming good wound healing with minimal redness and swelling in the soft tissues and presence of some soft plaque.
5、After 5 months, take impressions, and replace the abutments with Model ND-3025-2*2. Cement and fix the oxidized zirconia porcelain bridge permanently for final restoration.
DISCUSSION
1、The patient is satisfied with the current condition of their teeth, and the dentures function and appear excellent.
2、There is no pain, abnormal sensation, infection, or damage observed after the implantation.
3、During the clinical observation period, there was no evidence of gum recession.
4、X-ray findings show that the bone resorption around the neck of the implants in lower right 2 and lower left 2 during the observation period is less than 0.2mm.
