|
|
Simplified One Appointment
Reconstruction of the Severely Atrophied Mandible
Loss of bone in the mandible after tooth removal is not limited to alveolar bone,
basal bone may also resorbed.
This continuing loss of bone is associated with anatomical and
facial aesthetic complications and the instability of the mandibular
complete denture. Endosteal
implants are routinely used to stabilize and support the mandibular
prosthesis for the completely edentulous patient, and are placed
into the remaining native bone.
If the remaining vertical bone height is 6mm or greater and
the prosthesis is totally implant supported, grafting has been found
unnecessary. However when mandibular vertical bone height is less
than 6mm, grafting is considered necessary, Robert Marx AO
2005.
PREVIOUS TREATMENT CONCEPTS:
6mm or
greater bone height body of mandible
IMPLANT PLACEMENT
for the mandible involved: I.V. conscious sedation
or general anesthesia, 3 months healing time for
dental implants, second stage surgery
before loading, with the patient unable to
wear a lower prosthesis during much of the healing time.
M.I.S.
TREATMENT CONCEPTS:
6mm or greater bone height
body of mandible
A ONE SURGICAL APPOINTMENT
technique for the mandible using
Minimal Invasive Surgery:
I.V. conscious sedation, with implant placement, and
immediate implant loading with an interim prosthesis.
Approximately 2-4 weeks following surgery the
definitive prosthesis was started and inserted for case
completion.
CURRENT TREATMENT CONCEPTS:
Less than 6mm bone height
body of mandible
GRAFTING & IMPLANT PLACEMENT
for the severely
atrophic mandible involves: autogenous hip bone,
general anesthesia, 3-6 months healing time before
dental implants are placed & loaded with the patient
unable to wear a lower prosthesis during most of the
healing time.
M.I.S. TREATMENT CONCEPTS:
Less than 6mm bone height
body of mandible
A ONE SURGICAL APPOINTMENT
technique for the severely
atrophic mandible (less <6mm) using
Minimal Invasive Surgery:
I.V. conscious sedation, with implant placement,
onlay ridge grafting c PRP but without autogenous
hip bone, and immediate implant loading with an
interim prosthesis.
Approximately 2-3 weeks following surgery the
definitive prosthesis is developed and inserted for
case completion.
SIMPLIFIED ONE APPOINTMENT
RECONSTRUCTION OF THE SEVERELY ATROPHIED MANDIBLE
IT IS HYPOTHESIZED
that the osteocytes are
the primary mechanosensory cells of bone, and
that as the mandible flexes, they may signal
mechanical loading to osteoblasts through
release of extracellular nucleotides with
chemotactic bone formation in the mandible. This
can occur in a few months, FOLLOWING SURGERY
WITH GRAFTING & IMPLANT LOADING with the PATIENT
UNAWARE OF CHANGES.
TREATMENT GOALS:
RECONSTRUCTION OF THE
SEVERELY RESORBED MANDIBLE
-
§Single
stage surgical approach for
implant
placement with grafting and immediate
implant loading with transitional
prosthesis.
Patient always has prosthesis
during healing for function & aesthetics.
-
§Bone
regeneration utilizing “Banked”
cancellous bone from human cadaver
vertebra with Platelet Rich Plasma and
Minimal
Invasive
Surgical
technique.
-
§Increase
zone of attached keratinized tissue
around implants.
-
Two week healing with
interim prosthesis, then implant connecting
bar placed without loading contact of the
grafted and regenerating area with
definitive prosthesis.
-
Patient always has prosthesis
(teeth) during
healing for function & aesthetics .
CASE 1
CASE 2
CASE 3
[Top]
|
