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10801 West 87th Street, Overland Park, KS 66214

ADVANCING THE ART AND SCIENCE OF DENTISTRY

“Classic”

1. All teeth missing.
2. Advanced bone loss mandible.
3. Long-term use of complete dentures.
4. OVD less than ideal, needed to change.
5. Facial aesthetics needed improvement.

TREATMENT GOALS: RECONSTRUCTION OF THE SEVERELY ATROPHIED MANDIBLE
• Single-stage surgical approach for implant placement with grafting and immediate implant-loading with transitional prosthesis.
• Bone regeneration utilizing banked cancellous bone from human cadaver vertebra with Platelet Rich Plasma and Minimal Invasive Surgical technique.
• Patient always has prosthesis during healing for function and aesthetics.

 

Pre-Operative Photograph

Pre-Operative Photograph

Pre-Operative Radiograph

Pre-Operative Radiograph

 

Pre-Op CT Scan Overview Study

Pre-Op CT Scan Overview Study

 

 Pre-Op 3D Moveable (1)
 Pre-Op 3D Moveable (2)

Pre-Op 3D Moveable Translucent Image Showing Advanced Bone Atrophy

 

Pre-Op CT

Pre-Op CT Scan Panoramic View

 Pre-Op CT Scan

Pre-Op CT Scan Cross Sectional View

 

Pre-Op CT Scan

Pre-Op CT Scan Axial View

 Pre-Op CTS

Pre-Op CTS Cross Sectional View Showing Advanced Bone Atrophy Start First Year 4.8mm Mandible

 

Lingual Tunneling (1)
Lingual Tunneling (2)

Lingual Tunneling Technique and Creation of Irradiated Cancellous Bone & Marrow Vascularized Site for Bone Graft Placement

 

Healing With PRP
WHAT IS PLATELET RICH PLASMA (PRP)?
• Platelet Rich Plasma (PRP) is composed of platelets and plasma. Platelets are tiny cells that are partially responsible for causing blood to clot. Platelets also contain large reservoirs of natural growth factors. While a normal concentration of platelet circulating in your blood is 200,000 per microliter, the platelet count in PRP can exceed 2 million platelets per microliter.

WHAT ARE GROWTH FACTORS?
• Platelets contain potent growth factors necessary to begin tissue repair and regeneration at the wound site. Growth factors derived from platelets initiate connective tissue healing, bone regeneration and repair, and they promote development of new blood vessels and stimulate the wound healing process.

 

TREATMENT GOALS: RECONSTRUCTION OF THE SEVERELY RESORBED MANDIBLE
• Single-stage surgical approach for implant placement with grafting and immediate implant loading with transitional prosthesis.
• Bone regeneration utilizing banked cancellous bone from human cadaver vertebra with Platelet Rich Plasma and Minimal Invasive Surgical technique.
• Patient always has prosthesis (teeth) during healing for function & aesthetics.
• Increase zone of attached keratinized tissue around implants.

 

Minimal Residual

Minimal Residual Keratinized Tissue (Pre-Op)

Increased Residual

Increased Residual Keratinized Tissue (Post-Op) 2mm Keratinized Tissue Physiological Increase Keratinized Tissue From 2mm to 5-7mm

 

1.5mm Minimal (1)
1.5mm Minimal (2)

1.5mm Minimal Residual Keratinized Tissue Technique for Preservation of Keratinized Tissue Around Implants

 

1.5mm Keratinized (1)

1.5mm Keratinized Tissue Divided to Allow Increased Formation of Keratinized Tissue to Surround Implants

1.5mm Keratinized (2)

Minimal Tissue Opening to Allow Access and Elevation of Soft Tissue for Creation of Implant sites with Grafting

 

Lingual Tunneling (1)

Lingual Tunneling Technique to Allow Soft Tissue Dissection and Prevention of Inferior Alveolar Nerve Injury

Lingual Tunneling (2)

Implants placed prior to Bone Grafting and Healing Screws Placed for Low Height and Access to Grafting Site Then Changed to O-ring Abutments

 

Lingual Tunneling

Lingual Tunneling Technique and Creation of Vascularized Site for Bone Graft Placement

 

TREATMENT GOALS: RECONSTRUCTION OF THE SEVERELY RESORBED MANDIBLE
• Single-stage surgical approach for implant placement with grafting and immediate implant-loading with transitional prosthesis.
• Bone regeneration utilizing banked cancellous bone from human cadaver vertebra with Platelet Rich Plasma and Minimal Invasive Surgical technique.
• Patient always has prosthesis (teeth) during healing for function & aesthetics.
• 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.

 

Interproximal Sutures

Interproximal Sutures With Attachments Placed Day of Surgery

Interproximal Sutures

Interproximal Sutures With O-Ring Attachments Placed Day of Surgery With Rubber Dam in Place Beneath Attachments for Acrylic Pick-Up

 

Interim Prosthesis

Interim Prosthesis With O-Ring Attachments

Interim Prosthesis

Pre-made Interim Prosthesis with Picked Up Chair side c Additional Acrylic Resin O-Ring Attachments & Occlusal View Rubber Dam in Place Beneath Attachments

 

Pre-made Interim (1)

Pre-made Interim Prosthesis With O-Ring Attachments Frontal View

Pre-made Interim (2)

One Day Post-Operative

 

One Day Implant Placement

One Day Implant Placement

Five Days Post-Op

Five Days Post-Op Attachments and Immediate Loading

 

10-14 Days after Surgery

10-14 Days after Surgery M.I.S. Allows for final impression for
implant connecting bar Polyether material of choice for impression

 

Three Weeks (1)
Three Weeks (2)

Three Weeks Post-Operatively

 

Three Months (1)

Three Months Post-Operatively

Three Months (2)

Pre-Op CT Scan Cross Sectional View Start First Year 4.8mm Mandible

 

8.75mm Mandible

8.75mm Mandible Bone Regeneration Over Nerve Post-Op 1 Year CT Scan Cross Section

 

Pre-Operative (1)

Pre-Operative Photograph

Pre-Operative (2)

Post-Operative Photograph