CONTROL ID: 2600314
CONTACT: Giovanni Nicoli
Abstract Details
CURRENT CATEGORY: Case Reports/Case Series (Poster Only)


Immediately Loaded Full Arch Rehabilitation in Extremely Resorbed Upper Jaw with Angulated Implants Using Nasal Bone: Surgical and Ethical Analysis of a Case Report.

AUTHORS: Nicoli, Giovanni; Nicoli, Federico; Ferraris, Pietro

Introduction: To evaluate the outcome and special characteristics of immediate implant rehabilitation in extremely resorbed upper jaw using implants engaging nasal bone in order to avoid bone graft. Angulated 24 degrees implants 22mm of length and 4 mm of diameter were used.

A 45 years old male patient, non-smoker, partially edentulous with failed partial removable prosthesis was evaluated for an immediate fixed prosthesis on immediately loaded implants rehabilitation. Our protocol can be divided in three different phases.

Diagnostic phase:
Tc cone beam demonstrate extremely bone resorption distal to canine zone. On the right patient’s side crestal bone height was not more than 2 mm. On the left side we could measure 3 mm.

Surgical phase:
A 12 degrees angulated implant 3,25 mm wide, 13 mm long was placed in lateral right incisor zone. A 12 degrees 4 mm wide 13 mm long was placed in central left incisor zone. On the right side distal to canine area residual bone height was 2 mm or less and a 24 degrees 4 mm wide 22 mm long was placed in second premolar area. A window was opened in the lateral nasal wall and Schneiderian’s membrane was raised from sinus floor and medial wall. Site preparation with dedicated burs was performed through the sinus to reach the cortical of lateral nasal wall. A graft of mixed autologous and heterologous bone was inserted to have the whole intrasinus length of the implant completely in grafted bone. On the left side residual bone height is 3 mm and site preparation starting in second premolar zone is performed through the sinus without sinus floor elevation or graft. It comes from the zygomatic technique. All implants reached good primary stability more than 30 N/cm Prosthetic phase: Patient received fixed screw retained prosthesis in three hours.

These types of implants are a suitable alternative technique (e.g. the zygomatic implants or bone grafts). Therefore, this technique offers a faster and comfortable rehabilitation and an economical predictable solution for the patient.

This technique can be recognized how a valid alternative for dental rehabilitation in extremely resorbed upper jaw. The immediate loading represents a good compromise between the timing of the result and esthetic quality, and allow for an immediate improvement in the quality of life.

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