Full arch on bridges, upper and lower jaws, with a 7-year follow-up

Doctor Peng Dong, the expert of tooth implantation in Peking University International Hospital and president of Beijing Hedu Stomatological Clinic Co., Ltd

CASE OUTLINE

Upper Jaw: Teeth 8, 2 on the right side, and teeth 1, 2, 8 on the left side exhibit severe mobility ranging from Grade II to Grade III. Additionally, teeth 5, 4, 3 on the right side, and teeth 3, 4, 5 on the left side show varying degrees of gingival recession with mobility ranging from Grade I to Grade II. Following extraction, an immediate implantation procedure will be performed using C-Tech dental implants of models EL-3511, EL-4311, and EL5111, totalling 8 implants in the upper jaw. Lower Jaw: Teeth 3, 4, 5 on the right side, and teeth 4, 5 on the left side show gingival recession with mobility ranging from Grade I to Grade II. Following extraction, an immediate implantation procedure will be performed using C-Tech dental implants of models EL-4311, EL5109, and EL5111, totalling 6 implants in the lower jaw. Subsequent restoration will involve the use of zirconia full crown bridges.

TREATMENT PLAN

Upper Jaw: Teeth 2, 3, 5, 6 show ideal alveolar bone width and height. After the affected teeth are extracted, immediate implantation will be performed using C-Tech dental implants of models EL-3511, EL-4311, and EL-5111, totalling 8 implants. These implants will provide support for fixed temporary denture restoration. One month later, perform treatment for the lower jaw. Lower Jaw: Teeth 3, 4, 6 show ideal alveolar bone width and height. After extracting the affected teeth, immediate implantation will be performed using C-Tech dental implants of models EL-4311, EL5109, and EL5111, totalling 6 implants. These implants will provide support for fixed temporary denture restoration.

TREATMENT

Upper Jaw Implant Surgery
1. Perform standard disinfection and drape the area with cloths. Administer painless local infiltration anesthesia for the entire upper dental arch. Temporarily retain tooth 8 on the right side.
2. Make incisions along the alveolar ridge from left upper tooth 7 to right upper tooth 7, and in the sulcus of teeth 5, 4, 3, 2 on the right side and teeth 3, 4, 5 on the left side. Gently reflect the flap. Extract the affected teeth. Use bone forceps to remove the alveolar bone septum and a large round bur to smooth the bone surface.
3. Fix teeth 6 on both the right and left side, and drill progressive preparation holes to a depth of 4.7*13mm. Implant C-Tech dental implants of size 5.1*11mm in all these locations. The torque on the left upper 6 implant is insufficient. Fix teeth 5, 3, 2 on the right side and teeth 2, 3, 5 on the left side, and drill progressive preparation holes to a depth of 2.8*13mm for the teeth 2 on both left and right side. Implant C-Tech dental implants of model EL-3511 in these locations. Drill progressive preparation holes to a depth of 3.7*13mm for teeth 3, 5 on the right and left sides, and implant C-Tech dental implants of model EL-4311 in these locations. Utilize implants on teeth 6, 5, 3, 2 on the right side and teeth 2, 3, 5 on the left side to install Peek temporary abutments. For the left upper 6, use a cover screw. Cover the alveolar ridge of the left upper 6 and the bone gap between right upper 3 and 4 with bone powder, and cover with membrane. Securely suture the area.
4. Fabricate temporary dentures using the upper full denture and implants on teeth 6, 5, 3, 2 on the right side and teeth 2, 3, 5 on the left side. Adjust the occlusion.

Lower Jaw Implant Surgery
Perform standard disinfection and drape the area with cloths on the left tooth 1. Administer painless local infiltration anesthesia for the entire lower dental arch.
1. Make incisions along the alveolar ridge from left 7 to right 7, and in the sulcus of teeth 5, 4, 3 on the right side and teeth 4, 5 on the left side. Reflect the flap. Extract the affected teeth and use bone rongeurs to remove the thin sharp alveolar ridge edge. Use a round bur to smooth the bone surface.
2. Fix tooth 6 on the left side and drill a pilot hole to the working length. Then, use an expanding drill to progressively prepare the hole to a depth of 4.7*12mm. Implant C-Tech dental implant model EL-5111 with a Peek abutment of size Φ4.5H3, applying a torque force of 60N. The marginal bone height is measured at M1D1B0.5L0.5. Drill progressive preparation holes to a depth of 3.7*13mm for teeth 3, 4 on the left and right sides, and implant C-Tech dental implants of model EL-4311. For tooth 4 on the left side, use a cover screw with a torque force of 20N. The marginal bone height is measured at M2D2B1L2. Use a Peek abutment of size Φ4.5H3 with a torque force of 60N for tooth 3 on the left side, with a marginal bone height of M0.5D0.5B0.5L0.5. Use a Peek abutment of size Φ4.5H3 with a torque force of 60N for tooth 3 on the right side, with a marginal bone height of M1.5D1.5B0.5L1.

Use a cover screw with a torque force of 20N for tooth 4 on the right side, with a marginal bone height of M1.5D1.5B1L1.5. Fix tooth 6 on the right side and drill progressive preparation holes to a depth of 4.7*11mm. Implant C-Tech dental implant model EL-5109 with a Peek abutment of size Φ4.5H3, applying a torque force of 60N. The marginal bone height is measured at M-0.5D-1B0L-0.5. Implant bone powder and membrane for teeth 3, 4 on the left and right sides, and teeth 4, 6 on the right side. Close the wound with meticulous suturing and apply pressure to stop bleeding.
3. Utilize implants on teeth 3, 6 on the right and left sides to fabricate an immediate overdenture for the lower jaw. Adjust the occlusion.
4. After 10 months, take an impression, replace the restoration abutments, fix them with adhesive bonding, and provide permanent restoration with zirconia porcelain crowns.