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Tsuneyuki Tsukioka

Nerimaku Tokyo, Japan

Clinical case description:

Immediate Loading after introduced Sinus Floor Elevation in Edentulous Patient.

 

 

Patient Information

First visit Oct. 20.2004

58-year-old women

 

Chief Complaint

Dysfunction of removable denture in maxilla

 

General condition

Good

 

 

At the time of presentation, she compliant about poor stability as well as pain and discomfort in her complete over denture.

 

The patient had both a high functional expectation and a short treatment period.

The X-ray findings suggested that not enough bone height in molar site of maxilla.

But CT analysis suggested good bone quantity from premolar to anterior site and good bone quality.

The following treatment plan was proposed.

1. Extraction of the residual dentition

2. Bilateral sinus floor elevation

3. Implant placement and immediate loading.

After discussing the risks of immediate loading she accepted to undergo “Immediate Loading after introduced Sinus Floor Elevation”.

After 8 years, a clinical and radiographic follow-up took place, revealing stable conditions of the peri-implant soft and hard tissue with adequate function.

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<p>Occlusal view of the maxilla before treatment</p>

Occlusal view of the maxilla before treatment

<p>Panoramic radiograph analysis introduced  prior to extraction. It is difficult to define the bone height and cavity form of molar site.</p>

Panoramic radiograph analysis introduced prior to extraction. It is difficult to define the bone height and cavity form of molar site.

<p>The CT analysis with diagnostic stent suggested good bone quantity from premolar to anterior site and good bone quality.</p>

The CT analysis with diagnostic stent suggested good bone quantity from premolar to anterior site and good bone quality.

<p>The bone in the window area had to be completely removed.</p>

The bone in the window area had to be completely removed.

<p>The composite graft (autologous bone chips and Geistlich Bio-Oss<sup>®</sup> 1:1) was inserted.</p>

The composite graft (autologous bone chips and Geistlich Bio-Oss® 1:1) was inserted.

<p>Panoramic radiograph after surgery defined clearly augmented with Geistlich Bio-Oss<sup>®</sup> in sinus cavity.</p>

Panoramic radiograph after surgery defined clearly augmented with Geistlich Bio-Oss® in sinus cavity.

<p>Implants were delivered at adequate positions in 3months after (2006 )augmented sinus cavity.</p>

Implants were delivered at adequate positions in 3months after (2006 )augmented sinus cavity.

<p>Immediate loading and harmonious occlusion was introduced.</p>

Immediate loading and harmonious occlusion was introduced.

<p>Occlusal view of the maxilla with delivered with a temporally restoration.</p>

Occlusal view of the maxilla with delivered with a temporally restoration.

<p>After 8 years, a clinical follow-up took place, revealing stable conditions of the peri-implant soft and hard tissue.</p>

After 8 years, a clinical follow-up took place, revealing stable conditions of the peri-implant soft and hard tissue.

<p>Occlusal view of the maxilla delivered with a final restoration.  Harmonious occlusion was kept on the prostheses.</p>

Occlusal view of the maxilla delivered with a final restoration. Harmonious occlusion was kept on the prostheses.

<p>Panoramic radiograph showing a stable clinical situation 8years. A dome shaped structure was apparent at site 16,26.</p>

Panoramic radiograph showing a stable clinical situation 8years. A dome shaped structure was apparent at site 16,26.

Pre-surgery


							<p>Occlusal view of the maxilla before treatment</p>

							<p>Panoramic radiograph analysis introduced  prior to extraction. It is difficult to define the bone height and cavity form of molar site.</p>

							<p>The CT analysis with diagnostic stent suggested good bone quantity from premolar to anterior site and good bone quality.    </p>

Surgery


							<p>The bone in the window area had to be completely removed.</p>

							<p>The composite graft (autologous bone chips and Geistlich Bio-Oss<sup>®</sup> 1:1) was inserted.</p>

							<p>Panoramic radiograph after surgery defined clearly augmented with Geistlich Bio-Oss<sup>®</sup> in sinus cavity.</p>

Outcome


							<p>Implants were delivered at adequate positions in 3months after (2006 )augmented sinus cavity.</p>

							<p>Immediate loading and harmonious occlusion was introduced.</p>

							<p>Occlusal view of the maxilla with delivered with a temporally restoration. </p>

Follow-up after at least 6 months


							<p>After 8 years, a clinical follow-up took place, revealing stable conditions of the peri-implant soft and hard tissue. </p>

							<p>Occlusal view of the maxilla delivered with a final restoration.  Harmonious occlusion was kept on the prostheses.</p>

							<p>Panoramic radiograph showing a stable clinical situation 8years. A dome shaped structure was apparent at site 16,26.</p>