implants - the journal of oral implantology UK Edition

I 35implants1_2012 clinical_ implant retained crowns I of adjacent teeth and over-eruption of the op- posing teeth. 4) I has discussed with the patient potential complications and the requirement of addi- tional augmentation procedures such as bone grafting and conventional sinus grafting along with the relative risks, complexities and bene- fits of these procedures. We had also discussed the benefits and risks of guided tissue regen- eration for minor defects. _Treatment sequence Short term: The patient was advised of the importance of continuing hygiene treatment to stabilise the bleeding and reduce the pock- eting around the UL4 and UR4 areas. A tem- porary denture replacing the UL45 would be constructed. Medium term: The placement of implants UL45 as discussed above, and of course, main- tenance of hygiene. Long term: The patient was advised that alongside her home hygiene regime, it would be advisable to see the dental hygienist for treatment at least on a six-monthly basis. Post treatment reviews during the course of which I would be checking for peri-implantitis/infec- tions, loss of integrations, loss of bone and gingival heights, and dental hygiene were recommended at intervals of three, then six months and thereafter, annually. It was important to underline the need to monitor the bone loss around the UR4 area and the patient was advised that should fur- ther bone be lost, we would have to consid- er advising its extraction and prosthesis and should the crown further fracture UL6, its pos- sible replacement with a new crown. _Treatment appraisal The treatment was executed exactly as planned. The sinus was tenting in the UL4 area without perforation, no acute infection was present, the sockets were intact, and two implants were successfully positioned in the desired position. There was an initial doubt at the assessment at 10mms length when utilis- ing the osteotomes for the UR4 implant, which was confirmed with a periapical during the surgery, when I reached an area of less dense Fig5_HealedSite Fig6_Incision(Hshaped)and PlacementofHealingAbutments Fig7-8_HealedSulcusSites Fig.h_Componentfitcorrect,no spacebetweencomponents.Base bonelevelsnoted. Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. h