implants - international magazine of oral implantology

I case report Fig. 1_First examination. Palatal view. Fig. 2_First examination. Orthopantomograph. Periimplant defects in the maxilla, deep vertical defect #47, generalised horizontal bone loss. Fig. 3_First examination. Clinical view, Rigth. Fig. 4_First examination. Clinical view, Left. Fig. 5_Socket preservation: cleaning of the extraction sockets. Fig. 6_Socket preservation: sockets coverage. Implant-prosthetic rehabilitation of the severely atrophic maxilla Authors_Prof Dr Gregory-George Zafiropoulos, Aiman Abdel Galil, Germany 22 I implants4_2012 _Introduction Modern instrumentation and improvements in regenerative techniques have facilitated both the surgical treatment and the subsequent prosthetic restoration. Nevertheless, dentists and patients frequently are conflicted when deciding between fixed or removable full-arch restorations. Many patients,especiallythoserequiringextensivereha- bilitation, clearly prefer fixed, implant-retained restorations. Under certain circumstances, the pa- tient’saestheticdemands,however,canbedifficult to satisfy with this type of restoration. Aesthetic outcomes are most frequently hindered by bone loss resulting from advanced periodontal disease or by bone resorption following tooth loss. Al- though several methods can be used to augment hard and soft tissue to meet aesthetic demands, the patient can reject these options or the dentist might not be entirely familiar with the procedure selected. Both scenarios may produce unsatisfac- tory results that become apparent only when treatment is complete. Removable restorations that use telescopic crowns as attachments are an alternative to full- arch rehabilitation with fixed bridges. Removable restorations can be used especially in cases with extensive jawbone atrophy (e.g. resorption), re- Fig. 5 Fig. 6 Fig. 2 Fig. 3 Fig. 4 Fig. 1