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implants - international magazine of oral implantology International Edition

I industry report Fig. 1_Presurgical panorama X-ray. Fig. 2_Flap exposing the surgical field, first quadrant. Fig. 3_Display of the vestibular bone structure, first quadrant. _Introduction Particularlyyoungpatientsundertheageof30ex- perience high levels of psychological strain when faced with episodic loss of several teeth as a result of generalisedaggressiveperiodontitis.Theinfluenceof this disease on the patients' social life and their ca- reers can be enormous. _Case presentation In February of 2012, the patient presented in my practiceattheageof28.Despitehisyoungage,hehad already lost several teeth. The probing pocket depth was3.5–5mm,theplaquecontrolrecord(PCR)wasat 100 % and the gingival bleeding index (GBI) was at 90 %. Several different treatments were necessary: teeth 21 and 23 needed endodontic treatment and rootcanalfillings,along-termtemporaryrestoration was necessary for teeth 21 to 23, and a ceramic inlay was indicated for tooth 46. In addition, the patient sufferedfromhalitosis.Thecombinationofthesymp- toms proved a great burden on the patient. The patient described an episodic loss of teeth in the course of the past four years and a family history oftoothlossstartingattheearlyagesof20to25.The patient smokes. The patient was healthy otherwise and there were no further pathological findings. The patient gave up smoking in March of 2012 andimprovedhisoralhygiene,therebyloweringthe PCRto12%andtheGBIto8%andpermanentlyes- tablishing them below a value of 10–15 %. The pre- servative treatment was finished and the treatment of the periodontitis was concluded with a closed curettage. During regular follow-up care, the patient re- ceivedsupportingperiodontitistherapyandshowed excellentcompliance.InMarchof2013,westartedto plan an implant-supported restoration. The patient’s oral situation before proceeding: Multiple gaps in the upper and lower jaw. Addition- ally, a terminal gap can be seen at the far end of the upperjaw(rightsideonthepatient).Goodamountof bone available in the posterior tooth area. Less bone available in the upper incisal area. The presurgical panorama X-ray shows the initial situation before the implantation (Fig. 1). The implants were inserted in March of 2013. Extensive implant-supported restoration in generalised aggressive periodontitis Author_Dr Dr Philipp Plugmann, Germany 34 I implants4_2013 Fig. 2 Fig. 3Fig. 1