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ePaper created 2016-01-07, 12:59:38 | version 1.38.0
tomised gold implant abutment and new secondary telescopic crown were fabricated and integrated into the same position as tooth #15 (Figs. 14 and 15). Dur- ing a healing period as well as after the integration of thenewabutmentandthenewsecondarytelescopein thebridge,thepatientfurtherusedhistelescopicmax- illaryrestoration(Figs.16a–d). _Discussion The use of natural teeth and implants to support dentures incurs risks that may lead to loss of an abut- mentand,subsequently,thewholerestoration.Recent reports have demonstrated a high long-term success rate of removable restorations supported by natural teethandimplantswhendoublecrowns,e.g.telescopic crowns, are used as attachments.7–9 However, the use of the combination, e.g. connection, of natural teeth andimplantstosupportfixeddenturesisnotadvisable duetothehigherriskofcomplications.1,10 Causeforthe loss of the abutment in case 1 was trauma from a car accidentandnotmechanicalfailureorperiodontalin- fection or bone defects. Nevertheless, the resulting complications are similar to the ones described in the literatureforcaseswheretheabove-mentionedcauses leadtolossofanimplant.1 Incase2,thenaturalabutmentwaslostduetome- chanical reasons 13 years after loading. This kind of complications,e.g.fractures,havebeenreportedinthe long-term maintenance of fixed or telescopic recon- structions, when endodontically treated teeth were used as abutments.11,12 The complication discussed above could be avoided if the endodontically treated lastnaturaltoothabutment#15wasextractedandre- placedbyanimplant. In cases of full-arch restorations retained on both implantsandnaturalteeth,whenafractureofanatu- ral abutment occurs, removal of the restoration is of- tennecessary,regardlessofthetypeofrestoration(re- movableorfixed).Thiscancausenotonlyconflictsbe- tween patient and dentist, but also high financial and technicalefforts.Thetechniquedescribedaboveallows the successful replacement of the failed abutment by animplant,enablingthecontinuoususeoftheexisting restoration._ Editorial note: A list of references is available from the publisher. I case report Fig. 12_Orthopatomograph taken at the completion of the perio-implant-prosthodontic treatment. Figs. 13a & b_a) Surgical guide for implant placement #15; b) X-ray after implant placement. Figs. 14a & b_Customised gold implant abutment #15 in place; a) X-ray; b) clinical view. Fig. 15_Orthopatomograph taken at the completion of treatment. Fig. 16_Clinical view. 18 I implants4_2015 contact Prof.Dr Gregory-George Zafiropoulos Sternstr.61 40479 Düsseldorf Germany zafiropoulos@prof-zafiropoulos.de Fig. 12 Fig. 13a Fig. 13b Fig. 14a Fig. 14b Fig. 15 Fig. 16