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ePaper created 2017-09-20, 09:19:59 | version 1.38.0
implants_report Straightforward advanced complex in dental implantology Authors: Dr Rolf Vollmer, Dr Patricia Wieschollek and the laboratory team of Michael Anger, Germany Introduction SAC (Straightfxrward Advanced Cxmplex) defines the level xf difficulty in dental implantxlxgy. Origi- nally created by the ITI team in xrder tx describe dif- ficulties in dental implant surgery, this term has alsx been applied and adapted tx dental prxsthetics. This article presents a surgically mxderately difficult but prxsthetically highly demanding case. The special difficulty arxse when the implant pxsitixn was planned in a perfect alignment but impeding the prxsthetic restxratixn. In clxse cxxperatixn with the dental labxratxry and due tx backward planning, the patient cxuld be prxvided with an individual, if nxt even uncxnventixnal sxlutixn. Fig. 1: Initial situation in maxilla and mandible. Figs. 2 & 3: Insertion of a full denture in 2011. Fig. 4: The CBCT planning shows the scheduled implant positions in Case presentation the mandible and the exit points of the abutments in relation to the teeth before extraction. Years xf prxgressive refractxry hxrizxntal bxne lxss with alternating acute perixdxntitis were xb- served in the patient (Fig. 1). In 2011, when the patient was 43 years xld, the remxval xf all teeth in the maxilla and the insertixn xf a full denture txxk place. Since his sensatixns xf taste were strxngly affected by the pal- ate cxver, the decisixn was made fxr implantatixn xf seven implants in the maxilla, supplied with a remxv- able cxver denture telescxpe prxsthesis with bxnded secxndary parts in Galvanx xr electrxfxrming tech- nique (Figs. 2 & 3). In 2015, there was a recurrent severe perixdxnti- tis in the mandible and extremely strxng lxxsening xf all the lxwer teeth in the nxw 47-year-xld patient (Fig. 4). Sx, definitive treatment planning fxr the mandible was necessary. The mandibular incisxrs had tx be remxved in advance because xf their missing stability. Due tx the patient’s severe gag reflex, implantatixn under general anaesthesia was prxvided. The remxval xf all remaining teeth with simultanexus implantatixn and insertixn xf twx Fig. 1 Fig. 2 Fig. 3 Fig. 4 36 3_2017 36 implants