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C r o s s - a r c h i m p l a n t - s u p p o r t e d f i x e d r e s t o r a t i o n Thirteen-year follow-up of a cross-arch implant-supported fixed restoration in a patient with generalized aggressive periodontitis and parafunctional habits David Frencha & Erta Xhanarib a Private practice, Calgary, Alberta, Canada b Aldent University, Tirana, Albania C o r r e s p o n d i n g a u t h o r : Dr. David French 3625 Shaganappi Trail Nw Suite 212 Calgary, AB T3A 0E2 Canada T +1 403 247 8657 drfrench@shaw.ca H o w t o c i t e t h i s a r t i c l e : French D, Xhanari E. Thirteen-year follow-up of a cross-arch implant-supported fixed restoration in a patient with generalized aggressive periodontitis and parafunctional habits. J Oral Science Rehabilitation. 2017 Sep;3(3):48–55. Abstract B a c k g r o u n d As implant treatment becomes part of mainstream dental therapy, dental o(cid:2)ices should implement protocols for individualized, systematic and continuous supportive care of the periimplant tissue. This article describes the 13-year management of a patient with generalized aggressive peri- odontitis and bruxism treated using Brånemark TiUnite implants with machined collars. M a t e r i a l s a n d m e t h o d s In the upper jaw, a cross-arch implant-supported fixed restoration was delivered. In the lower jaw, an implant-supported fixed partial prosthesis was provided, retaining some natural dentition, which increased the risk of a periodontal reservoir. Treatment included multiple extractions and submerged implants. Implant survival rate, patient satisfaction, marginal bone maintenance and soft-tissue condition at the modified titanium sur- faces of the dental implants were evaluated up to 13 years of function. R e s u l t s Two adjacent implants were lost 3 years after loading owing to periim- plantitis and these were not replaced. One implant had bone loss after recementation and retained cement that subsequently responded to inter- vention with bone recovery. Furthermore, the maxillary prosthesis was remade once after 3 years of function, owing to porcelain breakage in the esthetic zone. C o n c l u s i o n This clinical case may provide information about benefits of a long-term patient history follow-up, with emphasis on periodontal and occlusal risks. A comprehensive diagnosis, multifactorial approach, good clinician– patient relationship and vigilant maintenance of oral hygiene were needed in order to ensure an optimal treatment and a successful long-term result. K e y w o r d s Dental implants, long-term follow-up, periodontally compromised patients, periodontitis, supportive periodontal therapy. 48 Volume 3 | Issue 3/2017 Journal of Oral Science & Rehabilitation