This 55 year old male patient with a history of implant loss in the lower jaw requested treatment first in the lower jaw, and later in the upper jaw. At the time of his visit the upper teeth and implants were stable. Details to this case and its solution with the technology of the Strategic Implant ® are given in the legends to the pictures.
Fig. 1: In the lower jaw one Implant had remained. The vertical bone loss along this implant had reached about 1/3 of the endossous length. There was pus discharge from the periimplant pockets. Considering this and the bad prognosis of this 2 stage implant, it was removed when the lower jaw was restored with a combination of compression screws and the Strategic Implant ®. A fixed metal-to-ceramic bridge was cemented postoperatively on day 3, see Fig. 2.
Fig. 2.a The vertical bone loss along the implants and the teeth in the upper jaw has progressed in the 1.5 years between this picture and Fig. 1. Because of the advanced periodontitis around teeth and periimplantitis around two stage implants all the upper restoration became very mobile. The patient sought treatment of the upper jaw when this situation had become unacceptable.
Fig 2. B: Clinical picture of the mobile restoration in the upper jaw, supported by teeth and two implants
Fig. 3: In one single intervention all teeth and implants were removed and 12 strategic implants inserted, providing multicortical anchorage. Also the upper jaw was restored with a metal-to-ceramic bridge within 3 days.
Fig. 4: Overview on the upper and lower jaw restoration 2 years after restoring the lower jaw and 6 months after restoring the upper jaw. There is no vertical (or crater-like) bone loss at all, and all implants are integrated uneventfully.
Fig. 5a: Clinical situation 6 months after the treatment of the upper jaw. No any sign of inflammation presents
Fig 5b Clinical situation of the lower jaw after two years of treatment. No signs of inflammation present
This patient case was successfully restored by the team of
Dr. Alexander Lazarov, Sofia, Bulgaria
IF Clinical Master of Immediate Loading
IF Teacher for strategic implantology