Dr. Jurgis Visockis discusses a case study that demonstrates the all-in-one concept for dental implant restoration.
The all-in-four concept is based on the placement of four implants in fully edentulous jaws to support a temporary, stable and immediate loading of a full denture arch. The combination of inclined and straight implants to support a fixed prosthesis can be considered a viable treatment method resulting in a simpler and less time-consuming procedure, with reduced financial costs and a more comfortable postoperative period for patients.
Import
A 58-year-old man, partially edentulous for a long time due to periodontal disease, was referred to us. The patient suffered for a long time trying to get used to various types of mandibular dentures. We choose this case because it was complex, involving removal of the remaining teeth and bone grafting.
The patient requested a fixed prosthetic restoration in the lower jaw. In his words, he was “tired of removable dentures on the lower jaw.”
Case report
A 58-year-old man was referred by his own dentist because of significant retention problems in his lower denture. The remaining teeth were painful and the denture was extremely loose. The patient could not eat, speak or perform many daily functions.
Several options were considered, but four Meisinger implants with multiple units and a direct implant retained temporary denture were agreed upon.
Distribution of Meisinger implants is key to establishmentall on foursauthorities. After five to six months of healing and implant integration, we will place the final screw device.
The “all on four” technique was planned for the restoration of the lower jaw.
With local anesthesia, the remaining teeth were removed and the sockets were cleaned. A full-thickness amputation incision was made from the right first molar region to the left first premolar. A midline release incision was made to facilitate flap reflection space approximately 2-4 mm osteotomy was performed to make the alveolar crest uniform. All sites were prepared using the manufacturer’s instructions (Meisinger Implants), under abundant sterile saline irrigation. A possible communication between the implant sites was checked before implant placement.
Four Meisinger implants were placed in a planed area.
After soft tissue management and closure, straight and angled multiple units were placed on the implants. A new temporary denture was fabricated which allowed the plate to be securely placed on the multiple implant units.
Five months later new impressions were taken for a final screw device.
The patient was happy with the result and can now eat and function normally with a secure and stable denture.
Discussion of restoration
A recent shift in practice paradigm has been to minimize treatment costs and patient morbidity while providing the most satisfactory patient-centered treatment outcomes consistent with state-of-the-art dental practice. The all-in-one treatment concept is an attempt to achieve these goals by providing a relatively simple, predictable treatment option for the restoration of edentulous patients with a high quality of life outcome.
In the present case report, we removed the remaining teeth and flattened the bony crest. Because of the adequate bone thickness distally we were able to place four axial implants. The majority of mandibular reconstruction cases require angled implant placement due to the foramen of the mental nerve.
Furthermore, there are no significant differences between axial and inclined implants in terms of success rates and marginal bone loss.
For more information on Meisinger implants visit meisinger.uk.
This article is sponsored by J&S Davis.