IMMEDIATE TOTAL LOAD UPPER AND SINGLE IMPLANTS IN PATIENT WITH KIDNEY INSUFFICIENCY
Carico immediato totale
Guido entered my office after many dentists refused to treat him due to his medical condition which forces him to do dialysis three times a week.
Over the years, he had lost almost all the dental elements of the upper and lower arch, the residual ones were carious, periodontal disease or with chronic lesions.
On his first visit he told us his medical history and expressed his desire to recover a normal condition for his mouth; a strong mutual sympathy was born immediately; Guido is a brilliant man with full of energy.
By the way, please watch the video of his case so that you can get to know him, it’s worth it.
Fig. 1 Guido’s smile on the first visit. Just mentioned, so as not to excessively show the lack of teeth.
Fig. 2 The situation in the first visit. Few residual elements in the upper arch, no posterior teeth in the lower arch, evident periodontal disease, and consequent recession.
By analyzing the radiographic, orthopanoramic and 3D CT examinations performed at our center, we verified the possibility of rehabilitating the upper arch thanks to a fixed full-arch prosthesis on Toronto Bridge type implants with immediate load, while the quantity and quality of the lower jaw bone allowed us to plan the insertion of two implants to recover the chewing function the addition of two molars.
Fig. 3 The orthopanoramic shows the signs of periodontal disease, i.e., loss of attachment of the periodontal ligament, bone resorption and recession. Carious lesions and granulomas involving some dental elements are also noted
After having subjected Guido to thorough professional hygiene and instructed him on the basics of home hygiene, we moved on to the surgical phase.
The residual dental elements of the upper arch, now compromised, were extracted, as well as the root residue left in the area of the second lower premolar on the right. The insertion of the implants, both above and below, was carried out immediately and in a single session, thanks to surgical procedures that require local anesthesia and sedation.
Fig. 4 In orthopanoramic, the implants and the titanium bar of the upper prosthesis are visible. The two implants placed in the lower arch will wait about 4 months before being able to be loaded and functionalized.
The dental technician work of my friend Marco Geroni on Guido’s case was meticulous, paying particular attention to the characterization and restoration of and aesthetic that is as natural as possible and in harmony with the complexion of the face.
Fig. 5 Models positioned in the articulator, the laboratory abutments that demonstrate the orientation of the implants are visible.
Fig. 6 The diagnostic wax-up with the teeth mounted. It is the phase of studying the position of the teeth.
Fig. 7 Here you can see the titanium bar fused to the abutments and the retention pins for the resin framework.
Fig. 8 The prosthesis is completed. The access holes for the fixing screws that will anchor the prosthesis to the implants are visible.
The delivery of the upper prosthesis took place the day after, using the “immediate load” protocols, while the wait for the lower implants was about 4 months, the minimum time necessary for the mandibular bone to be able to withstand the positioning of the crowns prosthetic.
Fig. 9 The upper prosthesis positioned in the patient’s mouth. The attention to detail in the production allows a perfect mimesis and a completely natural appearance, responding to the patient’s requests.
Fig. 10 Guido on the day of delivery.
I refer you to the video in which I describe Guido’s case and in which himself personally testifies how the work went. You can follow him on this page, at the beginning of the article, or on YouTube.
For other testimonials follow my channel (Giuseppe Bianco – YouTube). Good vision!
PROF. GIUSEPPE BIANCO
I am a clinician who has been working 10 hours a day for 20 years, since 1999 I have placed about 11,000 implants.
WHERE TO FIND ME
Via dell’umanesimo 308
00144 Rome (RM)
(0039) 06 591 0674
Mon.-Fri.: 8.30 – 20:00
Sat. and Sun.: Closed