IMMEDIATTE TOTAL UPPER AND LOWER LOADING IN DENTAL PHOBIC PATIENT

Carico immediato totale superiore e inferiore in paziente odontofobico

GIUSEPPE BIANCO

MARCO GERONI

Many patients take time to decide to do something to improve their situation due to fear of dentist.

I take dental phobia very seriously, I studied it thoroughly in the United States where I spent more than a weekend with a team of dentists and psychologists to find the best way to help this category of patients which is highly represented; just think that in Italy about 20% of the population suffer from it.

With great pride I can say that I have managed to pass this fear to all the patients who have come to me with this phobia; one of the strengths of my treatment is precisely in the empathic relationship that I can create with the patient, not being able to pass the fear of the dentist to a patient that I would feel like a huge defeat.

Fig. 1 The case of Luca.

Fig. 2 The situation in the first visit. Fractures, destructive caries, periodontal disease and consequent inflammation and recession. Oral hygiene is unfortunately very bad.

Luca is one of those patients who suffered a lot from this phobia and, while managing to endure it in the past to undergo previous dental treatments that, at the time, probably met his needs, he has neglected himself over the years and, not following adequate oral hygiene at home, has unfortunately developed destructive carious lesions, erosions, accumulation of tartar and a severe chronic generalized periodontitis (→ find out more) which resulted in the loss of numerous dental elements in the lower arch and a significant loss of periodontal attack with consequent recession and bone resorption.

Fig. 3 The orthopanoramic shows the signs of periodontal disease, ie loss of attachment of the periodontal ligament, bonne resorption and recession. Carious lesions and granulomas involving some dental elements are also noted.

The radiographic examinations performed on the first visit to my center, orthopanoramics and 3D CT, showed that Luca’s situation was solvable.

Having discussed the different therapeutic options, we opted together for an implant-prosthetic rehabilitation with immediate load of the Toronto Bridge type, both for the upper and lower arches.

Thanks to sedation and local anesthesia carried out in the office, which allow the patient to feel no pain, in a single session Luca underwent the extraction of his teeth, all now compromised by periodontal disease, and the placement of six implants in upper arch and six implants in the lower arch, some of which are post-extraction.

Particular attention has been given to the cleaning of the alveoli through piezosurgery, which through cavitation guarantees perfect cleaning of the extraction site.

Fig. 4 A detail of the intervention. The cleaning of the alveolus is carried out with a specific Piezosurgery® insert for this purpose.

Fig. 5 The orthopanoramic shows the implants placed and the titanium bars that solidify them, ensuring a much better implant survival.

I can say that I am particularly fond of this case because Luca’s joy was so great that it remained etched in my memories. I recently reviewed it after about 8 years after surgery and no implant shows bone loss or signs of peri-implantitis.

Fig. 6 The work completed, with the relined prostheses.

Fig. 7 In spite of his dental phobic disorder, Luca can finally smile again.

This post is also available in: Chinese (Simplified) Italian

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Carico immediato totale superiore e inferiore in paziente odontofobico

GIUSEPPE BIANCO

MARCO GERONI

PROF. GIUSEPPE BIANCO

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