Case Gallery

Case Gallery


Case Study 1 - Dental implant.

History

  • Medically fit and healthy, good periodontal condition, compliant patient
  • Chief complaint; “want to function and don’t want to be toothless at 40”
  • Multiple restorations
  • Previous crowns in all 4 quadrants
  • Oral hygiene reasonable
  • Bruxer, clinical crowns worn quite flat
  • Periodontal condition good
  • 47 extracted 8 years ago as overerupted due to 17 extracted many years earlier

case1 history 1


Diagnosis and Plan

  • Surgical/Radiographic guide needed to position head of implant,ConeBeam (CBVT) taken with radiographic guide in place
  • Plan for 5.0 Astratech Osseospeed TX implant 11mm long, single stage surgery.
  • Standard loading after 3 months
  • Prosthetically limited opening so screw retained crown planned followed by an occlusal splint

case1 history 1 case1 history 1


Procedure

  • Surgery carried out under local anaesthetic
  • Astratech OsseospeedTX 5.0 x11mm placed and positioned according to the surgical guide
  • Implant fully torqued to 35N/cm
  • 6.5mm wide healing abutment placed and soft tissues sutured into position
  • No temporary

case1 history 1 case1 history 1


Result

  • There is more treatment continuing in the remaining quadrants to address the bite and function
  • Implant specific reviews every 6 months along with hygiene
  • X-ray at 12 months to check bone level
  • Hygiene appointments every 4 months in first year then 6 monthly

case1 history 1 case1 history 1

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Case Study 2 - Lower overdenture.

History

  • 66 year old fully edentulous male
  • Lost teeth due to periodontitis over a long period of time, severely resorbed lower ridge
  • Had a full lower denture(FL), not very happy with it
  • Remaining upper teeth extracted about 3 years ago
  • Chief concern “wants to be able to chew and stabilize dentures“
  • Made him new FU/FL dentures which are not retentive as ridge severely resorbed.
  • Can function in new dentures but the lower moves and top drops down anteriorly
  • Patient not concerned about aesthetics just speech and function

Diagnosis and Plan

  • Place two lower implants(Nobel Active 4.3x13mm) with Locator abutments to stabilize lower denture
  • Medically compromised patient with difficult access. Single stage surgery under GA
  • Load implants after 2 months.

case2 diagnosis 1 case2 diagnosis 1


Procedure

  • Constructed well fitting FU FL dentures
  • After 1 month denture function and bite balancing, copied dentures to make up clear acrylic FU FL
  • Placed radiographic markers on the lingual of canine sites and obtained a Cone Beam Volumetric Tomogram(CBVT).
  • Drilled 2mm pilot drill holes in the guide adjusted accordingly from the markers on the CBVT

case2 surgery 1 case2 surgery 1


Result

Remaining Treatment
  • Fit Locator abutments
  • Remake FU/FL reset teeth lingually as patient has had 10 months of new dentures and should be able to cope with teeth set back
  • Fit locators to FL chairside with GC Unifast resin

case1 result 1 case1 result 1

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Case Study 3 - Posterior bridge and single molars.

History

  • 62 year old male
  • Healthy, non-smoker, compliant patient
  • Good periodontal condition
  • Patient wants to restore posterior function and does not want to wear down anterior teeth more than naturally would occur
  • Tried Partial dentures a few years ago but was not happy.

case3 history 2


Diagnosis

  • Old OPG revealed maxillary sinuses will complicate treatment
  • Obtained CBVT to help in diagnosis from another implant surgeon
  • Study models
  • Constructed radiographic guides which convert to surgical guides and arranged a CBVT with guides in place
  • Planned on Nobel Clinician

case3 diagnosis 1 case3 diagnosis 1


Procedure

  • All implants placed under GA
  • All implants fully torqued to 35N/cm
  • Sinus augmentation via lateral window approach using Bio-Oss and Bio-Gide
  • 2nd quadrant implants placed 2-stage surgery method
  • All other implants 1-stage surgery method
  • Astratech Osseospeed TX implants used 5.0x9mm for all except 24 and 25, 4.5x11mm
2nd Stage Surgery
  • Performed under LA
  • Modified Pallaci flap with a connective tissue graft (same site)

case3 surgery 1 case3 surgery 1


Result

case3 result 1 case3 result 2 case3 result 3

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Case Study 4 - Replacement for dental implant.

History

  • 11 failed implant in a female 59 yo
  • Implant removed by another periodontist and an immediate bone graft attempted.
  • Smoker otherwise healthy. Periodontal condition good for a smoker, no pockets etc

case4 history 2 case4 history 3


Diagnosis and Plan

  • Proposed Astratech implant to be placed gently. May need to be grafted
  • primary closure
  • pedicle flap
  • Close for 6 months then provisional crown and
  • leave for a couple of years and see.

case4 diagnosis 2 case4 diagnosis 1


Procedure

  • Performed with local anaesthetic and IV sedation
  • Astratech Osseospeed TX placed, labial bone grafted with Bio-Oss and Bio-gide and sutured closed
  • Left for 6 months and exposed

case4 surgery 1 case4 surgery 2


Result

  • Expose implant at 6 months and fit a long term provisional implant crown and temporary crown on the lateral
case4 result 1 case4 result 2 case4 result 3

Case Study 5 - Sporting accident.

Diagnosis and Plan

  • Figure 1 Sporting accident, no mouthguard worn on this one occasion, elbow to the teeth 11 12 resulting in a complex root fracture.
  • Central incisor not salvageable, needs extraction and an immediate implant placement
  • Lateral incisor needs to be endodontically treated and a crown

Result

Dr Zielinski & Associates

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Dr Zielinski & Associates

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Glandore SA 5037

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