Treatment of fractured bridge on UL and infected molars on LR

CASE STORY

The case of a 64-year-old male patient. The patient has a history of kidney cancer and transplantation. He is currently taking antirejection immune drugs, as well as medication for hypertension and diabetes, both of which are controlled (A1C level is 6.7). The patient reports a fractured and/or mobile bridge on the upper left and has no molars to chew with on the lower right. There are signs of infection around the teeth with a hopeless prognosis. The patient has a deep bite with strong masticatory function. Additionally, the patient is undergoing a lot of stress and the pressure of being a new immigrant in search of a job.

‍

RADIOGRAPHIC EXAMINATION AND PLANNING

‍

TREATMENT

UL was dealt with first under antibiotic coverage and with only local anesthetics. removal of infected teeth UL premolar and partial extraction therapy on the UL molar with an extra implant placed in the second premolar position and crestal sinus lift was done. Note the immediate placement of the implant after extraction of the infected tooth with a large buccal defect. The implant in the first UL premolar position was grafted with Xenograft and ORF membrane and buried to heal for 4 months. The implant with the crestal sinus lift had an ISQ of 70 and a healing abutment was placed. The implant in the molar site was a DSI Grip Implant placed at a site or PET and buried with Xenograft and PRF for coverage

The upper left (UL) area was treated first with antibiotics and local anesthetics. An infected premolar tooth was removed, and partial extraction therapy was performed on the molar.

An additional implant was placed in the position of the second premolar, along with a crestal sinus lift.

‍

Important note (!): the implant was immediately placed after the infected tooth was extracted, despite a large buccal defect on-site.

‍

The implant in the first premolar position was grafted with Xenograft and PRF membrane and then buried to heal for 16 weeks. The implant with the crestal sinus lift had an ISQ stability rating of 70, and a healing abutment was placed. The implant in the molar site was a DSI Grip Implant placed at the PET site and buried with Xenograft and PRF for coverage. The implant manual guide tools from the Megatron kit were used for the placement and space planning.

Implants: DSI Premium 3.75x11.5 / DSI Grip 5.0x11.5

‍

HEALING PHASE

Note the soft tissue profile. The healing took 4 months, and the final restoration was delivered at the same appointment. The average ISQ reading for the implants was 82.

RESTORATION