An implant-supported prosthetic restoration concept for edentulous atrophied maxillae

October 23, 2014

Autogenous bone block grafts, bone grafting material or a combination of both can be used to restore an implant site of adequate dimensions in an atrophied maxilla. If the vertical height of the bone is inadequate in the posterior region, a sinus floor lift is often indicated to stabilise the implants safely. In the case presented here, surgical treatment based on Prof. Fouad Khoury’s [1, 2] biological concept for bone grafting using a combination of autogenous bone block grafts and particulate bone chips is described. The case report also describes the layering technique as part of a sinus floor lift in conjunction with bone grafting material. The objective of the treatment is a restoration with longterm stability and a good aesthetic result. An im plant-supported bar-latch design based on Dr Friedrich-Wilhelm Pape’s prosthetic concept (Schellenstein concept) was used.[3] Initial situation The 60-year-old patient was referred to the practice with a telescopic restoration on natural abutment teeth 11, 21, 22 and 23. Crown and bridge restorations were used in the mandible; however, teeth 21 and 22 could not be preserved and were extracted. Abutment teeth 11 and 23 could not be preserved, but served as abutments for the temporary restoration until fabrication of the final prosthetic restoration. In the premolar region specifically, pronounced horizontal and vertical bone defects that required comprehensive augmentative measures were identified in the preoperative 3-D CBCT images (Figs. 1–4).