engleski

Alveolar Bone Reconstruction of Anterior Mandible in Implantoprosthetic Rehabilitation

Reconstruction of demanding areas represent a particular clinical challenge in implant dentistry. In mandible, the vertical atrophy laterally leads to the inability to place implants to the proximity of the alveolar nerve in one procedure. Horizontal atrophy can cause inability to place implants, even when the vertical dimension is satisfactory. Implantoprosthetic rehabilitation of the edentulous mandible is a substantial advance in comparison to a conventional complete denture. Proven advantages of this mode of therapy include better life quality and long-term support and prevention of bone resorption. Early implant therapy in the mandible considers fixed complete denture, but there are indications that removable solutions are also acceptable. Implant supported overdenture represents a possible prosthetic solution in situations where retention is enabled by implants and the greater part of load is distributed on the alveolar crest. Case: Female patient, aged 68 years, is referred to a prosthetic specialist due to the inability to wear lower complete denture. Diagnostics show massive alveolar crest resorption, and the treatment plan is presented to the patient, consisting of an implant-supported overdenture. Clinically there was an extensive resorption of the vestibular socket wall in the anterior region of mandible, where we were able to regain bone by combining iliac crest bone grafts and autologous bone material and by covering it with a resorbable membrane (Jason Membrane® - Botiss Dental, Germany). After 4 months of healing four implants were placed in the regenerated bone (AstraTech, Sweden, diameter 4.0 mm, length 9 mm), with satisfactory primary stability. A prosthetic treatment was done after three months using Astra Tech LocatorTM Abutment System for overdenture retention.

mandibular atrophy; bone reconstruction; dental implants

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