Reconstructive and Implant Dental Center - Kansas City                                                                                            dental-implants@dr-amet.com          Phone: 913-492-2233          Fax: 913-492-2234                 Office Information Video              

 ADVANCING THE ART AND SCIENCE OF DENTISTRY

 

SIMPLIFIED ONE APPOINTMENT RECONSTRUCTION OF

THE SEVERELY ATROPHIED MANDIBLE

 

Loss of bone in the mandible after tooth removal is not limited to alveolar bone, basal bone may also resorbed.  This continuing loss of bone is associated with anatomical and facial aesthetic complications and the instability of the mandibular complete denture.  Endosteal implants are routinely used to stabilize and support the mandibular prosthesis for the completely edentulous patient, and are placed into the remaining native bone.  If the remaining vertical bone height is 6mm or greater and the prosthesis is totally implant supported, grafting has been found unnecessary. However when mandibular vertical bone height is less than 6mm, grafting is considered necessary, Robert Marx AO 2005.

 

PREVIOUS TREATMENT CONCEPTS: 6mm or greater bone height body of mandible

IMPLANT PLACEMENT for the mandible involved: I.V. conscious sedation or general anesthesia, 3 months healing time for dental implants, second stage surgery before loading, with the patient unable to wear a lower prosthesis during much of the healing time.

 

 

M.I.S. TREATMENT CONCEPTS: 6mm or greater bone height body of mandible

A ONE SURGICAL APPOINTMENT technique for the mandible using Minimal Invasive Surgery: I.V. conscious sedation, with implant placement, and immediate implant loading with an interim prosthesis.  Approximately 2-4 weeks following surgery the definitive prosthesis was started and inserted for case completion.

 

CURRENT TREATMENT CONCEPTS: Less than 5mm bone height body of mandible

GRAFTING & IMPLANT PLACEMENT for the severely atrophic mandible involves: autogenous hip bone, general anesthesia, 3-6 months healing time before dental implants are placed & loaded with the patient unable to wear a lower prosthesis during most of the healing time.

 

M.I.S. TREATMENT CONCEPTS: Less than 5mm bone height body of mandible

A ONE SURGICAL APPOINTMENT technique for the severely atrophic mandible (less <6mm) using Minimal Invasive Surgery: I.V. conscious sedation, with implant placement, onlay ridge grafting c PRP but without autogenous hip bone, and immediate implant loading with an interim prosthesis.  Approximately 2-3 weeks following surgery the definitive prosthesis is developed and inserted for case completion.

 

SIMPLIFIED ONE APPOINTMENT RECONSTRUCTION OF THE SEVERELY ATROPHIED MANDIBLE

IT IS HYPOTHESIZED that the osteocytes are the primary mechanosensory cells of bone, and that as the mandible flexes, they may signal mechanical loading to osteoblasts through release of extracellular nucleotides with chemotactic bone formation in the mandible. This can occur in a few months, FOLLOWING SURGERY WITH GRAFTING & IMPLANT LOADING with the PATIENT UNAWARE OF CHANGES.

 

SURGICAL TREATMENT GOALS: RECONSTRUCTION OF THE SEVERELY RESORBED MANDIBLE

 

  • Single stage surgical approach for implant placement with grafting and immediate implant loading with transitional prosthesis.  Patient always has prosthesis during healing for function & aesthetics.
  • Bone regeneration utilizing “Banked” cancellous bone from human cadaver vertebra with Platelet Rich Plasma and Minimal Invasive Surgical technique.
  • Increase zone of attached keratinized tissue around implants.
  • Two week healing with interim prosthesis, then definitive implant prosthesis placed.

  •  placed without loading contact of the grafted and regenerating area with definitive prosthesis.    

  • Patient always has prosthesis (teeth) during healing for function & aesthetics .

     

 

CASE 1          CASE 2          CASE 3 

 

 

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