Examples of implant treatments

A 64-year old female, former nurse. She came to our practice with a request to solve her periodontally compromised teeth. Despite the fact that she had most of her own teeth, she was very well aware of the serious condition in her oral cavity.

After a thorough diagnostic and therapy preparation we started a complex reconstruction and rehabilitation of the patient’s teeth. As a qualified health care professional she was fully aware of the fact how seriously and negatively severe periodontitis and non-vital teeth can influence her overall health. The easier she accepted the radical solution to her condition.

Teeth in her jawbone were replaced by eight implants. Due to lack of bone in jaw, we performed bone abutment in both jaw cavities using the intervention called sinus lifting (see the X-ray picture taken after the implants placement) and placed implants during one implant session. Five one piece implants were implanted into the mandible.

The Brånemark bridge was made in the mandible and a fixed metal resin definitive full arch denture in the jawbone was opted for as the definitive treatment. After the patient’s previous long term discomfort, although having her own teeth, she was very pleased with the non-problematic result after this treatment.  

A 58-year-old male patient who had completely defective teeth. During two implant intervention sessions we replaced all patient’s teeth with eight implants in his jawbone and with six implants in his mandible. The patient had no toothless period since immediately after the implant procedures, temporary fixed dentures were made in his jawbone and mandible respectively.

At the end of the therapy, all teeth were reconstructed and the temporary dentures were replaced with fixed definitive highly functional and aesthetic dentures during one session. The patient has been included  in the long-term hygiene program in our practice. To have his own teeth was what the patient had wished for at the beginning of the treatment. Thus, after a short adaptation period he was very pleased and extremely satisfied with the result.

A 54-year-old male patient with a long-term neglected dental care. The patient decided to solve his long-lasting health problems and radically change his attitude to his dental health.

The patient‘s residual and highly destructed teeth needed to be removed. We replaced them with eight implants in his jawbone and six implants in his mandible. Metal ceramic fixed dentures were produced in several steps to be placed on the implants. The dentures replaced all the patient’s teeth in his jawbone and mandible.

The patient was trained and given detailed instructions how to perform oral hygiene. Besides the standard oral hygiene he was recommanded to use water flosser with special disinfection solutions. Such care significantly contributes to keeping non-inflammatory condition in the oral cavity which is one of the basic preconditions for a long-lasting functional and aesthetic stability of so reconstructed teeth.

A 61-year-old female patient. The patient had defective and extrememly severely damaged mandible bone. This was a consequence of  incorrect keeping untreated devital teeth in their original place for a long time (saving teeth “at all cost“). She was recommended to us for a complex solution of her condition.

After a thorough diagnostic and therapy assessment, we started the treatment. During one session we removed residual destructed periodontally compromised teeth. We thoroughly treated the patient‘s damaged bone affected by inflammatory processes and  implanted six one piece implants. After we treated the wound, we took impressions and a fixed temporary denture was made (see the picture with open mouth). After the necessary healing time (6 – 8 weeks) this denture was replaced with a fixed definitive denture which will fully functionally as well as aesthetically rehabilitate the patient in a long run. Eventually, the patient feels like having her own teeth after a long time.

At the same time the condition of jawbone teeth was resolved in the patient too. All failed teeth were extracted and immediately replaced with a totally removable denture. If, in the future, the patient decides for a fixed solution in her jawbone too, we will be able to meet her requirements.

A 27-year-old female patient. After the extraction of both premolar teeth in the right jawbone the patient was recommended to our practice to solve her condition.

After placing two implants in the area of her original teeth and after the necessary period of healing (6 – 8 weeks) the tooth reconstruction was performed. Two separate aesthetic metal ceramic crowns were fixly cemented to abutments attached to the body of the implant with a screw.

A 46-year-old male patient. He had a combined damage of teeth (local severe periodontitis, several failed devital teeth treatments with findings on roots, destruction of solid dental tissues under the level of the alveolar process bone) and long-lasting unpleasant problems with his teeth which were recurring despite long-term treatment by his previous dentist.

After a thorough diagnostic and therapeutic evaluation we opted for a fast and effective solution of the patient‘s problems in his mandible. During one session we removed all damaged and defective teeth in his mandible. Immediately after the extractions and treatment of the bone which had been damaged by destructive inflammatory processes, we implanted five one piece implants in the frontal area of the mandible. After the closure of the mucosa wound we took impressions and our prosthodontist made a fixed screwed resin denture which was immediately placed in the patient. Thus, the patient had no toothless period.  

During the period of healing (7 weeks), the temporary fixed denture, besides its aesthetic role, enabled the patient to take food more or less normally. The denture itself protected the mucosa wound in a very effective way which contributed to a non-problematic healing process as well as to the wound protection. The physiological loading of the implants themselves and their splinting with a temporary fixed denture significantly improves the osseointegration process of the implants. This solution is much more favourable than a procedure when an implant is healing without loading.

After seven weeks, a special construction, which enabled to replace all teeth in mandible, was made. Subsequently, we solved the problem in the jawbone too when we successfully stabilised a part of the patient’s own teeth.  

A 56-year-old male patient. Untreated periodontitis destructed the bone around teeth in his mandible.

Based on a detailed anamnesis as well as the assessment of the patient’s condition, and after the preceding hygiene preparation, we opted for a reconstruction with the use of dental implants. We placed six implants in the patient’s mandible. By the end of the following day we made a temporary fixed denture which enabled him to have no toothless period after the implant procedure and during the healing period since a toothless period is generally not perceived well by patients.

After the necessary period of healing, we made a metal ceramic denture in cooperation with our specialized dental laboratory. This definitive fixed metal ceramic denture served at the same time as a reconstruction and replacement of the alveolar process bone which had been seriously damaged by periodontitis.

Patients whose teeth are seriously affected by periodontitis should be treated only by experts who have experience with such conditions. Only a highly qualified approach can guarantee excellent long-term functional and aesthetic as well as stabile treatment results in implant therapy.

A 35-year-old female patient who was missing the first premolar tooth in jawbone.After a thorough examination and planning, we placed one implant and immediately reconstructed the condition with a temporary resin fixed crown. This crown temporarily fully rehabilitated the patient. At the same time it functioned as a special device shaping the gum. This is often very helpful and sometimes absolutely necessary in order to achieve the best possible aesthetic results.

After nine weeks, we performed a definitive reconstruction with a metal ceramic cemented crown. We adjusted the aesthetics of the crown to the patient’s aesthetics of the surrounding teeth. These were slightly discoloured (they had cut into the oral cavity in such colour). However, the patient had got used to them and did not reflect on our offer to an overall aesthetic solution of her condition. We fully respected her decision since her teeth were, in other respects, healthy.

A 52-year-old female patient who had many endodontically (treatment of root canals) but not quite correctly treated teeth.

After a detailed examination, consideration of all options, and consultation with the patient we performed a 3D CT examination. Subsequently, after a thorough planning, we performed a teeth extraction (of a lateral incisor tooth, canine tooth, and the first premolar; the patient did not have the other teeth on the given side of her jawbone any longer) and placed five implants. Immediately after the extraction and implant therapy (immediate post extraction implant therapy) three frontal teeth were reconstructed using temporary resin crowns which were placed in one block in order to achieve a better stability (immediate provisionalisation). This treatment enabled a perfect preservation of the supporting tissues (e. i. both bones and gums) which were not seriously affected by inflammatory processes caused by devital teeth. With the above described treatment, we relatively simply achieved the preservation of a natural look of the follow-up definitive reconstruction which was performed three months after the implant therapy.

A metal ceramic aesthetic bridge with precise red and white aesthetics was made as the definitive prosthetic work replacing all teeth in the left part of the jawbone. The patient has been included in the long-term hygiene program in our practice.

A 42-year-old female patient. She suffered from bad aesthetics of frontal section of teeth in the jawbone as well as from a defect in both side regions.

Firstly, we removed the roots of devital teeth and the patient took part in our hygiene preparation program. During the healing of the extraction wounds she had a partially removable denture. She tolerated the denture well which is not always the case.

After the period of healing of the extraction wounds (four months) we placed two implants on each side  (on the right side in the area of the first premolar and the first molar, on the left side in the area of both premolars).

Two months later, after the prosthetic preparation of the patient‘s own frontal teeth, a three-part bridge on the right side and a block of two crowns on the left side were made simultaniously. Aesthetic ceramic crowns were placed on the patient’s own teeth.

The patient is satisfied with the result very much and she regularly comes to our dental hygiene sessions. She does not want to have problems with her teeth any more. She is aware of the fact that the problems she had made herself were caused by her long-lasting ignorance of her oral health.

A 32-year-old female patient who had neglected her teeth for a long time. Besides other problems (incorrect position of teeth as a consequence of untreated anomalies of teeth position in childhood) she had lost posterior teeth in her jawbone.

After a thorough analysis of her status, a consultation with an orthodontist, 3D CT examinations and a gnathologic analysis we opted for the replacement of posterior teeth in the jawbone with three implants. Since there was insufficient volume of bone in this area, the implant treatment included additional procedure when we performed bone abutment and thus ensured its sufficient amount for a long-term stability of the reconstruction. The bone abutment and the implant treatment were performed in one session during one intervention (open sinus lifting with immediate implant treatment).

The prosthetic reconstruction was performed after the healing of the bone, e. i. six months later. After taking impressions in the specialised dental laboratory, a block of three crowns was made and cemented to the abutments screwed to the implants. After the implant treatment, the patient underwent orthodontic therapy to solve her unfavourable condition on the other side of the dental arch.

The decision to first reconstruct one side with the implants and only then undergo the orthodontic therapy, was made in oder to secure the function of teeth at least on one side and to make the subsequent treatment more comfortable. The patient has been included in the long-term hygiene program in our practice.