The replacement of multiple teeth with dental implants is challenging due to factors such as low density bone, atrophic alveolar bone, sinus morphology. In this particular case, treatment is complicated by a history of failed implants in a large atrophic span. Multiple useful options exist which were used to treat this deficiency, including guided bone regeneration, sinus lifting, and extra-oral implant placement. Our concern in this area includes the placement of implants in a largely de novo grafted sinus with concerns of long term stability in grafted bone.
This patient case report presents a complex case including atrophic posterior maxillary region, history of multiple failed implants, and complete lack of sinus floor, and the treatment to rehabilitate dental function. Use of extensive grafting, 3D modeling, and pterygoid implant sites were utilized in management of this case with a digital workflow and capitalize of primary stability and splinting.
Learning Objectives:
Learning that patient’s cause for failure may be multifactorial, and without a full set of records, we may never know the complete history.
Identifying the diagnostic challenges, and systematically identifying how to address each challenge. Additionally, able to utilize digital tools as an adjunct to the dental skill set.
Help determine the best prosthetic solution would be one which splinted the implants together
