Restorative dentistry and implantology – case 2

Case overview

Replacing missing teeth with stable solutions — a lower attachment-retained denture, crowns cemented on upper teeth, and implant-supported bridges.

• Starting point: Our 55-year-old male patient requested replacement of his missing teeth. He was interested in solutions that would seat stably in the mouth wherever possible. He was bothered by the irregular position of his teeth and uneven tooth shades, which made him hide his smile.
• Treatment plan: Because of advanced periodontal disease, hopeless teeth had to be removed. We could rely on a few teeth that supported a temporary cemented bridge during healing — so he never had to leave without a restoration. Lower: limited bone supply originally suggested bone grafting and implantation; at the patient’s request we opted for a removable denture stabilised with attachment-retained crowns. Upper: crowns cemented on teeth and bridges screw-retained on implants.
• Course of treatment: Treatment lasted 2 years. After oral hygiene therapy and motivation, hopeless teeth were removed; our patient left with a temporary restoration. After wound healing the lower metal-base denture was completed with attachment-retained crowns. Upper: implants were placed in stages, with a sinus floor elevation on the left. After 9 months of healing we placed the implants with dynamic navigation according to the ideal tooth positions, then completed the upper fixed restoration.
• Treatment outcome: Chewing function and facial aesthetics were restored. With regular check-ups we monitor that the previous periodontal disease does not reactivate. The patient’s chewing comfort is similar to that of natural teeth.