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Transition from hopeless dentition to full-arch fixed-implant-supported rehabilitation by a staged extraction
Eitan Mijiritsky1, Ziv Mazor, Adi Lorean
1From the *Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel; †Department of Medical Science, Faculty of Medicine, University of Eastern Piedmont, Novara, Italy; ‡Department of Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel; §Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel; and ∥Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Abstract:
Transition from a hopeless dentition to a fixed-implant-supported full-arch reconstruction can be difficult for patients if wearing a transitional removable denture is involved. In addition, an increased risk for trauma to bone augmentation areas and to the implant-bone interface exists when using a removable transitional complete denture during the implant healing period; such risk can compromise implant success or increase crestal bone loss around implants before the final restoration. This article describes a treatment approach that allows replacement of the hopeless dentition with an osseointegrated fixed prosthesis, without rendering the patient totally edentulous before the delivery of the final implant-supported prosthesis. A staged approach using a few hopeless teeth to support a provisional fixed restoration during the healing process can help avoid discomfort and improve implants' outcome. A treatment plan for a maxillary arch reconstruction is used to illustrate the staged approach protocol. This protocol addresses patients' psychologic need to remain dentate during partial or full-mouth rehabilitation, while providing good esthetics and function during restoration of a dental arch.
