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implants - international magazine of oral implantology

I clinical technique _ troubleshooting 30 I implants2_2011 plant. After its osseointegration, we incorporated acompletelynewbridgeusingtheexistingmesial implant. The results achieved here can help us learn fromdesignerrorsandselectadifferentapproach for future cases, so that we can also treat patients who have had failure of a comprehensive pros- thetic restoration. Our last case will illustrate this situation. _The unsuccessful conventional treatment versus the successful, well-planned implantological procedure(Figs. 21–34) Finally, we would like to present an unusual case: an unsuccessful conventional treatment that was replaced with implantological treat- ment carried out in close collaboration between the dentist and dental technician. The patient had experienced considerable complications duringprosthetictreatment(thegoalbeingatel- escopic partial prosthesis supported by teeth #43 and 33, while preserving the front teeth #42 to 32, which had been caries-free and without fillings until then, and replacement of teeth #47 to44and34to37).First,tooth#33fracturedand had to be extracted, in spite of the fact that preparation and casting had already been done. Treatment was replanned after this event, and teeth #42, 41, 31 and 32 were also prepared (the goal being telescopic crowns). Shortly before im- plementation, tooth #43 also had to be ex- tracted. The patient was unable to give the exact reasons for this. This left her with four teeth— #42, 41, 31 and 32—which all had telescopic crowns. Anchoring of the partial prosthesis was poor; the patient was able to loosen it with minimal tongue-applied pressure. The pronounced ten- dency of the prosthesis saddles to cave in also re- sulted in complications in the form of multiple recurrent pressure sores. The patient was re- ferred to us at this point. The reason for this ac- cording to her dentist was that implants, which the patient had inquired about, could be inserted Theunsuccessful conventionalsolution Figs.21–25_Owingtothelossof prospectiveabutmentteeth#43and 33duringtheprosthetictreatment phase,theremainingfrontteeth #42,41,31and32received telescopiccrowns. Fig.26_Thepartialprosthesisshowed insufficientmounting. Figs.27–29_Withtheaidof3-D imagingandplanning,fourimplants wereinsertedinregions#46,43,33 and36—withoutanyaugmentative treatment. Fig.30_Afterosseointegrationofthe artificialabutmentteeth,twoside- toothbridgesentirelysupportedby implantsandfourindividualcrowns wereintegratedwiththeremaining mandibularteeth. Fig. 22 Fig. 23 Fig. 24 Fig. 25 Fig. 26 Fig. 27 Fig. 28 Fig. 29 Fig. 30