case_images: PMC5379076_01
case_images: Starting case, clinical frontal view of the patient.
case_images: CRID2017-6348570.001.jpg
case_images: PMC5379076_01_CRID2017-6348570.001.jpg
case_images: fig1
case_images: Considering the clinical exam (Figure 1), radiographic exams (Figures 2, 3, 4, and 5), and examination of models (Figure 6), specialists in periodontics, implantology, prosthetics, and orthodontics made a diagnosis suggesting that the multidisciplinary approach was the best therapeutic choice to adopt for this complex case.
case_images: Starting case, full-mouth intraoral radiographic exam.
case_images: CRID2017-6348570.002.jpg
case_images: PMC5379076_01_CRID2017-6348570.002.jpg
case_images: fig2
case_images: Considering the clinical exam (Figure 1), radiographic exams (Figures 2, 3, 4, and 5), and examination of models (Figure 6), specialists in periodontics, implantology, prosthetics, and orthodontics made a diagnosis suggesting that the multidisciplinary approach was the best therapeutic choice to adopt for this complex case. The radiographic check at one year (Figure 24) demonstrated no bone loss around implants and teeth compared to the starting condition (Figure 2).
case_images: Starting case, teleradiographic exam.
case_images: CRID2017-6348570.003.jpg
case_images: PMC5379076_01_CRID2017-6348570.003.jpg
case_images: fig3
case_images: Considering the clinical exam (Figure 1), radiographic exams (Figures 2, 3, 4, and 5), and examination of models (Figure 6), specialists in periodontics, implantology, prosthetics, and orthodontics made a diagnosis suggesting that the multidisciplinary approach was the best therapeutic choice to adopt for this complex case.
case_images: Initial case, TC Dentascan, axial view.
case_images: CRID2017-6348570.004.jpg
case_images: PMC5379076_01_CRID2017-6348570.004.jpg
case_images: fig4
case_images: Considering the clinical exam (Figure 1), radiographic exams (Figures 2, 3, 4, and 5), and examination of models (Figure 6), specialists in periodontics, implantology, prosthetics, and orthodontics made a diagnosis suggesting that the multidisciplinary approach was the best therapeutic choice to adopt for this complex case.
case_images: Initial case, TC Dentascan, cross-sectional images perpendicular to alveolar process of the maxilla.
case_images: CRID2017-6348570.005.jpg
case_images: PMC5379076_01_CRID2017-6348570.005.jpg
case_images: fig5
case_images: Considering the clinical exam (Figure 1), radiographic exams (Figures 2, 3, 4, and 5), and examination of models (Figure 6), specialists in periodontics, implantology, prosthetics, and orthodontics made a diagnosis suggesting that the multidisciplinary approach was the best therapeutic choice to adopt for this complex case.
case_images: Analysis of edentulous space.
case_images: CRID2017-6348570.006.jpg
case_images: PMC5379076_01_CRID2017-6348570.006.jpg
case_images: fig6
case_images: Considering the clinical exam (Figure 1), radiographic exams (Figures 2, 3, 4, and 5), and examination of models (Figure 6), specialists in periodontics, implantology, prosthetics, and orthodontics made a diagnosis suggesting that the multidisciplinary approach was the best therapeutic choice to adopt for this complex case.
case_images: Diagnostic wax-up, frontal view.
case_images: CRID2017-6348570.007.jpg
case_images: PMC5379076_01_CRID2017-6348570.007.jpg
case_images: fig7
case_images: A simulation of the final rehabilitation through a diagnostic wax was realized (Figures 7, 8, and 9) and analysed with the patient, aiming at highlighting what the advantages and disadvantages of the prostheses would be.
case_images: Diagnostic wax-up, lateral right view.
case_images: CRID2017-6348570.008.jpg
case_images: PMC5379076_01_CRID2017-6348570.008.jpg
case_images: fig8
case_images: A simulation of the final rehabilitation through a diagnostic wax was realized (Figures 7, 8, and 9) and analysed with the patient, aiming at highlighting what the advantages and disadvantages of the prostheses would be.
case_images: Diagnostic wax-up, lateral left view.
case_images: CRID2017-6348570.009.jpg
case_images: PMC5379076_01_CRID2017-6348570.009.jpg
case_images: fig9
case_images: A simulation of the final rehabilitation through a diagnostic wax was realized (Figures 7, 8, and 9) and analysed with the patient, aiming at highlighting what the advantages and disadvantages of the prostheses would be.
case_images: One month after nonsurgical periodontal therapy.
case_images: CRID2017-6348570.010.jpg
case_images: PMC5379076_01_CRID2017-6348570.010.jpg
case_images: fig10
case_images: One month after nonsurgical periodontal therapy had been completed (Figure 10), implant surgery was carried out.
case_images: Inserted pins.
case_images: CRID2017-6348570.011.jpg
case_images: PMC5379076_01_CRID2017-6348570.011.jpg
case_images: fig11
case_images: Paracrestal full-thickness flaps were elevated; consequently the osteotomy was realized following the surgical stent (Figure 11).
case_images: Implants placement.
case_images: CRID2017-6348570.012.jpg
case_images: PMC5379076_01_CRID2017-6348570.012.jpg
case_images: fig12
case_images: Three implants (Astra Tech OsseoSpeed TX Dentsply) were inserted in a prosthetic guided position in site 1.4 with implant 3.5 mm in diameter and 13 mm in length, in site 1.5 with implant 3.5 mm in diameter and 11 mm in length, and in site 1.6 with implant 4.0 mm in diameter and 9 mm in length, respecting the interimplant distance of 2-3 millimeters (Figure 12) according to Tarnow et al. and Elian et al., throughout the implant length to influence in a positive way osseointegration (Figure 13).
case_images: Rx control post-op.
case_images: CRID2017-6348570.013.jpg
case_images: PMC5379076_01_CRID2017-6348570.013.jpg
case_images: fig13
case_images: Three implants (Astra Tech OsseoSpeed TX Dentsply) were inserted in a prosthetic guided position in site 1.4 with implant 3.5 mm in diameter and 13 mm in length, in site 1.5 with implant 3.5 mm in diameter and 11 mm in length, and in site 1.6 with implant 4.0 mm in diameter and 9 mm in length, respecting the interimplant distance of 2-3 millimeters (Figure 12) according to Tarnow et al. and Elian et al., throughout the implant length to influence in a positive way osseointegration (Figure 13).
case_images: Conditioned soft tissue.
case_images: CRID2017-6348570.014.jpg
case_images: PMC5379076_01_CRID2017-6348570.014.jpg
case_images: fig14
case_images: After four months necessary to osteointegration and conditioning soft tissue (Figure 14) the impression was taken for the definitive rehabilitation.
case_images: Lower final impression.
case_images: CRID2017-6348570.015.jpg
case_images: PMC5379076_01_CRID2017-6348570.015.jpg
case_images: fig15
case_images: Periodontal probing was within normal limits, and no inflammation was recorded neither around the teeth nor around implants (Figures 15, 16, and 17).