Volume 14, Number 2 -- November 2001

TEETH IN A DAY^TM in the Upper Jaw

TJ Balshi and GJ Wolfinger

The Surgical Procedure

A board certified anesthesiologist provided nasal intubation for general anesthesia. Local anesthetics were then delivered and the remaining maxillary teeth were removed. The same procedure was completed in the mandibular posterior where multiple teeth were removed. After all visible pathology was removed from the surgical sites, the area was irrigated with an antibiotic solution. The patient was then re-draped in the traditional sterile protocol for implant placement.

The maxillary left area was opened to obtain visibility for the placement of the zygoma implant. This follows the traditional zygoma protocol. A 45 mm long zygoma implant was placed in the area tooth #14.

Immediately following the placement of maxillary implants, all of the newly placed implants in the anterior and left side received appropriate abutments. The three original maxillary implants that were placed in 1992 had the abutments changed to 1 mm EsthetiCone abutments to enable a more esthetically pleasing restoration. Two implants in the maxillary right posterior had cover screws placed and were left submerged submucosally in the traditional 2-stage protocol. The prosthetic reconstruction, which had been fabricated in the laboratory at the newly restored occlusal vertical dimension, was then attached to all of the maxillary abutments except the last two on the right side using the conversion prosthesis technique.

The maxillary teeth were set into the precise special position and the conversion prosthesis was then removed from the mouth. Clinical laboratory technician team members refined this prosthesis and added additional reinforcing acrylic throughout the lingual and cervical areas to provide improved esthetics. This custom-made conversion prosthesis then becomes the TEETH IN A DAY^TM restoration.

While the maxillary prosthesis was refined in the laboratory, the mandibular implants were surgically placed. Four implants were inserted into both the left and right posterior regions. Cover screws were used on all eight mandibular implants and these were left submerged in the traditional Brånemark protocol since they would not be functional for at least three months.

After completing implant surgery in the mandible, the maxillary TEETH IN A DAY^TM refined and polished prosthesis was returned to the operating room from the laboratory and fastened to the titanium abutments with gold retaining screws. A little over four hours after implant treatment began, the patient awoke to see a new and esthetically pleasing smile and felt an entirely new and comfortable occlusal vertical dimension. She was delighted with her "new look" and the TEETH IN A DAY^TM treatment.

Introduction
Treatment Planning
Surgical Procedure
Post-Operative
Summary and Acknowledgements
Captions

A New Protocol for Immediate
Functional Loading of Dental Implants

Prosthodontic Insights Newsletter
November 2001, Vol. 14, No. 2