Journal of Oral Implantology April 2012 - (Page 177)

CASE LETTER Simplifying the Implant Treatment Plan for an Elderly Patient ´ Marcelo Munhoes Romano* Mario Sergio Soares Gisele Ebling Artes Daniela Giunte Yoshida ´ Flavio Eduardo Guillin Perez Carlos Alberto Adde INTRODUCTION n the search for a better lifestyle and increased life expectancy, more and more elderly are seeking dental treatment. However, many of these patients present systemic compromise that could affect the success and maintenance of the proposed therapy. In such cases, simple proposals, such as partial removable prostheses (PRPs), must be used. PRPs are widely used, especially when conditions for rehabilitation with a fixed prosthesis attached to implants are not favorable.1 In one study,2 10 patients were rehabilitated with inferior PRPs supported by implants in the posterior region; results show increased satisfaction in all patients, minimal wear of the component, absence of excessive bone loss, and periodontal health after 1 year of rehabilitation. Literature describing the combination of PPRs and implants is scarce and is based mainly on clinical reports of posterior implants for distal extension with PRPs.3,4 In this case, rehabilitation with fixed prostheses and implants was proposed to the patient, who required surgically guided bone regeneration through subantral graft or PRPs, but the patient declined both proposals. Following this, rehabilitation with implants in conjunc*Corresponding author, e-mail: DOI: 10.1563/AAID-JOI-D-10-00078 I tion with PRP was planned and proposed to avoid subjecting the patient to sinus lifting surgery and to preserve the remaining tooth and the residual ridge; however, the team explained that greater load would be generated on these if they received only PRPs. CASE REPORT A 71-year-old male patient with controlled hypertension and presenting with dental phobia inquired about dental implants, seeking to improve both esthetics and function. During the planning stage, the need for surgery to achieve maxillary sinus lifting was observed if rehabilitation with a fixed prosthesis on implants was chosen (Figures 1 and 2). However, following the clinical examination and according to patient history, planning was directed toward simplified rehabilitation, also involving implants, but associated with PRP. This solution rehabilitated the patient within his functional and esthetic expectations without subjecting him to greater stress. Following initial procedures of restorative care, the surgical implantology step was initiated, during which the region of missing elements 15, 22, 24, 36, and 46 received Cone Morse implants. After 4 months, implanted regions were reopened with placement of the healings. Then the prosthetic components were selected, highlighting the region of elements 24 and 25, which received o-ring abutment (Figure 3). Journal of Oral Implantology 177

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2012

Research Letters: A New Editorial Format for the Rapid Disclosure of Innovative Data and Concepts, Didactic Demonstrations, and Scientific Discussions
Effect of Defective Collagen Synthesis on Epithelial Implant Interface: Lathyritic Model in Dogs. An Experimental Preliminary Study
Presence of Aspartate Aminotransferase in Peri-Implant Crevicular Fluid With and Without Mucositis
Deformation of Implant Abutments After Framework Connection Using Strain Gauges
Implant-Retained Mandibular Bar-Supported Overlay Dentures: A Finite Element Stress Analysis of Four Different Bar Heights
The Efficacy of Mylohyoid Nerve Anesthesia in Dental Implant Placement at the Edetulous Posterior Mandibular Ridge
Metal-Ceramic Screw-Retained Implant Fixed Partial Denture With Intraoral Luted Framework to Improve Passive Fit
A Relaxed Implant Bed: Implants Placed After Two Weeks of Osteotomy With Immediate Loading: A One Year Clinical Trial
A Modified Technique for Removing a Failed Abutment Screw From an Implant With a Custom Guide Tube
Therapy for Missing Lower Medial Incisor by Means of Reduced Diameter Implants
Simplifying the Implant Treatment Plan for an Elderly Patient
The Use of Leukocyte- and Platelet-Rich Fibrin During Immediate Postextractive Implantation and Loading for the Esthetic Replacement of a Fractured Maxillary Central Incisor
Atraumatic Removal of an Asymptomatic Migrated Dental Implant Into the Maxillary Sinus: A Case Report
Tooth-Implant Connection: A Review

Journal of Oral Implantology April 2012