Placement of standard and zygoma implants and immediate placement of

a prefabricated bridge

David BloomGuy Mclellan

• Pt attended December 2006 c/o loose denture that had been placed 1 year previously due to periodontal problems. She was not completely happy with the aesthetics and wanted a fixed replacement if possible.

•  • We discussed all treatment options including bilateral sinus lifts but pt did not want the protracted

treatment times involved and was very conscious about people knowing she was having treatment as even her husband did not know she wore an upper denture .

•  • It was agreed to place 4 conventional guided implants and 2 zygoma implants along with a

transitional upper bridge. (anterior 4 x 13 nobel speedy inserted with standard protocols to 45 ncm; zygoma implants 2 x 47.50 zygoma implants and 17.5 multi unit abutments)

• This transitional fixed bridge lasted 2 .5 years until it fractured and so made the patient proceed with the final prosthesis. Compliance has always been an issue and in deed to date the patient has still not elected to proceed with the lower rehabilitation that was advised

Pretreatment examinations

Upper denture at presentation Edentulous ridge with single remaining molar (pre-op)

Pre-op OPG

Surgical and immediate prosthetic rehabilitation

Prefabricated acrylic bridge

Placing drill guide Drilling guide in place

Osteotomy site preparation for anterior guided implant

Osteotomy site prepared

Placing anterior implant Anterior implants in situ and guide removed

Preparation of zygoma site: lateral window visible

Placing zygoma implant

2 week review of transitional bridge

3 month review transitional bridge

Post-op OPG

Guided Abutments

Follow-up

Final bridge, patient chose shade

Final bridge