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Immediate Loading in an Atrophied Maxilla

The patient is a non smoking 74-year-old female, with a medical background of hypertension, diabetes and TIA in the past. She is taking anti coagulants. She has a fixed prothesis in the lower mandible, a removable upper denture and suffers from the inconvenience. The denture is supported by 4 implants with severe bone loss due to implantitis. Teeth #25 (13) and #26 (14) still remain.

The CBCT shows insufficient bone for implants under the sinuses. In the anterior zone there are four failed implants, which are not in a good enough position for a new rehabilitation.

The treatment plan included removal of the old implants and extraction of teeth #25 (13) and #26 (14).

The goal is to gain enough support for immediate loading.

The plan involves the placement of 2 pterygoid implants, 4 zygomatic and one anterior implant in the remaining bone. Bond Apatite® filling the bone defects, for enlarging the bone width and covering the zygomatic implants buccally in order to achieve sufficient width around the implants and long term soft tissue health.

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