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S&M Publications Clinical cases Implantology IMMEDIATE LOADING BIMAXILLARY PROSTHETIC IMPLANT REHABILITATION OF A PATIENT WITH SEVERE BONE ATROPHY BY MEANS OF CRESTAL EXPANSION ASSOCIATED TO IMMEDIATE LOADING IN THE LOWER ARCH AND MAXILLARY SINUS LIFT LOCALISED WITH THE CRESTAL APPROACH

BIMAXILLARY PROSTHETIC IMPLANT REHABILITATION OF A PATIENT WITH SEVERE BONE ATROPHY BY MEANS OF CRESTAL EXPANSION ASSOCIATED TO IMMEDIATE LOADING IN THE LOWER ARCH AND MAXILLARY SINUS LIFT LOCALISED WITH THE CRESTAL APPROACH

Tagliani M., Morandini E.

Tagliani M.

Private practice in Pavia, limited to periodontology, implant prosthodontics and implantology since 1988. Lecturer in national and international congresses.

Morandini E.

Dental technician in Salice Terme, owns a patent on the plaque with permanent surface humidity. Author of a book edited by Quintessenza. Keen on gnathology.

NumeriUno, 2: 4-6, 2008
The techniques of immediate loading in the edentulous mandibular arch nowadays have relatively minor risk factors if this rehabilitation is performed according to the guidelines shared by literature and widely used by dentists. 
On the other hand, the surgical techniques for crest expansion and localised sinus lift allow, according to the author, minimising surgical trauma, and the post-operative course and to obtain faster healing times compared to other surgical techniques, even though today these depend on the surgeon’s skills. Nevertheless, in cases like the present one, the sum of several risk factors requires extreme accuracy and attention in the pre-operative planning phase, in the programming of the final prosthetic structure and its completion. This study proposes combining the crestal expansion technique with the immediate loading technique. 
The surgical techniques used in performing this total bi-maxillary rehabilitation allow resolving the implant-prosthetic problem in impaired anatomic situations that could otherwise only be treated by guided bone regeneration techniques or bone grafts or other more invasive surgical procedures.  Those proposals are safe with comparable results in terms of prognosis as well as of efficacy and can be associated, at least in the lower arch, to immediate loading. 
 

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