Comprehensive case in a woman with periodontitis and large bone defects.

The current restoration is insufficient and the supporting implants show periimplantitis. A new full-mouth rehabilitation has to be planned. This comprehensive case was treated by Dr. Thomas Hitz, Frauenfeld, Switzerland.

Periodontitis case with acute pain and furcation involvement, fixed reconstructions on teeth, implants and tooth-implant combination.

Contents: - Considerations for prosthetic treatment planning (PowerPoint) - Production of the drill guide according to prosthetic specifications (PowerPoint) - Surgical procedure (film) - Flapless surgery - Access preparation - Pilot drilling using the drill guide - Preparation of the implant site - Internal sinus lift - Implantation Materials Checklist: Pilot drill; Alignment pin, depth gauge Straight osteotome for bone condensation (Ø 3.5 mm); Larger drills to enlarge the osteotmy; Round burs; Osteotome, angled, for sinus lift (Ø 4.2 mm); Ratchet, adaptor for ratchet (short); Holding key for transmission, SCS screwdriver (short); STRAUMANN Standard Plus RN implant (Ø 4.1 mm, L: 12 mm) and healing abutment (2 mm); STRAUMANN Standard Plus WN implant (Ø 4.8 mm, length 12 mm) and healing abutment (3 mm); Scalpel blade (15c) and scalpel blade holder (Martin); Two dental mirrors and dental forceps; Surgical forceps; Anatomical forceps; Probe; Periodontal probe; Sharp spoon; Sterile compresses (Hu Friedy); Isotonic sodium chloride solution, 0.9% (Braun).

Procedure - Incision in region 22 - Flap Design - Preparation of the Implant Bed - Implant Placement - Suture - Extraction of tooth 12 - Curretage - Implant Placement Materials Implant System: 3I, Osseotite, Ø 4mm Region 12: 15mm length Region 22: 13mm length

Procedure: - Incision - Flap Design - Application of the template - Implant Placement - Suture - Application of the provisionary Materials: E-Woo Picasso Trio: Digital Panoramic, Cephalometric and Dental CT (3in1)

Procedure: - Sounding - Extraction of the tooth 21 - Drilling and implantation - Soft tissue preparation (split flap technique / tunnelling technique) - Harvesting of the soft tissue graft from the palatal region and immediate closure of the site - Fixation of the transplant - Application of the healing abutments - Fixation of the transplant coronally Materials: Thommen Medical Implant System: SPI Element 4,2x14, 4,5 Implant shoulder Goretex 5,0, Premilene 7,0 Sutures Thommen gingiva former

Procedure: - Extraction of upper front teeth not suitable for preservation - Immediate loading of four NobelPerfectTM implants - Intraoperative registration of implant position - Flap-free Vestibular Bone Augmentation - Connective Tissue Graft for Periodontal Regeneration - Immediate Loading of temporary implants on the day of surgery - Definitive restoration 6 months later Materials: NobelPerfect Groovy Implants RP and NP; NobelPerfect Temporary Abutments RP and NP; NobelPerfect Implant Replicas RP and WP; Ribbond, Bondable Reinforcement Ribbon; Ethilon 5-0 FS3 Suture Material; Astra Bonetrap Bone Collector.