WHY ATTEND
Until 1950/1960, for young women in rural areas of Switzerland (e.g., in Entlebuch) it was common practice to have all their teeth extracted or even forced to have them extracted, in order to become eligible for marriage with full dentures. This was the only way their future husbands could be sure that they would not incur any costs in this regard! This practice, which would now be considered mutilation, has led to many women today wearing partially insufficient dentures and suffering from severe alveolar bone atrophy. (Figure1) If the local bone is no more sufficient to place conventional implants, alternatives such as invasive augmentation or zygoma implants are considered.
With the development of exact 3D manufacturing of patient-specified implants the treatment options of severe bone atrophy in both jaws have increased by the option of minimally invasive use of individualized implants. The last eight years show promising data for this relatively new treatment which is not to be compared with the old subperiostal implants.
The surgery is regarding the bone destruction minimally invasive, but the muco-periostal flap is far more extended as for normal implant insertions or other oral surgeries, so it should be performed by experienced surgeons only.
The insertion of the implants can be performed following the surgical guide provided by the manufacturer, manual changes of the bone reduction for a better fit of the implants is possible.
The use of collagen membranes for the thickening of the soft-tissue as prevention of dehiscencies should depend on the phenotype of the patient. Both cases in which we performed it show at least a significant thickening of the periimplant gingiva. Longterm observations should be performed.
Following the principles of Branemark (Osseointegration), Ledermann (Immediate Loading) and the modern principles of titanium implant surfaces Patient-specific Implants are a valuable alternative for Full-Arch-Treatments in severely atrophied upper and lower jaws.
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Learning objectives
By the end of this session, delegates will be able to:
- Describe the challenges associated with severe alveolar bone atrophy in the upper and lower jaws and identify the limitations of conventional implant treatment.
- Explain the indications and clinical principles of patient-specific implants as a minimally invasive alternative for full-arch rehabilitation in severely atrophied jaws.
- Discuss the surgical workflow for patient-specific implants, including 3D planning, guided implant placement, bone reduction and soft-tissue management.
- Evaluate the current evidence, benefits and limitations of patient-specific implants, including considerations for immediate loading, soft-tissue augmentation and long-term outcomes.
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