654 Theories and techniques of oral implantology

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Fig. 15-85. A, The only remaining maxillary teeth were the right central incisor and both 12-year molars, which were prepared for full crown restorations. Also seen are two deciduous second molars that were to be kept. B, Only two deciduous second molars and two permanent 12-year molars remained in the lower arch.

Case 7

Full mouth fixed dentures for partial anodontia

A 17-year-old boy was extremely upset over the condition of his mouth. He had only five permanent teeth: the maxillary right central incisor and the mandibular and maxillary right and left 12-year molars. His other teeth were deciduous and beginning to loosen (Fig. 15-84). Radiographic examination revealed no other permanent tooth buds.

All the deciduous teeth, except the four deciduous E's, were removed. The reason for retaining the deciduous E's was to maintain the buccolingual width of the alveolar bone. The ridges where the other deciduous teeth were extracted were completely knife-edged but camouflaged with a thick covering of fibromucosa.

All remaining teeth were prepared for full coverage restorations (Fig. 15-85) . Four blade implants were carefully set into the knife-edge ridges—two in each arch   and the sites sutured closed (Fig. 15-86).

After 5 days the sutures were removed (Fig. 15-87) . The tissue-bearing surfaces of the pontics were checked for impingement and all necessary adjustments made. The prosthesis were cemented into position, and the occlusion was carefully checked and balanced (Fig. 15-88).

The preoperative Panorex compared with the postoperative film is a good summary of the case

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Fig. 15-86. A, Blade implants were placed into the bone on both sides of the maxilla. B, The tissues were sutured. C, Two blade implants were tapped into the mandibular bone. D, The tissues were sutured.