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Treatment of Total Edentulism

Traitement de l'édentation totale

This is the basic treatment of oral implantology. When Prof. Brånemark in the early 60’s, thought about the different applications of osseointegration and to treat of edentulous patients wearing full dentures. Wearing removable dentures accelerates bone resorption. After a certain time this prosthesis does not fit anymore, chewing and speaking becomes difficult. We may call these patients oral invalids. Six maxillary implants, five implants in the mandible are usually sufficient to support a fixed anchored prosthesis.

These prostheses consist of a frame made of gold or titanium on top of which composite resin teeth are placed. They are fixed (screwed) onto the implants. So there is no more pressure of the prostheses on the mucosa, and no pain when chewing. The stability of the prostheses allows normal function. The number of implants varies depending on bone quantity and quality, occlusal forces and the concept of the (ceramic or resin) prosthesis.
A patient wishing to have a fixed prosthesis with a limited amount of bone may need eight implants. In other cases, four implants may be sufficient.
The practitioner determines the type of prosthesis, the number of implants to be placed but also the need for strengthening the bone. (Bone grafting, sinus lift). This type of treatment is actually the one who has undergone the greatest number of scientific publications in dentistry. Its reliability is nowadays fully proven.
It is possible, in some cases to reduce the number of implants at two in the mandible and place implants attachments in order to enhance the stability of total removable dentures. It goes without saying that the treatment of total edentulism using implant finds its quintessence in the installation of fixed prostheses in the maxilla or mandible. The first patient treated by Prof. Brånemark by this method had been in 1965 and retained their implants in place for over 40 years.

This type of treatment can last several decades when conditions are required.

1988 - Patiente de 46 ans totalement édentée. On peut noter une déformation du visage au niveau de l'étage inférieur consécutive à la perte des dents et de leur support osseux.

1988 – wait 46 years totally toothless. We can note a facial deformity at the lower level following the loss of their teeth and bone support.

1988 - Radiographie pré opératoire

1988 – Preoperative radiograph

1988 - Radiographie post opératoire 5 implants à la mandibule et 6 au maxillaire ont permis de traiter cette patiente et de lui poser des prothèses fixes ostéoancrées

1988 – Postoperative radiograph 5 implants in the mandible and 6 in the maxilla to treat this patient with fixed prostheses

Clinical view of the pillars upon which prosthetic implants are covered

Prothèses en place

Prosthesis in place

A noter la fausse gencive rendue nécessaire par la perte de substance osseuse

Note the false gingiva necessitated by the loss of bone substance

Vue clinique des piliers prothétiques sur lesquels seront visées les prothèses

Clinical view of the pillars upon which prosthetic restoration

The patient finds comfort function and aesthetics with these fixed prostheses

1989

1999 – Note the bracket lip found

1992

2009

2009

2009

2009

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