Combined with periodontal treatment, don’t blindly
- Reasons for treatment: long-term smoking, eating betel nut, periodontal disease, resulting in missing teeth
- Treatment methods: All-on-6 full mouth reconstruction, sleeping anesthesia, guided dental implants
- Attending physicians: Dr. Ye Liwei, Dr. Huang Yunxuan
The patient, who is in his fifties, suffers from severe periodontal disease and has the habit of smoking and chewing betel nut for a long time. The extensive missing teeth affect his eating and appearance. Finally, on the recommendation of a friend, I came to our clinic for evaluation and treatment.
The patient had severe periodontal disease, which resulted in the appearance of the teeth being blackened and a large area of the lower jaw missing teeth.
Although the patient's primary goal was to obtain dental implants, physicians in the past have recommended full tooth extraction and immediate reconstruction with dental implants. However, after carefully assessing the condition of each tooth, I found that there were still 8 teeth in the upper jaw and about 3 teeth in the lower jaw that could be preserved.
The condition of the upper and lower jaw after periodontal treatment showed that most of the teeth in the upper jaw had good treatment results and natural teeth were preserved. Due to extensive missing teeth in the lower jaw, an All-on-5 full mouth reconstruction plan was planned in the future.
The treatment effect of most of the upper jaw teeth was good, and the natural teeth were preserved. Due to extensive missing teeth in the lower jaw, an All-on-5 full mouth reconstruction plan was adopted.
If the All-on-X treatment mode is used for the entire mouth, all the remaining front teeth in the upper jaw will have to be extracted. As a periodontist, I believe that front teeth should not be sacrificed easily. Therefore, after communicating with the patient, I decided to use general dental implants to reconstruct the upper jaw. Although this method is more time-consuming, it can preserve valuable natural teeth. As for the lower jaw, after the teeth with poor prognosis are removed, the concept of full-mouth immediate dental implants can be used to quickly restore function and appearance, allowing patients to restore their quality of life in a short time.
During the reconstruction of the jaw, five implants were placed to achieve stability, and a special set of All-on-X dentures was installed. A full-mouth temporary dental bridge can be installed on the patient on the same day of surgery to quickly restore bite function and aesthetics.
Full-mouth rapid dental implant reconstruction for mandibular reconstruction: five implants are implanted and then locked in a special kit, allowing the function and appearance to be quickly restored on the same day of surgery.
The three edentulous areas on the upper jaw each underwent the following treatments:
- Upper right molar area: Internal sinus augmentation surgery was performed, and dentures were installed about 4 months after dental implantation.
- Upper left canine and first molar area: guided bone regeneration followed by dental implants in stages, with a treatment course of about one year.
- Left upper molar area: Dental implants after sinus augmentation in stages, the course of treatment is about one year.
In the circumferential X-ray of the full-mouth reconstruction case, six dental implants in the upper jaw and All-on-5 in the lower jaw were used to preserve the patient's multiple natural teeth and reconstruct the bite.
Here we introduce a full-mouth reconstruction case that combines general dental implants in the upper jaw and All-on-5 in the lower jaw to explain the characteristics, advantages and disadvantages of general dental implants and All-on-X technology.
The patient, who is in his fifties, suffers from severe periodontal disease and has the habit of smoking and chewing betel nut for a long time. The extensive missing teeth affect his eating and appearance. Finally, on the recommendation of a friend, I came to our clinic for evaluation and treatment.
患者存在嚴重牙周病，導致牙齒外觀黑化，下顎大範圍缺牙。
儘管患者的主要目的是進行植牙，過去有醫師建議全口拔牙並進行即刻植牙重建。然而，我仔細評估每顆牙齒的狀況後，發現上顎還有8顆牙齒，下顎約有3顆牙齒具備保留的條件。
經過牙周治療後的上下顎狀況顯示，上顎大部分牙齒的治療效果良好，得以保留天然牙；下顎由於大範圍缺牙，未來計劃採取All-on-5的全口重建方案。
若全口皆採用All-on-X的治療模式，上顎可保留的前牙將必須全數拔除。身為牙周病專科醫師，我認為不應輕易犧牲前牙。因此，我與患者溝通後，決定上顎採取一般植牙的方式重建。雖然此方式較耗時，但能保留寶貴的天然牙。至於下顎，拔除預後較差的牙齒後，應用全口即刻種植牙的概念快速恢復功能和美觀，使患者在短時間內恢復生活品質。
下顎的重建過程中，植入的五顆植體達到穩定性，並安裝All-on-X假牙專用套件。手術當日即可為患者裝上全口臨時牙橋，快速恢復咬合功能和美觀。
治療後效果
經過All-on-5手術後，下顎臨時牙橋當日裝妥，患者咬合和美觀得到恢復。全口即刻種植牙重建下顎，植入五顆植體後鎖上專用套件，手術當日即迅速恢復功能和美觀。
上顎重建療程
上顎的三個缺牙區分別經歷了以下療程：
右上臼齒區：進行內部鼻竇增高術，植牙後約4個月裝上假牙。
左上犬齒和第一小臼齒區：分階段引導骨再生後植牙，療程約一年。
左上臼齒區：分階段鼻竇增高術後植牙，療程約一年。
儘管手術次數較多，療程較久，但藉由牙周治療，保留了多顆自己的牙齒。
總結顯示，全口重建案例的環口X光片中，上顎六顆植牙和下顎All-on-5的方式，成功為患者保留多顆天然牙並重建咬合。
True testimonials from patients
I just want to find a dentist to re-do all my broken and rotten teeth. It was also because a friend came here and suggested to me that Modern did a good job here, and then suggested that I come here.
At the beginning, Dr. Ye was helping me with the assessment, and he told Dr. Ye very straightforwardly. Anyway, I completely trust you because you are professional. In particular, our entire medical team at Modern Hospital does a very good job and puts no pressure on patients. I feel very confident in the service. I am very grateful to our entire medical team at Modern Hospital.
Source:
Dr. Ye Liwei's personal website
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