The problem of sinusitis in interventions specific to dental implantology, more precisely in the procedure of lifting the maxillary sinuses, is not something unprecedented, but it is certainly a situation that puts many dentists in trouble. This is especially so when an accentuated bone resorption caused by periodontitis is revealed, as is the case we encountered and which we present in the following lines.
PERIODONTOSIS, ACCENTUATED BONE RESORPTION AND BILATERAL SINUSITIS
At the age of 74, last summer, Mrs. Toma Ghiorghita is a modest woman, with a soft word and a soft hand, a person who impresses you with her decent, even shy presence. Certainly, a confident smile would radically change his facial appearance, but unfortunately the periodontitis he suffers from had repercussions not only tooth loss, but also other complications.
As he confesses to us, the greatest desire of dance is "regaining the smile another time". We wholeheartedly want to help her, but this case is not a simple, ordinary one. In addition to the bilateral sinusitis she suffers from, the patient also has a very severe bone and gingival retraction, the latter caused by periodontal disease. And as if all this were not enough, we also notice big bite changes, plus major differences between the chains of the 2 arches (maxillary sagittal gap - mandible).
REFUSED BY CLINICS FOR IMPLANT OPERATION
It is indeed a more than difficult case, Mrs. Toma being refused for years by several dental clinics in Romania, the doctors shrugging at the patient's request to have dental implants. This is because you cannot do a sinus lift and bone addition (procedures that precede and require implants in this case), when the patient has sinusitis. It is also particularly difficult or even impossible to insert implants when the supply of bone tissue is so low.
All this was explained to him by the doctors, but the dance was not convinced. And not defeated. All this time he searched the internet, followed us on Facebook for a while, and now he took courage and knocked on the door of our clinic. It is probably the last attempt in which he puts all his hopes. And we, regardless of the situation, can not refuse a patient who wants so much to have new teeth.
So what to do?
MOBILE PROSTHESIS (UP) & FIXED IMPLANT WORK (DOWN)
Of course, Mrs. Thomas' case needs a very, very special approach. Normally, treatment would be as follows: treatment of sinusitis by an ENT doctor (approximately 12 months), return to the clinic for bone recovery procedures by bone addition and sinus lift (at least 6 months in case of dance) and finally, the insertion of dental implants. So, the complete treatment could last 18 months or even 2 years, an extremely long and stressful term for the patient.
Therefore, following the CT (computer tomography) imaging examination and consultation, we decide that the solution in this difficult case is the insertion of 4 AB Dental implants in the jaw and the application of the mobile prosthesis with staples. For the mandible we will use 8 implants from the same brand over which we will place a fixed metal-ceramic work.
FINAL RESULT 2 MONTHS FROM THE OPERATION
Proud that we dared where others gave back, he finds us at this moment, two months after the operation, face to face with the patient. It was a lot of work, but the reward (re) came, as the smiles of our patients come back every time.
We invite you to watch some images