09h30 Rehabilitation of the atrophic edentulous maxilla with early loaded short implants: a new treatment concept.

Keywords: short implants, early loading, temporary overdenture, locator fixed bridge.

Objectives: alternatives for bone reconstructive implant rehabilitation in Cawood & Howell Class V-VI maxillary atrophy are scarce. The presented clinical case highlights a new minimal invasive procedure with follow-up up to 2 years.

Material and Methods: a 57-year female edentulous patient was dissatisfied with her removable complete denture in the upper jaw. After clinical and radiographic CBCT evaluation a Cawood & Howell Class V maxillary atrophy was diagnosed. Standard implant treatment without bone reconstructive surgery was impossible. She refused this treatment option even as the current available alternatives, such as Zygoma or AMSJI implants. A new treatment concept with short implants, retentive abutments and the registered VD CLIC BAR® was suggested. This new concept invented by the author, consists of an inter-implant connecting bar, clicking on retentive abutments and stabilizes the implants during integration. A telescopic overdenture covering the bar serves as a temporary prosthetic solution one week after surgery. This clinical case was included in an ongoing prospective clinical study at the Ghent University Hospital. The treatment protocol was approved by the Ethical commission and informed consent was signed by the patient. The surgery was performed under local anesthesia. After flap elevation 8 short implants with diameter 5.0mm and length 5.2mm were installed (Copa Sky Short, Bredent Medical, Senden, Germany) and provided with retentive abutments (TiSi snap abutment, Bredent Medical, Senden, Germany). After an intra oral digital scan the bar and the telescopic overdenture were designed and manufactured with a milling equipment (DC-7, Dental Concepts, Wesertal, Germany). Within one week after surgery the bar was clicked on the retentive abutments with the telescopic overdenture. After 6 months the final prosthetic solution was elaborated by the prosthetic dentist (CC) and consisted of a LOCATOR FIXED® bridge. On regular basis the patient was seen on recall visits with evaluation of the stability of the implants by Periotest and the assessment of Oral Health Related Quality of Life with OHIP-14 questionnaire.

Results: after 2 years all the short implants were still in place. A remarkable improvement of OHRQoL was achieved and improved stability was observed.

Conclusion: this newly developed concept can be advocated as an additional minimal invasive treatment alternative for rehabilitation of atrophic maxillary jaws.