|Japanese Society of Oral Implantology
"A case of applied implant along with orthodontics for
In the past years, it is been notable the patient's demand
for dental examination and treatment
In our clinic, from the day of its establishment on, i have
tried to get improved the level of Orthodontics and implant
examination and treatment.
However, regarding actual examination and treatment, there
are cases where we encounter some restrictions due to the
patient's economic situation, treatment's required time, etc.
Now, we present a report regarding cases given in our
clinic over the past 3 years including interruption periods
where at last instance our patients were able to complete
their treatment almost as planned.
I would appreciate any opinion or criticism from our fellow
As for orthodontic examination and treatment, it is Doctor
Fujisaki who graduated from the same class as me (established
in Komagome, Tokyo) who is in charge for this clinic.
Patient is a woman born in 1948
First examination ：
March 25th 1996
Main complaint： Upper right molars
Existing teeth： 754321 |
7654321 | 123456
As symptoms, we have that the upper right bridge 7 6 5 is
in a decaying state and upper right 5 is in a state impossible
Also lower left 6 has being reduced to the root, lower left
7 is missing. At the time of the examination the occlusion was
supported by 9.
Since the patient refused to have the missing teeth
replaced by a false tooth, i wanted to somehow dispose of a
fixed restoration method.
The number of implants that the patient could afford was 2.
The only procedure available under these circumstances was
extracting upper right 5 and implant a prosthesis at the upper
right 56 part.
After the endodoncy, upper right 7 and upper right 4 were
restored with a single crown.
Restoration procedure was applied only to the right side. I
was unable to proceed the same way with the left side so i was
limited to only extracting lower left 6.
After the tooth extraction , the primary treatment
finishes. September 1996 Part 65. An ITI implant was
It is a total of 2 fixtures φ4.1mm, 12mm length
Upper right 7 and upper right 4 had attached a
single crown each during the implant treatment period.
n March 1997, the installation of the upper part of the
implant structure was tentatively complete.
Treatment at the secondary stage.
patient had been received periodical examination, but the
patient suddenly comes to the hospital
Argument of the patient for the visit： "I became able to
afford the medical expenses, so I want to take the full
I heard how the patient explained about having become able
to afford the medical expenses as her husband seemed to be
worried about her upper jaw front teeth.
Upper right 1 of the upper jaw was being projected against
the lip inner side. I was thinking about cutting the
prosthesis but i received patient`s approval to correct the
tooth alignment orthodontically.
In addition, I performed along the treatment to the upper
and lower molars on the left side which i had not done last
In November 1997, we started with the orthodontic
In July 1998, The orthodontic treatment was
almost complete. We started then with the Baoding treatment..
During orthodontic treatment, the condition of the
periodontal components surrounding the upper jaw front teeth
enworsed. It was not able to remove the Baoding device. The
upper jaw front teeth developed pockets around them
considerably deep. These were pockets more than 7mm long, so i
had to remove them surgically.
On the same month, upper jaw 3-3 parts F-Ope.
September 1998, an ITI implant was inserted into the the upper
left 67th part.
φ 4.1mm, 12mm length 1 piece
10mm length 1piece
In october 1998, an ITI implant was
inserted into the lower left 67th part .
φ 4.1mm, length 12mm 2 pieces in total
In June 1999, lower left 6 7 part had the superstructure
In July 1999, upper left 6 7 part had the
The oral cavity condition finally improved as stated by the
following dental formula below.
At the end, the
patient seemed to be really satisfied.
Her husband seemed
to be satisfied as well.
Also, occlusion support originally reported as 9 at the
beginning of the treatment, improved to 14
At the present
time, It is working fine without so much problem.
As results/ conclusions regarding the treatment of this
1. Depending on the application method of an implant, it
is possible to keep the right vertical occlusion of the molars
and also to prevent tooth misalignment and flare-up of the
2. Thanks to the success of the orthodontic treatment,
dental cuts and extractions were minimal and we had the
patient aesthetically satisfied.
This time, we split the examination and treatment into 2
parts to make them match patient's convenience but regardless
of that as for the patient and as well as for our clinic
everything went fine without so many difficultie It has served
well as a incentive of confidence and as result itself without
forcing in anyway the medical treatme Japanese Society of Oral
Implantology 32th Annual Convention
"One case where onlay
graft and sinus lift were applied to an aesthetic site
Recently, implants became important as
an option for deficient prosthesis cases.
Treatment ｔｅｃｈｎｉｑｕｅs and materials have been accomplished a
rapid progress every year, and now it is possible to treat
cases that were usually difficult to treat in the past.
This time, We applied a treatment based on onlay graft and
sinus lift to a case of accelerated bone resorption in front
We report as following the results of applying
implant prosthesis with the objective of achieving an
patient is a 36 years old woman. She requests to have
installed a tooth where it is missing.
The left slide is a picture of the inner oral cavity at the
time of the first examination. The right slide is an X-ray
The patient suffered a loss in the upper jaw front teeth
during a traffic accident. This was fixed at the time with a
metal bond bridge but the bridge broke apart and that's why we
have now her visiting our hospital.
At the time of the first examination, we found absorption
of an alveolar bone at high degree at the upper jaw front
On January 27th 2000, we extracted the upper left 123 and
an upper right 1 in a C4 state. The upper left 2 was in a
Upper left 3 was adhered to the bone.
Due to the several extractions , the alveolar bone absorption
of the front teeth enworsed. We previewed considerable
difficulties in the aesthetic prosthesis restoration.
Slide is an X-ray or CT photograph
taken after the dental extraction.
in order to perform the implanting, it is absolutely
necessary to improve the condition of the alveolar bone where
the implant is to be inserted by any means.
We constructed 2 superstructures, a perpendicular one and
the other one for being attached on both sides of the bone by
applying ｏｎｌａｙ ｇｒａｆｔ and sinus lift. With this we were ready
to insert the implant.
May 24th 2000, we presented this case to Meikai University
Department of Oral Surgery 1st course. On October 30th of the
same year, ｏｎｌａｙ ｇｒａｆｔ and sinus lift were applied
simultaneously. Right and left slides show the observationts
taken during the operation .
The bone was extracted from the mentalis muscle. I
performed the ｏｎｌａｙ ｇｒａｆｔ using a block-shaped bone and mainly
spongy bone for sinus lift.
spongy bone which I was able to extract was about 4.5CC. This
was used along with BONE JECT 2CC. The prognosis was good. The
left slide shows observations taken during the operation. The
right slide is a photograph taken inside the mouth to
establish a comparison before and after the bone creation.
slide is a photograph from inside the oral cavity at five
months of postoperation, The right slide is an X-ray
The left slide is
a CT photograph taken at this time, it shows an improvement of
the upper jaw alveolar bone.
As seen on the right
slide, In December 2001, the implant was inserted. An ITI
implant into upper left 3 and upper right 23.
A φ 3.3mm, 12mm length was inserted. Insertion into the
upper left 2 was abandoned as the palatal side was healing and
the bone was in bad conditions. φ3.3ｍｍ。。
The right side of
the right slide is an impression picture taken from inside the
mouth in December 2001.
side-screw-removable-type metal bond bridge served as
superstructure for the upper left and upper right 23 part.
Right and left slides are pictures taken from inside the
mouth at the time the last prosthesis was attached.
This slide is an X-ray dental photograph
taken at the time the last prosthesis was attached.
alveolar bone superstructure (GBR method) the perpendicular
one and the one applied on the 2 sides, both happened to be
satisfactory. Upper right 32 and upper left 3 could be
implant-inserted. The superstructure is a
side-screw-removable-type bridge but also resulted
aesthetically satisfactory .
We applied onlay
graft and sinus lift for achieving an aesthetic improvement in
a case of high bone resorption.
Compared to the traditional
method, this implant treatment had more satisfactory results
and presented less difficulties.
On the other hand, I had a really hard time when
transplanting the bone. I expect a prompt progress regarding
donation and development of materials.