This morning, at the Brueggen Dental Implant Center, we did a lower All-on-4 dental implants case for a 60 yr old gentleman from Colorado.
He was in town on personal business and learned about us from a T.V. ad. His medical history was non-contributory. Dentally, he was wearing an upper and lower denture. There was a mobile and failing unilateral subperiosteal implant on the lower left, and one had previously been removed on the lower right. Subperiosteal implants are placed beneath the “gums” and rest on, but not in, the bone.
Subperiosteal implants are used when there is inadequate bone volume to place a dental implant into the bone, and the treating doctor is not aware or trained in other options. They experience a very high failure rate. I have removed a number of subperiosteal implants but have never placed one.
These implants were placed in Colorado about 15 years ago when the upper and lower dentures were made. It was the doctor’s hope to attach the lower denture to the subperiosteal implants, but unfortunately, that was never possible.
This patient was displeased with the fit of his false teeth. Even with thick denture adhesives, he was unable to eat, and the lower was unstable even in speech. He was a very active gentleman and very frustrated with his situation because his previous dentist had told him that he did not have enough bone for dental implants.
We took a cat scan (a very sophisticated x-ray designed to allow precise measurements of bone in all dimensions) and determined that he did have enough bone for dental implants if the All-on-4 dental implants (a full set of upper or lower teeth fixed to 4 dental implants) technique was used.
Consultation revealed that financially doing this on the upper and lower was not feasible, so we elected to do a new denture on the upper and the All-on-4 dental implant procedure on the lower. Our in-house lab pre-made the upper denture, so when he arrived this morning, we were able to deliver that before I began the surgery.
Using conscious oral sedation, I began the surgery at 9:30 A.M. The failing subperiostel implant was removed, 4 endosseous dental implants were placed, and the surgery was completed at 10:55 A.M.
Impressions were taken for the lab and at 4:30 P.M., the patient was ready to leave with his new upper denture and new lower non-removable teeth attached to 4 implants.
His healing and recovery should be uneventful, and I anticipate making his final set of teeth in 6 months.
Houston Dental Implant Dentist