Implant supported rehabilitation with guided surgery in upper front sector affected by radicular cysts


ABSTRACT

Many times maxilla cysts, and especially those from dental origin, which not also are the most common but they can compromise the bone quantity when rehabilitating with implants. Patients are asking for more implant solutions, but there are certain situations which can modify the treatment make it longer. If the bone loss is due to a cyst, firstly it has to be removed, secondly make bone regeneration and then, when the bone is consolidated, proceed to place the fixings.

If these big cysts are placed in the anterior sector, the aesthetic compromised is larger when replacing dental pieces.
To achieve favourable results, we have to try to regenerate as much bone as possible, since vestibular reabsorption will happen. Besides, the quantity regenerated must be enough to achieve good results with our implants. We must not forget about the quality and quantity of keratinized gum as this is of a great importance to get good rehabilitations result. In case the gum has not an appropriate width, it would be convenient to increase the keratinized gum To achieve patients ́satisfaction, we must respect the following aspects: place implants able to support the prosthesis, try to preserve the keratinized gum, respect the minimum distance between implants, try to provide a biological space in the interfase implant-prosthesis and place the implants guided prosthetically In this way we will be able to manufacture a prosthesis aesthetic enough to achieve patient agreement. Regarding prosthesis, this has to have a good fitting and a good manufacturing. Cad-Cam procedures are a good option to get appro- priate results.

Prosthesis manufacturing procedures are the following:

1.Take implant impressions
2.Scan the impression
3.Manufacture Cad-Cam structure
4.Place last-generation porcelain
5.Finish

The objective of this article is to show how with significant bone losses caused by cysts in the upper front sector we can achieve good results with implantsupported rehabilitations.

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