Revisiting the Past
As clinicians it serves us to revisit and consider previous cases and determine what we can learn from them. I wanted to share this case I did several years ago that shows inadequate reduction, which is one of the major issues we see in full arch procedures. Nowadays, the fp1 and fp2 approach is working much better than the significant reduction needed to do an fp3 design.
I used a guide to place the implants, and to do the bone reduction. You can see where the guide didn’t extend back far enough. The guide didn’t fit on the bottom properly, so I had to go free hand in the posterior after that anterior osteotomies were done.
The sleeping implant didn’t have any torque, so I placed implants at 19 and 30, however, I didn’t revisit the reduction after the guide was removed, and ran into prosthetic space issues. I also didn’t flap the maxilla far enough back to reduce enough bone, and you can clearly see the excess present on the pano with red lines that is creating some distal extension issues from a zirconia thickness and VDO perspective.
The implants are BSB and now I use Neodent. I believe it is a superior product to many implant systems for multiple reasons.
Please let me know if you have any questions, and I’m more than happy to discuss the numerous appointments needed to correct this VDO issues and muscle pain she felt due to opening her VDO too much.
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