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European Journal of Oral and Maxillofacial Surgery 2022 April;6(1):51-7

DOI: 10.23736/S2532-3466.21.00260-5


language: English

Rehabilitation in severe bone atrophy of the upper jaw

Sergio DUS , Filippo DUS

Department of Oral Surgery, Dusmedical Clinic, Sacile, Pordenone, Italy

The purpose of this article was to evaluate which is the simplest approach to rehabilitate a long-standing edentulous patient with severe bone atrophy of the upper jaw, evaluating the surgical alternatives and the choice of the graft based on the implant-prosthetic rehabilitation proposed by the prosthetist, also reporting our experience with many years of follow-up. The severe bone resorption in the maxillofacial complex is generally due to early teeth loss, the resulting alterations lead to a progressive atrophy of the alveolar and basal bone especially if the patient is wearing a mobile prosthesis that presents instability, which, moving it, irreversibly increases bone resorption. The case reported treats a 69-year-old patient with premature loss of teeth due to periodontal causes and extractive surgery of the impacted canines, who has been wearing a removable upper prosthesis for over 20 years. In recent years she was no longer able to wear the prosthesis, due to excessive bone absorption which led to an instability of the prosthesis itself. After careful evaluation, a large bilateral maxillary sinus lift was performed, with the insertion of 5 implants and full arch prostheses, fully deferred. Therefore, in order to implement a correct surgical treatment plan according to the bone resorption of the jaws it is essential to classify the degree of resorption according to the classification currently most followed is that proposed by Cawood & Howell in 1988 in addition to the evaluation of bone quality. following the classification of Lekholm and Zarb. The surgical strategy is also agreed on the basis of the prosthetist’s choice of prosthetic treatment, evaluating a careful medical history of the patient, age, health conditions, etc. On the basis of these evaluations, a reconstruction will be chosen that is the least invasive possible to achieve an acceptable implant-prosthetic rehabilitation respecting the times of bone regeneration and implant osseointegration.

KEY WORDS: Bone and bones; Atrophy; Maxilla; Reconstructive surgical procedures

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