A 46-year-old patient comes to the office interested in replacing missing teeth.
Diagnosis
In the first visit the patient is diagnosed and a quotation is given for the exodontia of root debris in 17 and 26 and the performance of curettage in both arches, as well as the obturation of 2 proximal caries in 27 and 37.
The need for an orthodontic phase prior to the prosthetic replacement of the missing pieces 14,24,26 and 46 is also explained to him, whose objective is the alignment of the upper anterior sector and the intrusion of the same, especially of 23 and the closure of the diastemas present, centering the midline and improving the spaces for the placement of the respective implants and their corresponding crowns.
Given that he is not interested in the esthetic aspect, he only accepts the upper treatment described above, rejecting treatment of the lower arch.
Treatment plan
Digital models and bite registrations were made from intraoral scans.
Instructions were given to align and level the six upper anterior teeth, closing the spaces mesially and improving the overbite with intrusion of the incisors and especially the 23rd which was more extruded.
The stripping on upper lateral incisors and lower incisors should not be more than 0.3mm per side.
The treatment was carried out in a first phase of 12 Recode aligners for 4 months.
Having achieved the main objectives, a slight diastema persisted between 11 and 12 and an adjustment of the 22-23 contact was necessary, so it was decided to perform a refinement of only 4 Recode aligners for 30 days.
After refinement, a Zendura FLX retainer with slight correction was placed to consolidate the contact points while keeping the attachments in position.
After two months the implants were placed, 4 Biomimetic Ocean CC with conical connection, 3 in the maxilla and one in the mandible, and a new passive retainer was made without attachments with gingival relief at the surgical site.
The implants were loaded after two months with monolithic zirconia cement-retained crowns screwed on Avinent titanium interfaces.
Once the treatment was completed, the patient was scanned again to make an unloading splint.
Conclusions of the case
The patient was very satisfied with the evolution of the procedure and the result obtained, having recovered the functionality of the stomatognathic system and with a clear improvement at the esthetic level, thanks to the multidisciplinary treatment with RECODE Aligners and AVINENT implants, which proved to be fast and effective, achieving a highly satisfactory result.
