Pro Bono Case by Wendy Gill

Supported by Straumann Group

Case Notes:
                    Miss Jamielyn Gugiatti-Maloney
                    DOB: 08/01/1997


Implant Team:
                    Dr Wendy Gill (Periodontist)
                    Dr Brendon Joyce (Prosthodontist)
                    Mr Sasha Negrini (Dental Technician) 

 

Personal History

  • 19 years at presentation
  • Trauma to tooth 21 at 9 years of age
  • At completion of orthodontics (FFA)
  • Self funded orthodontics and will self fund surgery
  • Working full-time and studying full-time (Hoping to do dentistry)

Medical History

  • Woke up during a previous GA and had a seizure and very high BP
  • Prefers treatment under LA
  • Medications: OCP
  • No allergies

Consultation 

Examination

  • Periodontally healthy
  • Excellent plaque control
  • Impacted third molars
  • Caries free
  • Fixed retainers 13/12/11, 22/23

Site Assessment (see ERA)

  • Angled ridge
  • Labial defect
  • For digital planning
  • Implant: Straumann Bone Level
  • Contour Augmentation already required for aesthetics
  • No concern for primary stability, no advantage to use tapered
  • Advantages: biological compatibility, healing time, options for all componentry
  • For 3D printed stent and guided surgery

Surgery  28/03/2017

  • Treatment under LA: aseptic technique
  • 2.2mls art + adr infiltration buccal and palatal
  • Flap raised
  • Guided Osteotomy
  • 1 x PA
  • Site checked as proximity to incisal canal, all bone walls intact
  • Implant placed 30Ncm, excellent primary stability
  • ‘Bottle neck’ HA placed for improved buccal soft tissue bulk
  • Contour augmentation: bioss, bioguide
  • Flap advanced
  • Sutured
  • Suspension bridge fitted

‘Second stage’ surgery 01/08/2017

 

  • (delayed by patient)
  • 1.1mls art + adr, excess soft tissue at palatal removed
  • Healing abutment changed to 5mm x 4mm
  • Torque tested to 35Ncm

 

Final Restoration

  • Direct to Fixture, PFM, metal ceramic
  • Veneered with Creation CC