TEETH IN A DAY
Non-removable Implant Supported Teeth In Just One Day!

GRAPHICS AND FIGURES

For over two decades, the staff at Pi Dental Center has been focused upon and energized by creating healthy, brilliant smiles for many patients who thought they were in hopeless dental situations. With the development and perfection of osseointegrated dental implants and esthetic, functional implant prostheses, patients regardless of age can enjoy a compliment of permanent teeth, custom designed to suit their individual appearances. Today, many patients who have a debilitating dental condition can be treated with a new process entitled TEETH IN A DAY. The following clinical example is typical of patient treatment completed within 6 hours, permitting them to conclude the 1-day dental experience with a beautiful smile.

Methodology

Following a thorough clinical and radiographic evaluation of the patient's condition, diagnostic casts are prepared and articulated to provide the technical staff with the necessary information required for the construction of a TEETH IN A DAY prostheses. Immediate clinical intervention includes the removal of periodontally and restoratively hopeless teeth (Fig 1a, 2, 3), followed by the placement of time proven and tested Brånemark implants (Fig 4). The implants will become the immediate support mechanism to secure the TEETH IN A DAY prosthesis. After several hours of clinical and laboratory customization, the patient is dismissed with an intact dentition and a bright new smile.

The patient is a 51 year old female who avoided dentistry for many years because of her severe anxiety and phobia for dental treatment. She was chronically addicted to Ibuprofen analgesics due to her long standing dental pain. With the exception of an allergy to penicillin and frequent migraine headaches, her medical history was noncontributory. She did admit to smoking cigarettes at the rate of one pack per week. Her last dental treatment had been a decade prior and contributed to her high anxiety toward further dental care.

The initial 45 minute of the first visit was used to obtain pertinent clinical and radiographic information, leading to the treatment plan recommending TEETH IN A DAY. The patient presented with a totally edentulous maxillary arch which had been previously restored with a removable denture (Fig 3b, 7a) that had completely deteriorated. The mandibular natural dentition were held in position using super glue which the patient self-administered (Fig 3a,b,c) for several years due to her fear of further dental treatment.

After a comprehensive discussion of the treatment plan and review of the informed consent information for both tooth removal and implant placement, the patient agreed to proceed immediately with the recommended treatment.

Stage 1 laboratory procedures

Following articulation of the diagnostic casts a selection of prefabricated dentures were made to comply with the patient's facial appearance (Fig 6a). The dental laboratory technicians loosely retrofit the prefabricated dentures to the diagnostic cast while the clinical treatment began simultaneously.

First stage clinical treatment

Using local anesthesia, consisting of bilateral blocks and infiltration, the remaining periodontally hopeless teeth and impacted left bicuspid were removed and the mandibular arch was debrided of all pathology. Alveoloplasty was performed to level the sharp bony spines in the area of the anterior extraction sites.

Implant placement

Using the traditional osteotomy protocol for the placement of Brånemark implants, eight titanium fixtures were placed in the mandibular arch: six long implants between the mental foramina and two shorter implants, one placed distally in each first molar area (Fig 4).

Following implant placement, appropriate abutments were selected and the mucosa was sutured around the abutments (Fig 5). Then using the conversion prosthesis method of treatment (Fig 6b,c) a fixed mandibular implant supported prosthesis was constructed. The mandibular implant supported prosthesis was reinforced, refined and polished, and delivered to the patient within an hour after implant placement. The new maxillary denture was relined and delivered to the patient's satisfaction (Fig 1b,7b, 8a,b,c).

Postoperative patient management

The entire treatment process for TEETH IN A DAY can take between four and six hours. Postsurgical management includes a minimum of 48 hours, and preferably 72 hours, of cold therapy to minimize swelling in conjunction with the standard protocol of medications. These medications include at the very least antibiotics and analgesics.

The patient was also instructed to avoid difficult to chew foods and maintain a soft diet for 12 weeks immediately following the TEETH IN A DAY treatment. The patient returned to normal dietary and oral function after the 12 week period.

It is interesting to note that at the 24-hour follow-up the patient reported being totally pain free, comfortable, and very enthusiastic about her new smile.

Conclusion

The concept of TEETH IN A DAY is based on the research on the immediate loading of Brånemark implants which has been published in the dental literature . The customized process of TEETH IN A DAY was developed to fill a very special need in dental care. This method of treatment can provide patients with enormous instant gratification and can be accomplished using either local anesthesia or general anesthesia for those patients with extreme dental anxiety. Research for the immediate loading of Brånemark implants began at Pi Dental Center in 1993. The evolution to the current TEETH IN A DAY™ method relies heavily on the expert prosthetic abilities of the prosthodontist, the professional staff, and the dental laboratory technicians. The treatment method itself has been eagerly embraced by both the profession and patients alike.

Acknowledgments:

1. The Dental Implant Team at Pi Dental Center

2. Robert Winkelman, CDT, MDT, Owner

Fort Washington Dental Lab, Inc.

Tel: 1-800-541-3490;215-628-4994

Email: fortwdental@aol.com

Web site: http://fwashingtondentallab.com

References:

Balshi TJ. The Biotes conversion prosthesis: A provisional fixed prosthesis supported by osseointegrated titanium fixtures for restoration of the edentulous jaw. Quintessence Int 1985;16:667-677.

Balshi TJ, Wolfinger GJ. Conversion prosthesis: a transitional fixed implant-supported prosthesis for an edentulous arch - a technical note. Int J Oral Maxillofac Implants. 1996;11:106-111.

Balshi TJ, Wolfinger GJ. Immediate loading of Brånemark implants in edentulous mandibles: a preliminary report. Implant Dent 1997;6:83-88

Schnitman et al. Ten-year results for Brånemark implants immediately l oaded with fixed prostheses at implant placement. Int J Oral Maxillofac Implants 1997;12:495-503.

GRAPHICS AND FIGURES