Early functional loading in the fully edentulous mandible after mandibular resection and reconstruction due to an ameloblastoma: case report.

BACKGROUND

Immediate or early functional loading of implants in fully edentulous mandibles can enhance patient comfort and the ability to masticate within a few days after implant placement. Recently there has been evidence that this method of restoring edentulous mandibles is predictable.

PURPOSE

The goal of this case report is to present the treatment of a patient diagnosed with a large ameloblastoma in the mandible. After removal of the tumor and mandibular reconstruction, the patient had complete anesthesia in the right mandible, with an alveolar ridge deformity.

METHODS

Two years after removal of an ameloblastoma in the right mandibluar sextant, five implants were installed between the mental foramina. One implant was installed for safety reasons in the event one of the others was lost. This implant remains buried. A denture was used as a drilling guide. Abutments were attached to the implants, and impression copings were fixed to the abutments. The denture was used for the "pickup" impression. Flaps were sutured, maintaining exposure of the abutments. In the laboratory, gold cylinders were heat cured to the tissue side of the denture. The cylinders were attached to the cast with laboratory screws. The gold cylinders were heat cured to the intaglio side of the denture. Five days after implant placement, the nonmetal reinforced acrylic denture was fixed to the implants with laboratory screws. The bridge is removed annually, and the implants are examined for mobility and periapical radiographs are taken.

RESULTS

The patient has worn the prosthesis for 2.5 years without loss of implants and without breakage of the nonmetal reinforced denture. At 2.5 years the implants are stable, implant sites demonstrate stable crestal bone, and the patient is eating comfortably and without limitations.

CONCLUSION

Early functional loading of implants in the edentulous mandible may offer patients the option of wearing implant-supported prosthesis immediately or shortly after implant insertion.