Treatment of advanced periodontal destruction with immediately loaded implants and simultaneous bone augmentation: A case report

Background: Advanced periodontal destruction is often associated with extraction of the teeth. Oral rehabilitation in these cases may include the traditional prosthetic restoration or an implant-supported reconstruction. Immediately loaded implants present an alternative treatment modality using a bar in the anterior mandible, along with the placement of higher numbers of implants, which are connected with a fixed prosthetic reconstruction. Methods: This clinical case report presents the surgical and prosthetic rehabilitation in a patient who had lost all teeth due to advanced periodontal bone destruction. Six implants were placed in the upper and lower jaw each. Some implants required guided bone regeneration in conjunction with autologous bone grafting. All of the implants were connected with their abutments, and a temporary fixed restoration was placed immediately after surgery. The final metalloceramic-fixed reconstruction was cemented after 6 weeks of loading. Results: All of the implants were osseointegrated and showed no clinical signs of mobility or infection. Mobility values were evaluated during healing and were found to be reduced. Radiological findings showed a stable peri-implant bone level during the total 18-month loading observation period. Conclusions: This case report presents an alternative treatment concept for the oral rehabilitation in a patient with advanced periodontal destruction. The concept of immediate loading of implants might provide a better opportunity to meet patient needs than more traditional treatment modalities.