Perioprosthetic and Implant-Supported Rehabilitation of Complex Cases: Clinical Management and Timing Strategy

Abstract

Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy.

Multidisciplinary Approach in the Management of a Complex Case: Implant-Prosthetic Rehabilitation of a Periodontal Smoking Patient with Partial Edentulism, Malocclusion, and Aesthetic Diseases

“…It is extremely important to make the right choice between an endodontically or periodontally compromised treated tooth and implant. Therefore, in order to decide whether the tooth is safe or not, data that have to be collected are probing depth, attachment level, mobility, inflammatory and hygiene indices, root anatomy, furcation involvement, and crown-to-root ratio [13, 14], but not enough. Avila et al [15] consider six levels of evaluation to decide whether a tooth can be saved or not; for each level a number of variables are assigned with the green, yellow, and red colours to indicate long-term maintenance favorable, caution recommended, and long-term survival unfavorable, respectively; among these variables as well as parameters related to the specific site, variables relating to systemic condition, compliance, and expectations of the patient together with clinician's skill can be noted.…”