Implant prosthetics for atrophied maxilla and mandible using 2.9mm BioniQ implants
Dr. Volker Bonatz, M.Sc. M.Sc.
- Dr. Volker Bonatz received his dental education at the Christian-Albrechts-University of Kiel, Germany. He then gained diverse experience during his residency, serving at the Wilhelmshaven Naval Medical Corps and in various specialist practices.
- He earned a Master of Science (M.Sc.) in Oral Surgery/Implantology in 2010, and a Master of Science (M.Sc.) in Aesthetic Reconstructive Dentistry in 2013.
- He speaks at conferences in Germany and internationally on implantological and prosthetic topics. He is also a member of the German Society of Oral Implantology (DGOI).
- Dr. Bonatz operates a private practice in Landau, specializing in implantology and aesthetic- functional treatments. His approach focuses on providing patients with aesthetically pleasing and long-lasting functional solutions, carefully tailored to each individual‘s manual dexterity and financial considerations.
Anamnesis
The patient presented to Dr. Volker Bonatz with residual lower anterior teeth and a 35-year-old full-arch maxillary bridge, which had already deteriorated. The patient reported reduced masticatory function accompanied by pain. Following the extraction of the remaining teeth, a total of ten BioniQ implants with a diameter of 2.9 mm were placed. A basic pilot guided drilling was selected. Due to significant atrophy, the treatment goal was to achieve a removable prosthetic solution for both the maxilla and mandible. Wearable provisional prostheses were used for approximately three months before the final restorations were delivered.
Clinical casebook
Initial situation: residual lower anterior teeth and 35-year-old fullarch deteriorated maxillary bridge, which remained in place only on a few severely compromised abutments.
Following atraumatic extraction, alveolar curettage, and suturing, two provisional prostheses were inserted. Based on the 3D imaging data, BioniQ implants with a diameter of 2.9 mm were planned for the maxilla.
The highly atrophic hard tissue did not allow fixation of a surgical template with guided fixation pins and the the limited mouth opening restricted the use of a fully guided implant placement technique in the posterior region. Basic pilot guided drilling was performed.
After removal of the surgical template, preparation was performed using a sountersink.
BioniQ S2.9 implants are inserted in the areas of teeth 13, 14 and 15.
A total of six BioniQ implants with a diameter of 2.9 mm were inserted in the maxilla and four in the mandible. The inclination and insertion sites were planned in the mandible with respect to the position of the mental foramina.
Due to the patient‘s bone density and advanced age, the healing phase was extended to four months. Connected galvanized secondary telescopes in the maxilla.
The accuracy of the impressions and the anterior tooth positioning were verified during a follow-up visit using implant control splints and esthetic templates.
In the maxilla, a palate-free telescopic denture was fabricated with acrylic components that only minimally interfered with the tubercle area to achieve a stable position.
The final bar framework was designed for optimal hygiene maintenance.
In the mandible, the anatomically shift of four implants to the anterior region required a bar-supported prosthesis, ensuring easy cleaning and long-term retention by preventing friction loss.
Lateral profile of the patient with final prosthetic restoration after completion of the treatment.
Here you can download clinical casebook
