Oral Health Group

Implantology: Expect the Unexpected!

July 1, 2003
by Blake Nicolucci, BSc, DDS

Most of the time, when a patient comes in for implant treatment and you have done all of the pre-treatment work-up (complete and thorough) you might probably expect the case to go to completion with little (or no) complications. As routine as this might be in a high volume implant practice, it is not always the rule. I’ve found out very recently that there are ALWAYS exceptions to the rule.

The following case involves a man in his 60s who has been wearing dentures for the past 30 + years, and has had a tremendous amount of bone loss – both in the maxilla, and in the mandible. His wife had just had a subperiosteal implant placed and was extremely happy with the results. She seemed to be the ‘test’ case. After he saw the results of her treatment, the husband decided to have his whole mouth rehabilitated with implants, and his wife decided to have implants placed in the maxilla as well. Both of them required Iliac Crest hip grafts to the maxilla due to the tremendous amount of bone loss. This case presentation deals with the husband’s treatment only.


After a period of about four months of healing from an Iliac Crest graft, the patient came in for assessment of the bone for implant placement. Clinically there appeared to be sufficient bone present to place implants in both mandible and maxilla. The patient wanted a removable bridge as opposed to fixed crown and bridge for ease of cleaning, and for a slightly lesser cost (due to fewer implants). The surgical templates were made from a temporary denture set up that the patient seemed to be pleased with. All of the regular pre-treatment work ups were completed. The surgery was then booked.

The following is a pictorial of the events that transpired, and the case as it was followed to completion.

Blake Nicolucci is president of the Canadian Society of Oral Implantology and Oral Health’s implantology Board member.

Oral Health welcomes this original article.