Placing Dental Implants through Impacted Teeth to Support a Fixed Partial Denture in a Geriatric Patient as an Alternative to Invasive Extraction Surgeries

Abstract

Multiple dental impactions not associated with craniofacial syndromes are a rare condition and present the dentist with a therapeutic challenge when it comes to performing surgical/restorative treatments in adult patients. This case report describes a geriatric patient with multiple impacted teeth restored by means of two different protocols. In the second quadrant, an impacted tooth was extracted followed by regeneration and placement of an implant. In the third quadrant, implants were placed though impacted teeth for restoration with a fixed partial prosthesis. Placing dental implants through impacted teeth may offer a possible therapeutic option for implant-supported restorations in middle-aged or elderly patients, for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery.

Fig. 1

( A ) Clinical image of third quadrant, showing deciduous teeth: canine and first and second molars. ( B ) Panoramic radiograph of patient showing multiple impacted teeth, one canine in the first quadrant, and one canine and two premolars in the third quadrant. It is also noted an implant placed in second quadrant.

Fig. 2

( A ) Clinical image shows acceptable clinical outcome of the implant-supported crown in the upper left quadrant in position of the canine 8 years after implant placement. ( B ) Periapical radiograph of the implant–crown complex in canine position in second quadrant, exhibiting no bone loss.

Fig. 3

Panoramic radiograph of the patient 8 years before. No significant changes in the positions of impacted teeth have taken place up to the present.

Fig. 4

( A ) Clinical image after extracting deciduous teeth, finishing drilling sequence through impacted teeth. ( B ) Clinical image of implants anchored through impacted teeth after regenerating the gap with particulate xenograft. ( C ) Postsurgical periapical radiograph showing implants placed through impacted teeth.

Fig. 5

( A ) Clinical image of individualized abutments screwed to implants; image shows good gingival health. ( B ) Periapical radiograph verifying correct fit of individualized abutments.

Fig. 6

( A ) Clinical image: checking metal prosthesis on individualized abutments. ( B ) Occlusal view of fixed partial denture.

Fig. 7

Periapical radiograph after 24 months follow-up. Neither impacted teeth nor implants have undergone any changes.