Treating severe periodontitis with staged load applied implant restoration: A case report

Table 2 The cases comparison of periodontal disease treatments

Case	Treatment step 1	Treatment step 2	Treatment step 3	Treatment step 4	Prognosis and follow-up
Combined periodontal and implant treatment of a patient with chronic periodontitis and severe alveolar bone loss	Basic periodontal treatment (non-surgical) and reassessment	In the area of tooth #21, conducted GBR tissue increment surgery and dental implantation simultaneously	Temporary restoration on the implant was made for gum shaping	Removed bad prosthesis in the area of tooth #11; permanent restorations were made	Received good feedback from patient; new therapy idea combined implantation, periodontal and restorations. This patient only has a limited number of bone defects
Implant treatment of a case of severe chronic periodontitis	Initial periodontal treatment: Oral hygiene instruction; scaling and root planning; tooth extraction (teeth #11, #12, #16, #21, #22, and #27); partial denture therapy (teeth #12-22); root canal treatment and hemisection (tooth #46); Occlusal adjustment (teeth #13 and #23)	Oral functional rehabilitation treatment: Implant prosthesis (in the areas of teeth #12, #16, #22, #36, and #41)	Temporary restoration: During the 5-mo relief period, a partial denture was placed in the maxillary anterior region	Permanent restoration: All custom abutments and porcelain fused to metal crowns were retained	The screw was restored after cleaning and occlusal adjustment. The patient’s oral hygiene has been well maintained. There has not been any recurrence nor has the patient's periodontal disease worsened among other natural teeth
Treating severe periodontitis with staged load applied implant restoration	First load-bearing stage: Removed the remaining teeth in the jaw; conducted immediate All-on-6 implant restoration and immediate loading	Second load-bearing stage: Inserted four temporary Osstem mini implants; performed immediate loading, maxillary GBR technique, and lateral maxillary sinus lifting on both sides	Third load-bearing stage: Four temporary implants were removed, and eight permanent implants were placed; performed immediate loading	Fourth load-bearing stage: The resin bridge was segmented for gingival repair	Restored with custom abutments and the zirconium crown-bridge prosthesis

GBR: Guided bone regeneration.