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Wannes: Upper jaw small and narrow. Malpositioned implants. Redo with Le Fort I, bonegrafts and all on four. PEEK implants for the asymmetry

Facial diagnosis

  • Receding upper jaw
  • Too short upper jaw

Dental diagnosis

  • Class III

Treatment jaw surgery

  • Advancement upper jaw (Le Fort I)
  • Extensive bone graft from the posterior hip region

Treatment dental implants

  • Implant supported bridge (fixed denture) upper jaw
  • Implant supported bridge (fixed denture) lower jaw

Treatment aesthetic surgery

  • Jaw angle augmentation
  • Lipofilling

About this case

Describing the case of Wannes is difficult and his story was particularly psychologically traumatic for him self. He putted initially a lot of effort, investment  and hope in the placement of implants with a bone graft elsewhere. The result was as well facially as comfort wise spoken rather disastrous. He came to me without too much hope and very uncertain. We talked together a long time about the possible solutions and eventual compromises that would be necessary along the road. Finally we sticked to the following work-up: 1/ a considerable Le Fort I advancement. 2/ a considerable bone graft vestibularly around the crest of the upper jaw and also covering this way the existing implants with bone. 3/ an immediate loading with provisional fixed teeth and then after months a final construction in Titanium porcelain. Addressing his asymmetry in his face: Wannes was very concerned and conscious about this topic, but finally declined the possibility of a lower jaw osteotomy. On the other hand he was open for the possibility of creating  more symmetry by means of computer guided PEEK implants. So two PEEK Implants were added on his lower jaw and some area’s were shaved and reduced as wel. Also Wannes was very sensitive towards anything disturbing his palatal vault. Since the implants were too much in a palatal position, we studied a long time to construct the right components in the final construction. This way the palate would become totally free and comfortable. The outcome was upmost rewarding for Wannes. Not often i had a more thankful patient. And this is finally why we are doing it for! Thanks for your confidence, Wannes.