Rehabilitación completa de paciente geriátrico diabético e hipertenso: caso clínico

Abstract

An edentulous state is the total or partial loss of teeth and is mainly caused by caries and periodontal disea-se. Pre-existing systemic diseases must be under strict control prior to dental appointments for a favorable prognosis after treatment. Objective: To restore esthetics, function, and phonetic function in geriatric patients with pre-existing systemic diseases by applying a complete oral rehabilitation protocol. Case Presentation: A 74-year-old woman with history of hypertension and diabetes was medicated with Glucophage (metformin) and Losartan (hydrochlorothiazide). She presented a superior total edentulous maxilla and a partial edentulous Kennedy class I in the mandible. Treatment was performed in four phases. Phase I corresponded to the proper planning of the clinical case with plaster and virtual models. Phase II corresponded to the surgical phase, in which the U-shaped flap technique was performed and 6 dental implants with a diameter of 3.75 mm x 11.5 mm were placed. (Two conical connection implants (I.e. Morse Alvim) were placed in the anterior regions (13 and 23), and four other conical connection implants (i.e. Drive implants) were used in the posterior regions (14, 16, 24, and 26). Phase III oral rehabilitation the based on gnathological philosophy. Dental endodontics, lithium disilicate veneers, ceramic metal crowns with ERA attachments and removable partial dentures were used. Phase IV corresponded to the execution of an upper hybrid prosthesis with multiunit abutments of different angles. Conclusion: This minimally invasive multidisciplinary approach is considered predictable regarding esthetics and recommended for the restoration of patients’ appearance and self-esteem..