International Journal of Clinical Case Reports 2024, Vol.14, No.1, 1-13 http://medscipublisher.com/index.php/ijccr 5 4) Status of tooth loss: During the treatment, 35 teeth were extracted, which will be reflected in the images. 5) Soft tissue condition: The condition of soft tissues, including the health of the gums, is an area where improvement is expected in the later stages of periodontal treatment, although this may not be easily observable in CT images. Figure 2 The CT scan taken on June 21, 2015 shows the oral condition after nearly 10 months of periodontal treatment Based on the two CT images provided, the following analysis can be offered: In the 2015 image, the alveolar bone in the lower jaw appears fuller compared to the 2014 image, suggesting a potential improvement in alveolar bone quality. The areas where teeth are missing do not seem to exhibit significant new changes, indicating no further tooth loss (with one tooth extracted). There are no apparent new signs of alveolar bone resorption or inflammation in the images, which may suggest an improvement in periodontal conditions. The positions of the teeth appear relatively stable, with no obvious displacement, which is favorable for implant surgery. 3.2 Implant surgery process After stabilizing the periodontal treatment, implant surgery planning was conducted based on a comprehensive evaluation and three-dimensional simulation using full-mouth CT scans. The implant surgery was carried out in multiple stages, starting with the placement of implants in the posterior mandibular missing areas. Implants made of titanium alloy with a moderately rough surface were selected to promote osseointegration. The surgery employed minimally invasive windowing techniques to reduce tissue damage and postoperative discomfort. In the subsequent months, the integration of implants with the bone was assessed through clinical and radiographic evaluations. Once osseointegration reached the expected standards, the missing tooth area in the upper jaw has also been implanted with implants. Based on the CT scan images from October 2, 2015 (Figure 3), several key points regarding the implant placement (typically referred to as fixtures) can be observed. Here are some professional assessments based on the images: 1) Implant positions: The images show multiple implants have been placed in the mandible. They appear evenly distributed in the areas of missing teeth, aiming to restore both function and aesthetics. 2) Implant angulation: The angles of the implants appear appropriate, indicating they should be able to support future crowns and restore a normal bite. The angle of the implants is crucial for successful implantation as they need to mimic the position of natural tooth roots.
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