Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: 15 Jul 2025

Maxillary Implant-Supported Overdenture in a Heavy Smoker Patient With Generalized Stage IV Grade C Periodontitis: A Clinical Case Report

Dr med dent,
Prof Dr med dent, and
Dr med dent, Dr phil, MA, MSc
Page Range: 258 – 263
DOI: 10.1563/aaid-joi-D-24-00173
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We present a clinical case report of a 54-year-old female heavy smoker (30 pack-years) with generalized periodontitis stage IV grade C who underwent implant surgery and prosthetic rehabilitation following the failure of her natural dentition in the maxilla. The surgical treatment involved the insertion of 4 implants with a bilateral external sinus procedure, and the decisions and steps taken to achieve the final treatment outcome were discussed in detail. This highlights the challenges in patient management as the need for sufficient oral hygiene and cooperation is mandatory due to the increased failure rates in smokers. After a healing phase of several months, uncovering was performed, and the prosthetic treatment was carried out. A palate-free fixed prosthesis with a computer-aided design/computer-aided manufacturing bar was inserted. This case illustrates a challenging treatment plan, considering the patient’s desire for a relatively cost-effective, fixed, and palate-free restoration of the maxilla.

Keywords: periodontitis; nicotine abuse; smoking; dental implants; implant-supported dentures
Copyright: 2025
Figure 1.
Figure 1.

Panoramic radiograph at the initial presentation to the prosthodontist.

Figure 2.
Figure 2.

Clinical situation after insertion of the maxillary and mandibular interim dentures.

Figure 3.
Figure 3.

Three-dimensional implant planning with cone-beam computerized tomography.

Figure 4.
Figure 4.

Intraoral view during the preoperative wax try-in.

Figure 5.
Figure 5.

Surgical site after insertion of the 4 oral implants.

Figure 6.
Figure 6.

Saliva-proof wound closure for closed healing of the implants.

Figure 7.
Figure 7.

X-ray control image after augmentation and simultaneous implant placement.

Figure 8.
Figure 8.

Panoramic radiograph after exposure of the 4 oral implants.

Figure 9.
Figure 9.

Blocking of the impression posts with stable wire and Ceramill Gel (Amann Girrbach, Pforzheim, Germany).

Figure 10.
Figure 10.

Frontal view of the final restoration.

Figure 11.
Figure 11.

View of the upper jaw after treatment.

Figure 12.
Figure 12.

X-ray control image after incorporation of the final restoration.

Figure 13.
Figure 13.

Panoramic radiograph 15 months after completion of the oral rehabilitation in the upper jaw.

Contributor Notes

*Corresponding author, e-mail: hansulrich_brauer@za-karlsruhe.de
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