Dental Tribune United Kingdom Edition

19Implant TribuneMay 23-29, 2011United Kingdom Edition The following points should be noted: • The use of a single post for temporary and final pros- thetic work • As long as the frequent re- placement of parts is not avoid- ed, repeated destruction of the connective- tissue attachment of the biologic width occurs increasing the risk of bone re- sorption A special implant and abut- ment design (a ledge and inte- gration of the biologic width/ tapered shape of the post) fa- cilitates nonsurgical lengthen- ing and thickening of the peri- implant soft tissue. This leads to the establish- ment of a wider and more resist- ant zone of connective tissue. A micro- rough and nano-rough titanium surface extending to the implant shoulder in con- junction with the platform switching concept provides os- seous integration along the en- tire length of the implant. A fine thread optimally dis- tributes the masticatory forces in the region of the implant neck, avoiding further bone loss in this region.15 Possible interactions amongst factors contribut- ing to peri - implant bone loss These factors include: • Surgical and anatomical con- siderations such as mucope- riosteal flap design, thickness of buccal and lingual cortical plates of bone remaining after osteotomy preparation, bone quality, healing technique sub- merged or nonsubmerged, ear- ly unintentional cover screw exposure by mucosal dehis- cence and amount of kerati- nized Gingiva • Patient risk factors such as medical and pharmacologi- cal status, habits including cigarette smoking, poor oral hygiene, excessive alcohol consumption, mucosal erosive pathology like lichen planus, previous or present periodon- titis (chronic or aggressive); • Biologic width related fac- tors such as level of the micro- gap, platform switching and implant- tooth or implant-im- plant distance • Implant design including ge- ometry, surface, length and di- ameter • Biomechanical factors in- cluding time of loading, type of loading, type of prosthesis, habits like bruxism Flap design It was reported in the literature long time ago32 that, when- ever a mucoperiosteal flap is reflected about a tooth, some crestal bone resorption will occur. Similarly elevating a flap to place a dental implant will lead to crestal bone loss and there is evidence sug- gesting a direct relationship between size of full thickness flap and the resulting post-op bone loss. Other studies33 reported no statistically significant differ- ences using more traditional histological evaluation of re- trieved specimens after 12 weeks of site healing. Becker reported the same magnitude of difference in buccal vertical implants bone loss as Jeong, one millimeter less for flapless approach. Alveolar bone thickness The main blood supply for buccal alveolar bone is sup- plied by vessels in the overly- ing muco periosteum34 and is greatly affected by elevating a full thickness flap to facilitate placement of a dental implant. Studies suggest that if residual facial bone thickness is less than 2mm and/or if dehiscenc- es or fenestrations of facial bone occurred during osteoto- page 20DTà ‘It was reported in the literature long time ago that, whenever a muco- periosteal flap is reflected about a tooth, some cre- stal bone resorption will occur’ NEW DIGIXPAD COMPACT DENTAL IMAGING AND DIAGNOSTIC SYSTEM DigixPad provides a the ideal solution for any practitioner wishing to upgrade to Digital X-ray Imaging without the need for costly and complex PC integration and networking. Providing quick and easy chairside image capture and manipulation, DigixPad from eschmannDirect will save you time and money and will easily integrate into your surgery. For details and orders call EschmannDirect on: 01903 875787 ic.sales@eschmann.co.uk | www.eschmanndirect.com from Direct *Prices excl. Carriage and VAT valid to 31st Aug 2011 LittleSisterDigixpad  High Definition, crystal clear radiographs.  Instantaneous image generation.  Rapid apex location during endo treatments  High resolution endoral sensors.  Large 4.3” integrated touch screen.  No need for specialist software.  Permanent image storage via USB flash drive or SD card.  WiFi or direct image transfer to PC.  Compact and portable for use at chairside.  DigixPad is designed to work with all digital and analogue x-ray systems.  VisualVi software upgrade provides enhanced image manipulation, ideal for implantology.  Cost effective alternative to other digital imaging systems.  Solution for practices requiring space for a dedicated decontamination room Digixpad DigixPad System £4495.00 (rrp £4995) OFFER PRICE FREE Visual Vi software included worth £750