implants - international magazine of oral implantology

I case report _ prevention of implant resorption 08 I implants3_2011 clusal forces. This could be achieved without trans- planting osseous blocks from different parts of the body, which makes it a less invasive implantology. The disadvantages of sinus elevation, taking osseous blocksfromdifferentpartsofthebodyandnerverepo- sitioning are well known. Disadvantagesofsinuselevation 1. Extended trauma of soft and hard tissues 2. Operation lasts considerably longer 3.Surgery exposes the wound to a higher risk of bac- terial and viral contamination 4.Expandedpost-operativeswellingandhighlevelsof pain are inevitable with the risk of post-operative complaints 5.Sometimesonly3to4mmcanbegainedinorderto avoid creating large pointed loads on the sinus membrane 6.The following may occur during or after the opera- tion: a) Soft-tissue complications b) Rupture of the Schneiderian membrane c) Contamination d) Fistula e) Cavity f) Infection g) Soreness h)Lost of bone and resorption of the graft material (resorption of more than 2 mm in two years) i) Peri-implantitis j) Bleeding k) Exuding of pus l) Future loss of implants. Disadvantagesoftakingosseousblocksfromdifferent partsofthebody 1.Insensibility of the dental lower nerve when blocks of mandible have been cut 2. Mandibular fractures 3.Numbness of the anterior or posterior mandibular teeth when blocks are taken from the chin or the area of the mandibular branch 4.Exposureoftheblocksandfixationscrewsowingto insufficient soft tissue to close the incision com- pletely 5.Soft- and hard-tissue complications 6. Inflammation 7. Bleeding 8. Exuding of pus 9. Infections that may cause loss of the blocks. Disadvantagesofnerverepositioning 1. Extended trauma 2. Operation lasts considerably longer 3.Surgery exposes the wound to a higher risk of bac- terial and viral contamination 4.Expandedpost-operativeswellingandhighlevelsof pain are inevitable with the risk of post-operative complaints 5. Insensitivity of the lower dental nerve 6. Soft- and hard-tissue complications 7. Inflammation 8. Bleeding 9. Infections. However,usingCT,virtualmodelsandguidescould be created to insert implants in the places in which there is good bone quality and no nerves, arteries, si- nusesornosefossaeareaffected.Thisoperationofin- sertingimplantswithoutsoft-tissuereflectionismin- imally invasive and is usually of shorter duration. In addition,thedangerofcontaminationandpost-oper- ative complaints are less likely, the healing and os- seointegration times are shorter, inflammation and pain are minimal and, frequently, the patient reports no pain at all. Thedistributionofchewforcesusingindividualim- plants and one implant per root lost eliminates a united rehabilitation,4 and also avoid the cantilever5 that causes the resorption of the mesial and distal wallsoftheimplants,owingtotheleverageforcesap- plied by the cantilever. Misch mentioned that with a greaternumberofimplants,resorption,bonelossand theconsequentlossoftheimplantscanbeavoided. In addition,Perelmentionedthatpoorplanningofacase will lead to failure. In his conference paper, “Plan it or lose it”, he recounted that any case must entail plan- ning for adequate function in the future and must Fig. 4_ I.P.S.P.S. diagram for implants of 3.10, 2.75 and 2.50 mm in diameter. Fig. 5_Case of 27 crowns on 27 individual implants (1991). Fig. 6_Case of 40 implants in a 58-year-old male patient (2001). Fig. 4 Fig. 5 Fig. 6