implants - internationalmagazine of oral implantology

clinical study _ extraction plus technique I ForthemaxillacaseB1-2,22%oftherespondents gave (+++), 26% gave (++) and 39% disagreed, but for case B2-2, 16% gave (+++), 21% gave (++) and 45% disagreed. These results reflect a balance be- tweenthosewhoagreedanddisagreedwiththistech- nique, which means that the clinicians were hesitant to give definite decisions on the short implants alter- native in the posterior maxilla. For the bone block augmentation technique in the mandiblethroughtwo-stagesurgeryincaseA1-3and caseA2-3,therewerenosignificantdifferencesinthe results of the case A1-3, where 9% agreed by (+++), 19% agreed by (++) and 38% disagreed, compared withthatofcaseA2-3,whereonly6%agreedby(+++) and 17% agreed by (++) and 50% disagreed. This in- dicatesthatclinicianstriedtoavoidthecomplications on both donor and recipient sides associated with bone augmentation by the bone block (autogenous) technique, aside from it being a more time-consum- ing alternative treatment. From the results of cases A1-4 and A2-4, it is clear that the mandible distractor device was not preferred because for case A1-4, 3% gave (+++), 9% gave (++) and 59% disagreed and for case A2-4, only 1% gave (+++) and 69% disagreed. This reflects the rare use and difficulties of application of this device and clini- cians’desiretoavoidcomplicationsofthisalternative treatment. For the last alternative presented for cases A1 and A2, nerve transpositioning, the results for both cases A1-5andA2-5 werethesame,whereonly3%agreed by(+++)andalmost80%disagreedwiththiscompli- cated and risky technique being a viable alternative treatment. The results of case B1-3 demonstrate that internal sinus lift is the most preferable alternative technique (60%agreedby(+++),21%by(++)andonly5%dis- agreed),comparedwiththeresultsofcaseB2-3,which demonstratethatcliniciansdidnotsupporttheuseof thistechniqueinthecaseofanunhealthytooth(31% gave (+++) and 13% disagreed). This demonstrates clinicians’ confusion and no definite decision when it seems doubtful that the natural tooth can be pre- served, and clinicians may prefer the extraction plus technique alternative in this situation. In comparison, using external window sinus lift with a bone block graft for case B1-4 was not much more preferable, as evident from the results: 14% agreed by (+++), 26% agreed by (++) and 34% dis- agreed. The positive results for this technique de- creasedevenfurtherincaseB2-4,whereonly8%gave (+++), 14% (++) and 55% disagreed. These results demonstrate that the clinicians considered this tech- nique a good alternative treatment when the natural tooth is healthy but not when its survival is doubtful, in order to avoid the complications associated with this technique. _Conclusion for surveys The extraction plus technique was considered by the respondents as one of the better alternatives, es- peciallywhenthetoothtobeextractedwasunhealthy butlesssowhenthetoothtobeextractedwashealthy. Usingtheshortimplanttechniqueinthemandiblewas Fig. 15_Shows the final restoration in seated right side. Fig. 16_Shows the occlusal view of final restoration. Tab. 3_Comparison between the result of survey 1 mandible case A1 and alternatives with the result of survey 2 mandible case A2 and alternatives. I 23implants4_2011 Fig. 15 Fig. 16 Table III