implants - internationalmagazine of oral implantology

tions made over one year of a representative case, in which the edentulous poste- rior regions of the maxilla were reconstructed using implant-supported FPDs. _Case report A 51-year-old male patient (non-smoker) presented himself at the practice of a colleaguebecauseofadvancedperiodontaldestructioninthemaxillaryarchoneyear before the start of the treatment described in this report (Fig. 1). Teeth #12, 14 to 18, 24 (retained root) and 25 to 27 were extracted. The extraction sockets were covered with dPTFE membranes (Cytoplast, Osteogenics Biomedical) with no additional use of grafting material, as previously described (Hoffmann etal.2008; Zafiropoulos et al. 2010). The mucoperiosteal flap was repositioned and fixed in the region of the papillae using interrupted sutures (Cytoplast, Osteogenics Biomedical). The mem- branes remained partially exposed and were removed after four weeks. The edentu- lous areas were then fitted with a model cast prosthesis. About one year after the extractions in the maxilla, the patient presented at our practice for implant treatment. The patient suffered from bilateral chronic sinusitis and would not allow a sinus augmentation to be performed. Five implants (3.75 mm in diameter and 11.5 mm in length; SoftBone, Dentegris) were placed in regions 12, 14, 16, 24 and 26. The implants inserted in regions 12, 14, 16 and 24 were inserted conventionally, i.e. axially, and an internal sinus lift was performed in region 16 (Fig. 2). The implant inserted in region 26 was inserted at an angle of 35° to the vertical axis and immediately provided with a 35° titanium abutment (DAAS abutment 35°, Dentegris; Fig. 3). An impression was taken using system-specific impression posts (pickup posts were used for the axially placed implants and DAAS posts for the tilted implants,bothDentegris)andapolyetherimpressionmaterial(Impregum,3MESPE; Fig. 4). The implants were then provided with system-specific healing caps (Dente- gris; Fig. 5). Threedaysafterimplantation,transferkeyswereusedtofitindividualabutments. To fabricate the individual abutments, platinum/iridium/plastic abutments (PTIR abutments, Dentegris) were used as a modelling aid consisting of a prefabricated cast-on base made of platinum-iridium and a screw channel made of residue-free burn-out plastic. To fabricate the abutment for 26, a system-specific castable plas- ticcylinder(DAASplasticcylinder,Dentegris)wasused.Onthesameday,bothametal framework made of a cobalt–chromium alloy (ZENOTEC NP, Wieland) and a tempo- rary restoration made of plastic (ZENO-PMMA; Wieland) were milled for immediate restorationofimplants14to16and24to26.Theframeworkwasfittedandthetem- poraryrestorationwasfixedusingatemporarycement(TempBond,Kerr;Figs.6–11). Four months after implant placement and progressive immediate loading with the long-term temporary restoration, the final restoration was fitted using a temporary eugenol-free cement (Implant-Provisional, Alvelogro; Fig. 12). _Conclusion Undercertainconditions(noactiveperiodontaldisease,goodpatientcooperation, goodbonequality),successfulearlyorimmediateloadingofimplantsintheposterior maxillaispossibleinselectedcases.Primarystabilityandimplantdesignplayamajor roleinthesuccessoftheimplantationandrestoration/loadingofbridgerestorations on tilted implants (Javed & Romanos 2010, Javed etal. 2011). On the basis of the sci- entific results published to date, it is not possible to discuss evidence-based contra- indications (based on the required and measurable values of primary stability, bone density and quality, and influence of occlusal forces). As a result, many questions re- main unanswered and risks uncertain (Roccuzzo etal. 2009). In our opinion, the primary benefit of using tilted implants is not necessarily the optionofimmediateimplantationandloading,butfirstlytheavoidanceofaugmen- Enhanced Hard and Soft Tissue Management with the patented TRI Dental Implant System. Designed in Switzerland. Made in Germany. TRI® Performance Concept A revolutionary new implant concept in implant dentistry Image: EstheticHealingCollar(TVHC50-60-A) For soft tissue suture fixation, 45 Euro TRI-Vent Implant (TV41B11), 115 Euro TRI® Performance Days 23.11.2011 Reggio Emilia 26.11.2011 Hamburg Speaker: Dr. Marius Steigmann 3.5 1. TRI® – Friction This frictional connection guarantees maximum stability and eliminates the risk of a microgap in the platform switch concept. 2. TRI® – BoneAdapt The patented conical implant body has been designed to perform and adapt ideally in the respective bone areas. 3. TRI® – Grip The apical part of this implant allows for a maximum of initial stability for all indications, but specifically for immediate placement. «One size fits all.» 1 platform – 3 implant diameters 3.75 – 4.1 – 4.7 Through Research Innovative www.tri-implants.com Gratis Infoline: 00800 3313 3313 Scientific Co-ordinators: Sergio Spinato Alberto Caffarri, Roberto Franceschetti TRI® Performance Concept A revolutionary new implant concept in implant dentistry Performance Concept A revolutionary new implant concept in implant dentistry 3.5 gnilaeHcittiehtsEEs t tissue sor sofftFFo ent ImplanVVeTRI- 1. TRI® Image: )A-06-05CHVVHT(ralloCg ouration, 45 Ee fixxat tissue sutur ourV41B11), 115 EEuTent Implant ( ® – Friction This frictional connection guarantees maximum stability and eliminates the risk of a microgap in the platform switch concept. 2. TRI® – The patented conical implant body has been designed to perform and adapt ideally in the respective bone areas. 3. TRI The apical part of this implant allows for a maximum of initial stability for all indications, but specifically for immediate placement. This frictional connection guarantees maximum stability and eliminates the risk of a microgap in the platform switch concept. – BoneAdapt The patented conical implant body has been designed to perform and adapt ideally in the respective bone areas. 3. TRI® – Grip The apical part of this implant allows for a maximum of initial stability for all indications, but specifically for immediate placement. Enhanced Hard and Soft Tissue Management with the patented TRI Dental Implant System. Designed in Switzerland. Made in Germany. TRI® Performance Days 23.11.2011 Reggio Emilia 26.11.2011 Hamburg Enhanced Hard and Soft Tissue Management with the patented TRI Dental Implant System. Designed in Switzerland. Made in Germany. Performance Days Reggio Emilia Speaker: Dr. Marius Steigmann Scientific Co-ordinators: Sergio Spinato Alberto Caffarri, Roberto Franceschetti ough RThr Gratis Infoline: 00800 3313 3313 ch Innovativeesearough R com.tri-implants.www Gratis Infoline: 00800 3313 3313 AD