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Dental Tribune United Kingdom Edition

15Endo TribuneApril 9-15, 2012United Kingdom Edition For more information, contact BioHorizons Customer Care: +44 (0)1344 752560 or visit us online at www.biohorizons.com Laser-Lok 3.0 is the first 3mm implant that incorporates Laser-Lok technology to create a biologic seal and maintain crestal bone on the implant collar1 . Designed specifically for limited spaces in the aesthetic zone, the Laser-Lok 3.0 comes with a broad array of prosthetic options making it the perfect choice for high profile cases. SPMP10109 REV D SEP 2010 1. Radiographic Analysis of Crestal Bone Levels on Laser-Lok Collar Dental Implants. CA Shapoff, B Lahey, PA Wasserlauf, DM Kim, IJPRD, Vol 30, No 2, 2010. 2. Implant strength & fatigue testing done in accordance with ISO standard 14801. 3. Initial clinical efficacy of 3-mm implants immediately placed into function in conditions of limited spacing. Reddy MS, O’Neal SJ, Haigh S, Aponte-Wesson R, Geurs NC. Int J Oral Maxillofac Implants. 2008 Mar-Apr;23(2):281-288. 4. Human Histologic Evidence of a Connective Tissue Attachment to a Dental Implant. M Nevins, ML Nevins, M Camelo, JL Boyesen, DM Kim. International Journal of Periodontics & Restorative Dentistry. Vol. 28, No. 2, 2008. • Two-piece 3mm design offers restorative flexibility in narrow spaces • Implant design is more than 20% stronger than competitor implant2 • 3mm threadform shown to be effective when immediately loaded3 • Laser-Lok microchannels create a physical connective tissue attachment (unlike Sharpey fibers) 4 Treat small spaces with confidence Introducing the Laser-Lok® 3.0 implant Human histology shows the apical extent of the junctional epithelium below which there is a supracrestal connective tissue attachment to the laser microchannel surface2 . Radiograph shows proper implant spacing in limited site. Laser-Lok 3.0 placed in aesthetic zone. Image courtesy of Michael Reddy, DDS Image courtesy of Cary Shapoff, DDS Treat small spaces with confidence spaces with confidence spaces with Introducing the Laser-LokIntroducing the Laser-Lok® 3.0 implant3.0 implant Bio Horizons_treat small.indd 1 01/03/2011 16:33 tioning as abutments. Tooth #37 showed an occlusal filling in the crown. Palpation of the buccal fold was not painful and there was no mobility of teeth #36 and 37. The pockets of #36 were within normal limits. However, periodontal probing distal of #37 provoked strong pain and extreme bleeding. The distal pocket measured approximately 6mm. As the previously taken ra- diographs were not available and the OPT was considered unsuitable for proper diagno- sis, a peri-apical radiograph (Fig. 3) was taken. The radio- graph showed that tooth #37 had previously been treated endodontically. The mesial canals were filled with silver cones rather too short of the apex. There also appeared to be some gutta-percha and a large metal post in the distal canal. Additionally, radiolu- cency was noticeable around the apex of the mesial root. According to the patient, he had received endodontic treatment about 15 years ago owing to pain following bridge cementation. The tooth had been without symptoms since then. Considering the history and my clinical and radio- graphic findings, my differen- tial diagnosis was: 1painful AP owing to rein- fection or leakage 2painful marginal perio- dontitis distal of tooth #37 ow- ing to poor oral hygiene 3vertical root fracture (VRF) of the distal root of tooth #37 As diagnosis 1 and 3 would have required rather invasive therapies (retreatment or ex- traction), we opted to rule out the local marginal periodon- titis first. Under local anaes- thesia, the distal pocket was thoroughly cleaned and the patient was instructed to use dental floss distal of tooth #37 on a daily basis. On 31 January, three weeks after initial treatment, the pa- tient returned for evaluation and appeared free of com- plaints. Therea was no bleed- ing on probing and pain could not be provoked. It should be noted that by selecting this strategy, neither an AP nor a VRF was defini- tively excluded as a cause of pain. It should be taken into account that owing to the patient being on antibiotics, the symptoms of the AP may have temporarily disappeared and returned at a later stage. Nevertheless, at that point we treated the patient based on history, a radiograph and pa- tient complaints rather than merely on the basis of the ra- diolucency evident on the ra- diograph. In May 2011, the patient returned to our office once again. He was free of com- plaints, pockets were within normal limits and there was no bleeding on probing. DT “The radiographic picture is only one means of diagno- sis… the picture may show a lot of rarefaction, but to use it as the sole means of diagno- sis is unwise.” Thomas Philip Hinman, 1921 About the author Dr Sander Loos Heuvelweg 21, 3761 XL Soest, Neth- erlands s.loos@acta.nl Fig 3