implants - the journal of oral implantology UK Edition

I 17 case report _ multiple implants I implants1_2012 lars and along the sides of the dental nerve to form the bipod that mandibular molars need to support the occlusal forces. This could be achieved without transplanting osseous blocks from different parts of the body, which makes it a less invasive implantology. The disadvantages of sinus elevation, taking osseous blocks from different parts of the body and nerve re- positioning 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 bacterial and viral contamination 4. Expanded post-operative swelling and high levels of pain are inevitable with the risk of post-operative complaints 5. Sometimes only 3 to 4mm can be gained in order to avoid creating large pointed loads on the sinus membrane 6. The following may occur during or after the operation: 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 2mm in two years) i) Peri-implantitis j) Bleeding k) Exuding of pus l) Future loss of implants. Disadvantagesoftakingosseousblocksfromdiffer- entpartsofthebody 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. Exposure of the blocks and fixation screws owing to insufficient soft tissue to close the incision completely 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 bacterial and viral contamination 4. Expanded post-operative swelling and high levels of 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, using CT, virtual models and guides could be created to insert implants in the places in whichthereisgoodbonequalityandnonerves,arter- ies, sinuses or nose fossae are affected. This operation of inserting implants without soft-tissue reflection is minimally invasive and is usually of shorter duration. In addition, the danger of contamination and post- operative complaints are less likely, the healing and osseointegration times are shorter, inflammation and pain are minimal and, frequently, the patient reports no pain at all. The distribution of chew forces using individual implants 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 walls of the implants, owing to the leverage forces applied by the cantilever. Misch mentioned that with a greater number of implants, resorption, bone loss and the consequent loss of the implants can be avoided. In addition, Perel mentioned that poor 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