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implants international magazine of oral implantology

I case report Fig. 10a & b_Clinical bilateral view of initial situation. Fig. 11_Panoramic radiograph of initial situation. Fig. 12_Tomograph of initial situation at each site. Fig. 13a & b_Detachment of the mucosa and preparation of the implant bed, using countersinks to expand the bone area, resulting in an increase in volume. Fig.14a&b_Appearanceofthe implantsimmediatelypost-placement. Figs. 15a & b_View of the mucosa (a) and radiographic control (b) three months after the surgery. flammatory Profenid every 12 hours for three days post-operativelytocontrolpainandpreventinflamma- tion. In addition, rising twice a day with a 0.12% chlorhexidine mild mouthwash was recommended. Post-operatively, the implant was followed clinically andradiographicallyandnoabnormalitywasdetected aftertendays(Figs.9a&b). CaseII A61-year-oldfemalepatientpresentedtotheclinic. Examination showed that bilateral tooth replacement wasneededforteeth#13to16and23to26.Afterade- tailedanamnesis,itwasconcludedthatthepatienthad nosystematicproblems.Afterclinical(Fig.10)andradi- ographic(Fig.11&12)examination,thenecessarycon- ditions for the expansion technique and immediate placementoftheimplantswereestablishedaswiththe previouscase. The small volume of bone was confirmed after the openingofthemucosal(Fig.13).Sixinternalconicalim- plants, measuring 4.0 mm in diameter and of different lengths,wereinserted(Fig.14)andsutured.Post-oper- ative prescription and care were the same as with CaseI.Clinicalandradiographiccontrolfollowedpost- operatively and after one month (Figs. 15a & b), show- inggoodresults.Inbothcases,thetomographicmeas- urements after placement of the implant were used to measure and evaluate the expansion volume during surgery. _Results Thevolumeoftheboneregionsthatreceivedtheim- plantswasmeasuredpriortotheexpansion.Theprob- ingdepthinmillimetresattheflangewasusedforcal- ibration and measurement around the implantation area (Fig. 16a) and confirmed with the tomographic measurements. After implant placement, these were usedforcalibrationbeforethefinalmeasurement(Fig. 16b). Measurements were done using the Image Tool (version 3.0) for Windows (Microsoft), and the results areshowninTableIandFigure17. _Discussion Thispaperpresentsarelativelysimpletechniquefor placing implants in regions with insufficient bone tis- sue, with the use of expanders to obtain an increase in bonevolume.Therehavebeenfewerstudiesonthesur- gical expansion of the bed margin than studies on the 28 I implants2_2012 Fig. 13a Fig. 13bFig. 12 Fig. 14a Fig. 14b Fig. 15a Fig. 15b Fig. 10a Fig. 10b Fig. 11