Dental Tribune United Kingdom Edition

Discover MeToo, a totally new range of Professional whitening products, both comprehensive and wide-ranging to cover all your patients requirements. MeToo provides you with fast, effective and gentle strategies of treatment for chairside as well as for take-home whitening to give your patients the smile they deserve. W e t o c r e a t e For further information: 01480 477307 info@acteongroup.co.uk | sales@acteongroup.co.uk | www.acteongroup.com EVERYBODY DESERVES A BEAUTIFUL SMILE Take-home Whitening To enhance the whitening results, patients can treat themselves at home, at their chosen time using MeToo Day or MeToo Night (as per their dentist’s recommendation). MeToo Calm is also available for the relief of any teeth sensitivity issues. The patented NeoDam gel changes colour whilst curing MeToo Deluxe MeToo Compact Powerful whitening lamps, complete whitening kits, innovative disposable retractors with integrated suction system, new colour-changing gingival dam – everything is clearly presented and easy-to-use to make your work simple and your patients happy. Chairside Whitening Kit 2012 MeToo Teeth Whitening Ad (Dental Tribune)_2012 MeToo Teeth Whitening Ad (Dental Tribune) 21/06/2012 11:42 Page 1 sites. If any modification has to be done, there is still time to adjust the drill sleeves to adequate posi- tions and to re-sterilise the guide. The next step is the transfer of the occlusion to the articula- tor. Usually an occlusion guide is engineered before surgery and screwed into an adequate posi- tion. It is then adjusted and some silicone material is added to en- sure a perfect bite (Fig 8). The transfer is made to the articulator before starting surgery. It is some- times possible to retain a molar with compromised prognosis un- til the end of definitive prosthesis, thereby keeping a reference point of initial occlusion. When all materials are ster- ile, surgery can be initiated un- der the usual conditions. The flap is raised, the remaining teeth planned for extraction are re- moved and the surgical guide is placed on teeth or screwed onto implants. Holes of 2.0 and 2.8mm are drilled through the sleeves us- ing the VECTOdrill™ (Thommen Medical) with a smaller tip fitting in and following the prepared drill hole. Control of the depth is visual, since depth marks on the drills can be easily seen on the facial aspect of the surgical guide. Speed and torque are according to the manufacturer’s instruc- tions. Cooling is performed on the facial side (Fig 9); the flap is main- tained properly by the guide on the palatal side. Once the drilling has been completed, the surgical guide is removed and the last step of implant site preparation is done using implant-specific drills, bone spreaders or piezosurgery inserts. The choice of the implant relies not only on the diameter, but also on the implant length and profile to achieve the best possible im- plant stability. Implants with ad- vanced surface technology, pro- viding additional security in the early healing phase such as the super-hydrophilic Thommen im- plant lines SPI®ELEMENT (cylin- drical profile) and SPI®CONTACT (conical-cylindrical profile) with INICELL® (Thommen Medi- cal), are preferred. In order to perform immediate loading, the implant should be inserted with a minimum torque of 25Ncm. If the bone provides poor primary sta- bility, then a two-stage approach is required to ensure proper os- seointegration before placing the prostheses. SPI®VARIOmulti abutments (Thommen Medical) are connected to the implants by selecting proper width, height and angulation. Next, impres- sion copings are connected to the SPI®VARIOmulti abutments and bone-grafting material such as BioOss® (Geistlich) is then spread on the facial bone in order to avoid facial bone resorption.14 All synthetic bone graft material is covered by a thin and long-lasting membrane such as Remotis® membrane (Thommen Medical) and flaps are sutured with partic- ular attention to ensuring wound closure. The impression tray is con- nected to the initially placed im- plants and silicone material is injected into the tray around im- plant transfers where room has been preserved for the impression material (Fig 10). Once the im- pression tray has been removed, protective caps are positioned on the SPI®VARIOmulti abutments in order to maintain gingival spacing during the last laboratory prosthetic phase. A panoramic X- ray is performed to ensure proper positioning of implants and abut- ments, and to ensure that no ra- diopaque sterile silicone material remains. The maxillary plaster model is trimmed to leave space for abut- ment analogues and plaster is poured to fill this open space af- ter the impression tray has been secured to the trimmed model (Fig 11). The modified model si- page 22DTàFig. 6 Initial impression of two initially placed implants Fig 6 21Implant TribuneNovember 19-25, 2012United Kingdom EditionUnited Kingdom Edition