Please activate JavaScript!
Please install Adobe Flash Player, click here for download

implants - international magazine of oral implantology

industry report I crownwasfixed(Fig.24).Itwillremaininsituforat least six months, in this case, even for twelve months. _Additional measures A Michigan splint protects the surgical site from pressure. It should be worn for eating and sleeping for at least four weeks. Figure 26: The root-canal treatmentinregion12wasrevised.Afterrevisionof the root-canal treatment and internal bleaching, a ceramic pin was fitted into the root canal and ce- mentedin(Fig.27).Figure28givestheresultsofthe X-ray examination of the inserted ceramic pin. In addition, impression-taking of the definitive abut- ment was conducted and the natural post for man- ufacture of the definitive full ceramic restoration was placed (Fig. 29). Figure 30: The position of the abutment was transferred to the master case with theaidofaplasticcoping.Figure31showsthesitu- ation twelve months after implant placement: The tissue has matured and the gingival recession was minimal. Also, the definitive full-ceramic crowns were placed; the dentition was compensated to the contralateral teeth (Fig. 32). Care was taken not to crushthepapillaebetween11and21.Figures33–35 give the results one year, two and five years after loading. _Conclusion In esthetically high-risk cases (high smile line, thin gingiva, prior operations), it is important to carry out all required measures in only one surgical procedure, if possible at all: atraumatic tooth ex- traction, scar correction, gingiva thickening, im- plant placement and possibly bone grafting. In this case, a partial socket preservation was conducted. Usingthe“earlyabutmenttechnique”aftertwodays —during the healing phase—the definitive ceramic abutmentwasplacedandleftinsitu.Asaresult,the wound adhered to the abutment, and there was a tissue adhesion in the implant shoulder region. This procedure has been in use in our practice since 2002 and has proven successful. A decisive factor is the application of minimally invasive mi- crosurgery:fewverticalincisions,minimalincisions, checking the bone and soft-tissue situation by probing.Thehealingphaseshouldlastatleastsixto ninemonthstoallowthetissuetomature.Inourex- perience, platform switching is also required after formation of the soft tissue, because the soft tissue has more space with this technique. The combina- tionoftechniquesdescribedhereoffersawayofin- creasing the probability of optimum tissue reten- tion with the right indications._ Fig. 29_Impression-taking of the definitive abutment and the natural post. Fig. 30_Transfer of the abutment position to the master case. Fig. 31_Twelve months post-op. Fig. 32_Twelve months post op: placement of the definitive full-ceramic crowns. Fig. 33_X-ray one year after loading. Fig. 34_Two years after immediate implant placement. Fig. 35_Five years after loading. I 37implants3_2012 Dr S.Marcus Beschnidt Privatpraxis für Zahnheilkunde LichtentalerAllee 1 76530 Baden-Baden,Germany Tel:+49 7221 3939719 info@beschnidt.com www.beschnidt.com _contact implants Fig. 34 Fig. 35 Fig. 32 Fig. 33 Fig. 29 Fig. 30 Fig. 31