implants - international magazine of oral implantology

I research _Introduction Delayed immediate implantation is a viable al- ternative to immediate implantation, for which there is no distinct evaluation in the literature, and a “regular” implantation after complete osseous healing of the former extraction area, generally as- sociated with volume loss. Lossofosseousvolumeafterextractionofanon- conservable tooth may be a limiting factor for later implantation. To avoid this problem, many authors recommend immediate implantation, where an im- plant is inserted immediately after careful and gen- tle tooth extraction. In cases where immediate im- plantationisnotwantedorpossible,delayedimme- diate implantation after reconstruction of the for- mer tooth area, which is generally carried out three to four weeks after extraction of the non-conserv- able tooth, is a viable alternative. If the alveolus is (still) mostly intact after extraction, the precondi- tion for immediate implantation can be optimised with a collagen membrane and cone unit. The procedure presented in the form of the fol- lowingthreeexemplarypatientcasesalsoacknowl- edges this easy surgical procedure. The focus of interest is on procedures for pre- servingosseousvolumeafterextraction—manyau- thors emphasise the value of closing the wound by means of a “punch”, which they claim to have con- siderable advantages with regard to protection against resorption. Undisturbed growth of bone- formingcellsintheformertoothsocketispromoted by preventing the connective tissue from growing into the alveolus. However, this procedure presents moreofachallengeforthesurgicalskillsoftheden- tal surgeon in terms of production and insertion, and it is more demanding for the patient, both sur- gically and financially. The insertion of so-called collagen membrane and cone units can simplify closure of the alveolus considerably and avoid removal of the punch at a later time. A second procedure is not required be- cause of the absorbability of the material, since the collagen membrane cone unit does not have to be removed. _Procedure The manufacturer recommends the following procedure for the insertion of collagen membrane and cone unit: Structure and volume in delayed immediate implantation Authors_Dr Georg Bach & Christian Müller, Germany 06 I implants1_2013 Fig. 1bFig. 1a Fig. 1c