Implant Tribune Italian Edition

15Implant Tribune Italian Edition - Settembre 2013 A disadvantage is the higher ini- tial outlay, but this is balanced by increasing use owing to a targeted and quicker workflow and thus less reworking. Implantation always re- quires a 3-D radiograph. These new techniques have greater logistical requirements than conventional dental procedures do and require extensive involvement of the teams involved in order to achieve treat- ment success. It should be borne in mind that every surgery is accompanied by a certain risk in spite of the safety precautions taken. In addition, too much confidence in methodologies may lead to carelessness. Errors may even arise with 3-D planning, which may hold negative conse- quences for treatment. Therefore, it is important to be familiar with each step and error source and thus expert training is crucial. In addition, maintaining a critical attitude throughout treatment is necessary to avoid errors. The ad- vantages of 3-D planning are so significant that it has become indis- pensable. Figs. 6a & b - Loading of an edentulous mandible with a fixed bridge on inter-foraminal implants: Planning detail (a). Four years post-treatment (b). Figs. 7a-c - X-ray after Implantation with mucosa-born drilling template in situ (a). Surgical site with lingual position of the medial implants (b). After exposure (c). 1. Ehrl, PA: Systematisches Vorgehen bei der augmentierenden Therapie von Kie- ferdefekten, 47 Oraclchir J, 1/2003, 47ff. 2. Kirsch A, Nagel R, Neuendorff G, Fi- derscheck J, Ackermann K-L: Backward Planning und dreidimensionale Dia- gnostik. Teamwork J Cont Dent Educ, 11. Jg., 06/2008: 734-754. 3. Arutinov SD, Panin AM, Antonik MM, Iun TE, Adamian RA, Shirokov II: Oc- clusion patterns of dental arches con- taining implant-supported restoration. Stomatologiia (Mosk) (Russia 2012; 91(1): 54-8. 4. Kinsel RP, Liss M: Retrospective analysis of 56 edentulous dental arches restored with 344 single-stage implants using an immediate loading fixed pro- visional protocol: statistical predictors of implant failure. Int J Oral Maxillofac Implants 2007 Sep-Oct;22(5):823-30. 5. BdiZ EDI, Berger C: Leitfaden Kurze und angulierte Implantate. Konsen- suspapier der Europäischen Konsen- suskonferenz (EuCC) 05.03.2011. 6. Ritter L, Reiz SD, Rothamel D, Drei- seidler T, Karapetian V, Scheer M, Zol- ler JE: Registration accuracy of three- dimensional surface and cone beam computed tomography data for virtual implant planning, Clin Oral Implants Res 2012 Apr;23(4):447-52. 7. Luthardt RG: Die Genauigkeit zahnärztlicher Abformungen für fest- sitzenden Zahnersatz. Dtsch Zahnärztl Z 59, 372 (2004), zitiert aus: Skript zur Abdrucknahme der Poliklinik für zahnärztliche Prothetik der Universität Köln. 8. Limkangwalmongkol P, Chiche GJ, Blatz MB: Precision of fit of two mar- gin designs for metal-ceramic crowns. J Prosthodont 2007 Jul-Aug;16(4):233-7. 9. Limkangwalmongkol P, Kee E, Chiche GJ, Blatz MB: Comparison of marginal fit between all-porcelain margin versus alumina-supported margin on Procera Alumina crowns. J Prosthodont 2009 Feb;18(2):162-6. references works cited < pagina 14 In addition, they can aid determina- tion of the positions of the implants in consultation with the dental technician and planning for ade- quate space for the attachment box. Discussion Three-dimensional planning for implants holds the advantage of higher quality owing to (a) risk iden- tification; (b) planning reliability; (c) production of near-natural struc- tures; (d) targeted and fast work; (e) patient compliance; and (f) cost transparency. These advantages are largely due to the greater amount and quality of information gained. Three-dimensional diagnostics ena- ble us to obtain reliable information about the condition of the alveolar process and important anatomi- cal structures. With the additional planning cast, information about the restoration of function and aes- thetics is obtained. Combining both information sources will result in optimal treatment planning. In ad- dition, an experienced surgeon can address surprises if the patient is flexible. Intra-operative decisions may also need to be made if unex- pected situations arise. Knowledge of 3-D data permits planning, which entails devising a well-considered procedure and obtaining the necessary tools and substitute material, for example suitable implants and bone substi- tutes. Owing to the traceability of diagnosis and treatment, as well as the resulting safety, patients will regard the procedure particularly positively. 10. Ahuja S, Cagna DR: Defining available re- storative space for implant overdentures. J Prosthet Dent 2010 Aug;104(2):133-6. 11. BDO, DGI, DGZI, MKG: Die Indika- tionsklassen der Implantattherapie nah dem Konsensuspapier der Verbände, zuletzt geändert 2002. 12. Behneke A, Burwinkel M, Knierim K, Behneke N: Accuracy assessment of cone beam computed tomography-derived labo- ratory-based surgical templates on partial- ly edentulous patients, Clin Oral Implants Res 2012 Feb;23(2):137-43. 13. Bidra AS: Consequences of insufficient treatment planning for flapless implant surgery for a mandibular overdenture: a clinical report, J Prosthet Dent 2011 May;105(5):286-91. 14. Brånemark PI, Zarb GA, Albrektsson T (ed.): Gewebeintegrierter Zahnersatz, Quintessenz, Berlin 1985. 15. Donitza A: Creating the perfect smile: pro- sthetic considerations and procedures for optimal dentofacial esthetics, J Calif Dent Assoc 2008 May;36(5):335-40, 342. 16. Drago C, Carpentieri J: Treatment of ma- xillary jaws with dental implants: guide- lines for treatment, J Prosthodont 2011 Jul;20(5):336-47. 17. Ehrl, P.A.: Augmentationschirurgie und 3-D-Planung in der Implantologie ZWP 1+2/2008. 18. Ehrl,P.A.: Planungsstrategien bei inter- disziplinären Behandlungen in der Oral- chirurgie, Oralchirurgie Journal 3/2008, 6-8, 2010. 19. Ehrl, P.A.: Der aktuelle Stand der DVT- Technik in der Zahnmedizin, In: Digitale dentale Technologien, Jahrbuch 2011, 54- 58. 20. Ehrl, P.A.: Indikationen der Volumentomo- graphie heute, Zahn Prax 13, 4, 258-263, 2010. 21. Ehrl, P.A.: Planungs- und Bohrhilfensyste- me der Implantologie, Jahrbuch Implanto- logie 2011, 196-198, Oemus-Verlag. 22. Ehrl, P.A., Kapogianni, E.: 3-D-Diagnostik und –Planung in der Zahnmedizin, Quin- tessenz Focus, Navigierte Implantation, 2011, 6-16 und Quintessenz Zahntech, 36(12): 1572-1582, 2011. 23. Gross MD: Occlusion in implant dentistry. A review of the literature of prosthetic determinants and current concepts, Aust Dent J 2008 Jun;53 Suppl 1:S60-8. 24. Karimi-Boushehri F, Cable C: Advan- ced implant overdenture superstructure treatment planning with computer-assi- sted design systems, Int J Comput Dent 2010;13(1):57-65. 25. Ntounis A, Petropoulou A: A technique for managing and accurate registration of pe- riimplant soft tissues. J Prosthet Dent 2010 Oct;104(4):276-9. 26. Ritter L, Neugebauer J, Dreiseidler T, Rothamel D, Cizek J, Karapetian VE, Mi- schkowski RA, Bindl A, Zoller JE: 3D X-ray meets CAD/CAM dentistry: a novel proce- dure for virtual dental implant planning, Int J Comput Dent 2009;12(1):29-40. 27. Rossi R, Morales RS, Frascaria M, et al.: Planning implants in the esthetic zone using a new implant 3D navigation system. Eur J Esthet Dent (Germany), Summer 2010, 5(2) p172-88. 28. Worthington P, Rubenstein J, Hatcher DC: The role of cone-beam computed tomo- graphy in the planning and placement of implants. J Am Dent Assoc 2010 Oct;141 Suppl 3:19S-24S. bibliography Diventa autore Contatta Chiara Siccardi chiara.siccardi@tueor.it per “Implant Tribune” Letteratura Internazionale