implants - international magazine of oral implantology International Edition

research I theinitialpreparationoftheimplantsite,usingonlythe pilotdentaldrillsavailableinallimplant-prostheticsys- temsonthemarket(Figs.13–14).Thisisduetothefact that the rotation of the bur, and therefore its macro- movement, makes its stabilisation exactly where de- siredbytheoperatorintheinitialphaseextremelydiffi- cult,alsoincasealance-tipburisused.Inthissense,the useofthePESisanimportantimprovementforthecli- nician,asitisasafeandreliablemethodwithclearben- efits from both an intraoperative (technology-related) andbiologicalpointofview(seeLabancaetal2008for review,Figs.5–10). The main technical-executive advantages for the operatorcanbesummarisedasfollows: −It allows for more stable positioning of the guide in- sert on the crestal profile for the creation of the first implanthole. −Itallowsthedefinitionofamorecorrectimplantaxis, favouring the success of the implant-prosthetic re- habilitation. −It allows for possible intra-operative corrections of theimplantaxisabovementioned. −It makes the crestal cortical osteotomy procedure safer, since the piezoelectric ergonomic handpiece is not subject to tilt and therefore does not pose those “shaking” phenomena, specific to each rotating systeminitialworkingphases. −It makes the initial osteotomy less traumatic, fully exploiting the cavitation process with constant irri- gation. −It reduces the emotional impact on the patient, who does not feel the annoying vibrations caused by the dentaldrill. Thebiologicaladvantagesareinanycasetechnical- relatedandconsistof(Figs.20–23): −Reductionofthermalstressonbonetissue; −betterbonevitality; −greater respect of the osteoblastic turnover and bet- terboneresponseafterresection; −preservationofsofttissueandofanynobleanatom- ical structures (inferior alveolar nerve, Schneiderian membrane,etc.)adjacenttotheosteotomy. This paper will therefore illustrate the fundamen- tal execution techniques, aimed at achieving the best possible clinical success both from a biological and functional and aesthetic point of view, in order to achieveimplant-prostheticrehabilitationmorelikely to meet the daily demands of both the clinician and the patient. I 15implants4_2013 SMALL IN SIZE, GREAT IN PERFORMANCE... IMPLA Mini Implants » 50 years’experience in implantology » sand-blasted and acid-etched surface » minimally invasive procedure » short drilling protocol = shorter surgery times » economic implant restoration AD