implants - international magazine of oral implantology International Edition

I research Figs. 5–7_Implant site preparation with only the use of piezo inserts. Figs. 8 & 9_Final result of the implant site preparation; a modest vestibular dehiscence is evident. Thetechniqueproposedbytheauthorsisintended to use the piezoelectric surgery in the initial stage of preparation(Fig.11),inordertobenefitfromitsundis- puted advantages, namely in the drilling phase of the cortex, the definition of the working length and the inclination of insertion and complete, however, the implantsitepreparationwithdedicatedburs(Fig.12). Theauthorsthinkthatinthefinalstagesofprepa- ration the level of friction, and therefore the over- heatingleveloftheburonthebone,isremarkablyre- duced, while it is essential for a correct fitting of the implant, and a proper compliance with the surgical protocol suggested by the various dental implant manufacturers, that the burs have the shape and length suitable and specifically dedicated to the im- plantconcerned.Theuniversalityoftheimplantinsert doesnotallowafinalpreparationthatisexactlycon- gruentwiththemultiplicityofexistingimplants,thus risking losing retentive capability or fitting accuracy. The paper is aimed at describing the results ob- tainedandobservedaftera36-monthtrial,assessing the effectiveness of the technique from both a clini- cal and histological point of view; a technique which providesfortheuseofpiezoelectricinserts,insteadof other surgical methods, during the first stage of preparation of the implant site. _Materials and methods Asalreadypointedoutintheintroduction,thegoal oftheresearchwastosetup—onarandomsampleof patients—a comparison between the preparation of the implant site using piezoelectric inserts only dur- ing the early stages, compared to the conventional technique with dental drills, or that is the exclusive use of piezoelectric inserts. The main evaluation parameters considered were the following: − Immediate biological response, assessed by histol- ogyoftissueremovedduringsurgery(Figs.15–16). − Successful implant-prosthesis on medium (12 months) and long term (36 months), checked with intraoralperiodicX-rays(Figs.17–19),andperi-im- plant plaque and bleeding indices every six months from the placement of the final prosthesis. Thirty patients were randomly selected. Inordertocreateprotocoluniformity,thepatients wererequiredtonecessarilymeetthefollowingbasic requirements: − Aged between 30 and 50; − good general health (absence of decompensated systemic diseases); − no smoking; − interlayer edentulism; − residual alveolar process in the edentulous area sufficient to the insertion of an implant not less than 10.0 mm long and not less than 4.0 mm wide; − lack of necessity for regenerative surgery. Inordertostandardisethesurgicalprocedures,the following common features were chosen: − Use of submerged implants with surface obtained by subtraction. − Implantdimensionnot<10.0mminlengthandnot <4.0 mm in diameter. − Use of grafting materials avoided. − Bone density between values 2 and 4, according to the classification of Misch. − Implant placement only in edentulous areas with the exception of the incisal areas and distal ones at the sixth teeth . − Implantplacementthroughsurgical“fullthickness” flap. − Implants inserted at least four months after tooth extraction. 16 I implants4_2013 Fig. 5 Fig. 6 Fig. 7 Fig. 9Fig. 8