implants - international magazine of oral implantology International Edition

meetings I metalobjectstogeneratetheartefactsontheimage. The implant was placed in between two metallic posts of similar diameter in the same line separated byequaldistancesinthesimulatedboneblock.Four- teen different combinations were prepared using two posts to simulate the possible locations of such posts in vivo. Thus, prepared blocks were then used to record the images using both modalities by ad- justingtheexposureparameterstothedensityofthe simulation device. The images obtained were analysed by five oral radiologists and their confi- dence levels regarding their assessment of the im- ages were recorded for both modalities. The ob- servers were asked to score the images in the central regions of the implants. A visual grading character- istics analysis was carried out to assess the relative confidence levels of observer responses for both modalitiestodeterminetheirstatisticalsignificance. Theassessmentofperi-implantanatomyusingCBCT was significantly better in the central region of the implant in comparison to VT, whereas in the periph- ery of the implant region both modalities performed similarly. A recovery case with maxil- lary sinusitis and inferior alveolar nerve paralysis YoshishigeTaniguchi This case report presents a four- year follow-up of an implant recovery case caused by inappropriate implant therapy owing to insufficient examinationanddiagnosis,whichwasresolvedbythe removal and replacement of the implants with new implants. Casedescription A 62-year-old male patient complaining of im- plant movement and discomfort while eating first visited our clinic in March 2007. He had maxillary si- nusitis on both sides and implants in positions 15–17, 25–27 and 45 with severe peri-implantitis. The screw was loosening in implant 17 and the im- plant fixture in position 25 was fractured. Other complicationswerethatpatienthadinferioralveolar nerve paralysis on the right side of the mandible and fluid leaking from the nasal passage after drinking. The patient had always felt extremely dissatisfied with his dental treatment. He desired retreatment with new implants. Our clinical examination of both maxillary sinuses found that they were packed with non-absorbable bone substitute from the implant site;thiswasthecauseofthesinusinfection.Thepa- tient underwent radical maxillary sinus surgery, and alltheimplantsandaloosetoothwereextractedata university hospital. After nine months (January 2008), new implants (NobelSpeedy Groovy; Nobel Biocare)wereplacedinpositions47,44,42and32in ourclinic.Animplantwitha15degreetiltwasplaced inposition44.Atsametime,absorbablebonesubsti- tute was used to avoid the mental foramen and ow- ing to the severely atrophic alveolar ridge. In Octo- ber 2009, new implants (NobelSpeedy Groovy) were inserted into the maxillary alveolar bone in accor- dancewiththeAll-on-4concept.Aprovisionalpros- thesis was then made from acrylic resin and seated on the same day. Resultsanddiscussion The final prostheses were fabricated six months fromthedayofsurgery.Thepatient’scomplaintshave been resolved and the final prostheses for both jaws are stable. Applying the All-on-4 concept in the max- illae and implant tilting in the mandible are the best methods available for implant recovery cases for pa- tientsforwhomsinusaugmentationisimpossibleand who have a severely atrophic alveolar ridge around the molars in the mandible._ I 45implants1_2014