Implant Tribune Italian Edition

18 Implant Tribune Italian Edition - Novembre 2014Speciale Regeneration SR Structure and volume in delayed immediate implantation Dr Georg Bach*, Christian Müller** Introduction Delayed immediate implantation is a viable alternative to immediate im- plantation, for which there is no dis- tinct evaluation in the literature, and a “regular” implantation after com- plete osseous healing of the former extraction area, generally associated with volume loss. Loss of osseous volume after extrac- tion of a non-conservable tooth may be a limiting factor for later implan- tation. To avoid this problem, many authors recommend immediate implantation, where an implant is inserted immediately after careful and gentle tooth extraction. In cases where immediate implantation is not wanted or possible, delayed immedi- ate implantation after reconstruction oftheformertootharea,whichisgen- erally 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 precondition for immediate implantation can be op- timised with a collagen membrane and cone unit. The procedure pre- sented in the form of the following three exemplary patient cases also acknowledges this easy surgical pro- cedure. The focus of interest is on procedures for preserving osseous volume after extraction—many au- thors emphasise the value of closing the wound by means of a “punch”, which they claim to have considera- ble advantages with regard to protec- tion against resorption. >> pagina 19 Case 1 - Due to an extensive dental history, none of the anterior teeth of the maxilla were conservable (Fig. 1a) and had to be removed gently (Fig. 1b). Immediately following extraction of the teeth, collagen and membrane cones were inserted (Fig. 1c) for the purpose of socket preservation and integration of the previously produced (Fig. 1d) interim prosthesis. Figures 1e and 1f show the clinical situation one and four weeks after surgery; Figure 1g shows the situation after delayed immediate implantation. The intraosseous suture material was removed seven days after implantation (Fig. 1h). After completion of the osseointegration phase, the casting was done (Fig. 1i), followed by insertion of the abutments using the prepared insertion aid (Figs. 1j–l). Figure 1m shows the exact conformity between planning (template) and achieved result (abutments). *Oral surgery specialist ** Master Dental Technician articolo in lingua originale

Implant Tribune Italian Edition

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