Implant Tribune Italian Edition

19Speciale RegenerationImplant Tribune Italian Edition - Novembre 2014 SR << pagina 18 Undisturbed growth of bone- forming cells in the former tooth socket is promoted by preventing the connective tissue from grow- ing into the alveolus. However, this procedure presents more of a challenge for the surgical skills of the dental surgeon in terms of production and insertion, and it is more demanding for the pa- tient, both surgically and finan- cially. The insertion of so-called colla- gen membrane and cone units can simplify closure of the al- veolus considerably and avoid removal of the punch at a later time. A second procedure is not required because of the absorb- ability of the material, since the collagen membrane cone unit does not have to be removed. Case 2 - In the right half of the maxilla, the two remaining posterior teeth were fractured and deeply damaged by caries (Fig. 2a), thus non-conservable. The two alveoli remained largely intact (Fig. 2b) after gentle removal of the roots, and a customised collagen membrane and cone unit was inserted (Fig. 2c). The suture material was removed one week after surgery (Fig. 2d). After four weeks, the bone bed showed no irritation and a prima- ry reconstruction to a large extent. We were able to insert two implants after this short waiting period. Figure 2e shows the condition after implant bed drilling; Figure 2f shows the two inserted implants. Please also see the corresponding dental panoramic X-ray (Fig. 2g). Upon completion of the osseointegration period, the implants showed no irritation (Fig. 2h), so that the impression could be taken with a customised spoon (Fig. 2i) and the dental lab work (Figs. 2j & k) was executed. Figure 2l shows the inserted abutments, and Figure 2m shows the integrated product in the patient’s mouth. Figure 2n shows the corresponding sagittal view. Procedure The manufacturer recommends the following procedure for the in- sertion of collagen membrane and cone unit: 1. Preparation for a tight closure After gentle and non-traumatic extraction of the non-conserva- ble tooth, the marginal gingiva is minimally detached to the al- veolar process so that the free membrane side of the collagen membrane and cone unit can be inserted. 2. Customising collagen membrane and cone unit Moistening is to be avoided because this would make it more difficult to achieve a good fit to the alveolus. Rather, the collagen cone is fitted to the alveolus with the scalpel, >> pagina 20

Implant Tribune Italian Edition

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