Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2015-09-15, 12:06:46 | version 1.38.0
I research Fig. 15_Promotion of perfusion and healing by micro-invasive implant surgery with implant abutment insertion into vascularized blood-supplied alveolar bone. Fig. 16_Micro-invasive implant surgery to protect alveolar bone avoiding machined insertion and implant fixation with torque wrench. Fig. 17_Sinus elevation # 26 with implant placement prior to periimplant enlargement. Fig. 18_Periimplant soft tissue extension with apical fixation prior to free gingival grafting during implant healing. Fig. 19_Free gingival graft in situ prior to suturing. Fig. 20_Unstable periimplant gingiva with poor hygiene capability, persistent inflammation # 34 and chronic sensitivity. Fig. 21_Plastic pedicle flap surgery (Edlan-Mejchar) to remodel free into attached periimplant mucosa. Lack of buccal implant bone with oversized implant diameter. Fig. 22_Unobtrusive healing for eigth weeks posttherapy with functional relief by enlargement and periimplant stabilization. sertion into local bone, enlargement of periimplant gingiva with a ridge incision 1–2 mm orally is usu- ally adequate. In lateral augmentation in the max- illa, periimplant enlargement is frequently manda- tory as result of flap advancement to cover the de- fect. During healing and prior to implant exposure, vestibuloplastic surgery with free autogenous gin- gival graft from palate at implant site in a separate visit (Figs. 17–19). In individual cases and eden- tulism in the mandible, periimplant enlargement withEdlanMejchar-Vestibuloplasticsurgerytocre- ateattachedmucosabyapedicleflapwithadequate esthetics prior to implant placement. Also, to achievesofttissueprotectionfollowingimplantin- sertion (Figs. 20–22). Thickening: To safeguard implant placement and protect against periimplant diseases, an adequate periim- plantwidthismoreneededthansofttissuethickness. Following thickening by free autogenous soft tissue grafts from the palate or roll flap, loss of periimplant dimensionisanticipatedduetoshrinkageandfurther scar formation. Periimplant thickening is limited to individual patients with esthetic needs in the upper frontofthemaxilla.Shortcomingsfollowinghealing, scar formation, normal biologic resorption and fail- ingoflong-termstabilityareusuallycompensatedby individualprostheticabutmentsandceramiccrowns withawideperiimplantshoulder. Shortanddiameter-reducedimplants Theusageofshortimplants<9mmdemandsmin- imalization of surgery. Implant placement and heal- ing are customer-friendly. However, micro-incision surgery requires additional efforts by 3-D imaging (DVT)duringplanningandsensitivenessinclinicalre- alization. Evidence-based clinical data for short and diameter-reduced implants are inconsistent and in- dustry-driven. Biomechanical research underesti- mates the functional adaptive capacity of implant bone.15, 16 In clinical practice, horizontal alveolar bone loss is the most frequent demand: Mandible: 1. Advanced alveolar bone loss in premolars and molars (numerous; Figs. 23–29). 2. Proximity to N. alveolaris. 12 I implants3_2015 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 22 Fig. 15 Fig. 16