cone beam – international magazine of cone beam dentistry

case study _ implant treatment I Inordertoreducetheriskofprogressive vertical and horizontal alveolar ridge atrophy and subsequent loss of the papillae, an OsseoSpeed Profile (ASTRA TECH Implant System) was selected, with the expectation that its sloped im- plant design would optimally support the anatomical structures. Treatment Cone beam computed tomography (CBCT) was used for the planning of the case. After measuring the lingual and buccal preparation depth, an Osseo- Speed TX Profile was inserted. The final alignment of the sloped implant shoul- der was carried out using the specially markedimplantdrivertoensurethatthe implant was placed flush to the bone. This allowed the marginal bone around the implant to be optimally supported. After approximately four months, the peri-implant mucosa was healed without irritation. After making a final impression with a Profile Impression component, a TiDesign Profile Abutment (DENTSPLYImplants)wascustomisedinthelabora- tory, and a metal ceramic crown was fabricated. About five months after implant placement, the ceramic veneered crown was cemented. _Case study Adapting to the anatomical situation using a sloped implant design Long-term clinical and aesthetic success of im- plant therapy can only be achieved if peri-implant hard and soft tissue structures are preserved to the greatest extent possible. Bone resorption after tooth loss in the posterior region can occur in a oro-vestibular as well as in a mesio-distal direction. In both cases the OsseoSpeed Profile implant (DENTSPLY Implants) is adapted to the anatomical situation because of its sloped implant design. The primary ob- jective of implant therapyistoachieve lasting functional and aesthetic suc- cess with minimal risk and without complications.Asa result of tooth ex- traction or loss, however, horizon- tal and vertical resorption occurs. Horizontal re- sorption starts at the thinner alveolar outer walls. Vertical bone resorption is characterised by being more pronounced buccally than lingually, which can lead to a difference of up to two mms from the lingual to the buccal bone lamella.1 Anatomicallyshapedimplantshoulder Whenbonelossoccurs,conventionallydesigned implants with flat implant shoulders can only partially support the peri-implant structures. This can result in discolouration of the buccal soft tissue margin or the unsupported bone may be resorbed (Fig. 1). In order to avoid such undesirable consequences, the OsseoSpeed Profile implant was developed. The OsseoSpeed Profile implant is supported by the ASTRA TECH Implant System BioManagement Complex: OsseoSpeed, MicroThread, Conical Seal Design and Connective Contour. The implant is available in different lengths and diameters. As a result of its construction, the anatomical features Figs. 4a–b_Clinical images taken before implant placement show the pronounced buccal and slight lingual resorption of the alveolar ridge. Fig. 5_After crestal incision and elevation of a mucoperiosteal flap, the atrophied alveolar ridge is clearly visible. Fig. 6_The buccally insufficient ridge width caused a bone dehiscence. Figs. 7a–b_Nice transgingival healing of the OsseoSpeed Profile implant with support of the peri-implant hard and soft tissue structures caused by the anatomically natural contour of the implant neck. Fig. 7c_X-ray after 16 weeks at re-entry. I 09 cone beam 1_2016 Fig. 6 Fig. 4b Fig. 5 Fig. 4a Fig. 7c Fig. 7b Fig. 7a CBE0116_08-11_Noelken 21.01.16 11:00 Seite 2 CBE0116_08-11_Noelken 21.01.1611:00 Seite 2

cone beam – international magazine of cone beam dentistry

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