Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2016-03-11, 23:13:06 | version 1.38.0
issue 2016 — 19 Advanced Implant Esthetics Article Editorial note: A list of references is available from the publisher. The first part of this article series, titled “Lateral maxillary incisor implant: Key issues for esthetic success,” was published in Clinical MastersTM , March 2015, Volume 1, Issue 1. Conflict of interest: The authors declare that they have no conflict of interests relating to this article. – Women were affected more than men. – It was more noticeable in long rather than short faces. – There was no correlation with age. – The patients were more satisfied with the results than were the practitioners. Thefindingsofthesameresearcherswere presented at the 2012 Academy of Os- seointegrationannualmeetinginPhoenix, Ariz.,U.S.,byTorstenJemt,whoattributed implant-supported crown infraocclusions toposteriormandibularrotationresulting in verticalization of natural incisors that is not followed by the crowns on the im- plants.Intheresultsreported,19outof69 cases presented infraocclusions of more than 1 mm and the phenomenon affected twice as many women as men. A recommendation has been made bythe practitioners of the Brånemark clinic in Gothenburg, Sweden,to place implants in apalatalpositioninanticipationofpossible verticalizationofthecentralincisors.Such placement also facilitates any prosthetic adjustment.39 Favor a palatal positioning of implants. — Conclusion Replacement of a lateral maxillary incisor is a difficult task.The great visibility of the toothinthesmileandcomparisonwiththe contralateral tooth in the same view are factorswithintrinsicestheticrisks.Inboth parts of this article series, emphasis has been placed on the most difficult situa- tions when the lateral incisor is small. In such circumstances, any lack of precision in the positioning has powerful implica- tionsfortheestheticplan.Inthissituation, using small-diameter implants would ap- pearto offer advantages forthe height of the papillae around the implant. In about one-third of cases, continuous maxillary eruption undermines the initial estheticoutcome,whichmayresult,atthe very least, in having to change the crown ontheimplant.Thischangetotheesthetic outcomeshouldformpartoftheinforma- tion provided to patients before starting treatment.40 Figs. 18a & b Smile of female patient in 1998 (a). Smile of female patient in 2014. Egression of natural teeth (b). Figs. 19a–c Smile of female patient in 2001 (a). Clinical situation in 2013 (b). Verticalization and egression of central incisors, lateral view (c). Fig. 18a Fig. 18b Fig. 19a Fig. 19b Fig. 19c Article_Russe_00-00.qxp_Layout 1 02.03.16 20:52 Seite 8 Article_Russe_00-00.qxp_Layout 102.03.1620:52 Seite 8