implants_international magazine of oral implantology No. 1, 2016

| research implants 1 201620 Ideally, the implant should be inserted between 4.5 and 5.5 months after the graft (Fig. 13). “Fully reconstruct papillary support.” Insertion of implant Choice of implant The mesio-distal dimension of the gap will deter­ mine the choice of the implant. When this is close to or less than the average size of 6.5 mm, the bone and papillary volume around standard size implants will be limited. According to Hasan et al.10 and Bourauel et al.,11 the disadvantage of small diameter implants is that they transmit higher stresses to the crestal bone than do standard implants. When re­ placing a lateral maxillary incisor, it is possible to arrange both the anterior guidance and the deduc­ tion in such a way as to make them largely affect the natural teeth, in the absence of any significant malpositioning, and in this way reduce the stresses applied to the implants. Under these conditions, small diameter implants have the advantage of in­ creasing surrounding residual bone volume as well as space available for papillary healing. In a forthcoming study of 120 NobelActive 3 mm diameter implants, one of the conclusions con­ firmed the importance of these small diameter im­ plants as regards the additional height of the papil­ lae, resulting in an improvement in the Fürhauser pink aesthetic score12 (Figs. 14, 15a & b). Fig. 16: Mobile Anyray 2 (VATECH) X-ray generator. Fig. 17: Intraoperative X-ray, Precision Drill inlay (left on picture) and in situ (right on picture). Fig. 18: Clinical outcome five months after the graft. Postoperative X-ray NobelActive 3/0 implant and 15° abutment in place. Fig. 19: Initial situation. Fig. 20: De-epithelialisation of a palatal flap into a diamond shape. Fig. 21: Unfoldment of palatal flap, vestibular edge. Fig. 22: Creation of flap envelope, Swann-Morton blade through the envelope. SM 63, inlaid with transparency. Fig. 23: Passage of suture through the envelope. Fig. 24: The palatal flap is folded into the vestibular envelope using a suture thread. Fig. 16 Fig. 19 Fig. 20 Fig. 21 Fig. 22 Fig. 23 Fig. 24 Fig. 17 Fig. 18 1201620

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