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Dental Tribune Middle East & Africa Edition No.2, 2016

GregoriM.Kurtzman,DDS,MAGD PrivatePractice SilverSpring,Maryland MarkusL.Weitz,DDS PrivatePractice Cedarhurst,NewYork RonKaminer,DDS PrivatePractice Hewlett andOceanside,NewYork DanielD.Gober,DDS PrivatePractice Cedarhurst,NewYork ◊Page2 Figure1.Pre-op Figure2.Pre-opocclusion Figure 9. Hydrolic sinus lift using normal saline through theosteotomy Figure 10. Bone harvesting from the external obliqueridge Figure 11. Blood extraction for PRF membrane preparation Figure12.PRFmembrane Figure 3. Pre-op full upper dental arch with miss- ing teethandbonedefect Figure 5. occlusal view showing buc- caldefect Figure7.Fullthicknessflapeleva- tion,and thinridge Figure 8. Complete exposure of the site after vertical releasing incision Figure 13. Sinus floor elevation usingPRF Figure 18. Correction of the buc- caldefect Figure 19. Ti mesh use to protect the bone theaugmentedsite Figure 20. Ti mesh stabilize by cover flat screw Figure 14. Implant Placement and thenarrowridge Figure 15. Buccal view of the implant site showing bone de- hiscence Figure21.BuccalviewofTimesh Figure22.TimeshcoveredbyPRF membrane Figure24.Healedsite Figure 23. Tension free closure andPTFEsuture Figure16.Augmenting thesite Figure17.Fullyaugmentedsite Figure 6. Buccal view during ortho- dontic treatment Figure 4. Pre-op x-ray showing short boneheight ÿPage4 Dental Tribune Middle East & Africa Edition | 2/2016 implant tribune 3 ageoralterationoftitaniumsurfaces from a diode laser, regardless of the power setting.8 No visible difference between lased and non-lased tita- nium surfaces after irradiation has been reported, ensuring that the result yields the best surface guided tissue regeneration compared to ei- ther mechanical debridement or a Er:YAGlaser. Success in peri-implantitis treat- ment is strongly linked to the ability to eliminate the bacteria in the site thatcouldhamperregeneration. This becomes more critical with implants that have been surface treated. Treated implant surfaces exhibit micro roughness that are advantageous for initial integration, but also will harbor bacteria when peri-implantitis has occurred. Re- moval of bacteria in these micro ir- regularitiesisdifficultbymechanical means. The diode laser has the ability to decontaminate the exposed surface and threads without any negative effects.9 Conclusion The key to successful peri-im- plantitis treatment is early iden- tification to limit bone loss from inflammation and infection. The diode laser is a powerful adjunct to treating periimplantitis, allow- ing better access to eliminate more granulation tissue than when only mechanical means are utilized. This case demonstrates that the protocol can provide long-term predictable results showing 5-year maintenance of the grafted area and an absence of inflammationoverthattime. Acknowledgement Treatment for the case present- edperformedbyDr.MarkusWeitz. References 1. Authors, the reviewer requested anadditionalreferenceforthisstate- ment.Canyoupleaseprovideone? 2 . Barboza CA, Ginani F, Soares DM, et al. Low-level laser irradiation in- duces in vitro proliferation of mes- enchymal stem cells. Einstein (Sao Paulo).2014;12(1):75-81. 3. Authors, the reviewer requested anadditionalreferenceforthisstate- ment. Can you please provide one? PerhapsDörtbudakO? The full list of references is available fromthepublisher. Multidisciplinary approach

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