Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2016-05-19, 12:42:25 | version 1.38.0
| industry 34 implants 2 2016 implant (BIC), less periimplant bone loss and less gingival inflammation. Another advantage of flap- less surgery that both the clinician and patient ap- preciate is the significant reduction in intraopera- tiveandpostoperativebleeding.Theabsenceofflap and suturing greatly simplifies the surgery, short- ening its duration in most of the cases. For these reasons, patients will feel more comfortable and less swelling, pain and other complications in and after the surgery. However, one should always notice that this type ofsurgeryrequiresspecialconcentrationasitcomes from a technique without direct vision of the bone. This implies the importance of a preoperative design of the precise position of the implants. And strict in- clusion criteria should be established. The following principles must be observed in the flapless proce- dure: 1. More keratinised tissue must be present (at least 5.0 mm) because the flapless procedure requires the actual removal of some of the tissue; and 2. more bone width (at least 4.5 mm) must be avail- able without undercuts of more than 15°. Since visibility is more limited when using the flapless technique, it is more difficult to ensure that the implant is positioned in the centre of the crestal bone. In the reported case, a patient with suffi- cient bone volume and good health was chosen, and preoperative design was made through the CBCT radiograph and the wax-up. The surgery Variables of the pink esthetic score Variables Absent Incomplete Complete Mesial papilla Shape vs. reference tooth 0 1 2 Distal papilla Shape vs. reference tooth 0 1 2 Level of soft tissue margin Level vs. reference tooth Major discrepancy > 2 mm Minor discrepancy 1–2 mm No discrepancy < 1 mm Soft tissue contour Natural, matching reference tooth 0 1 2 Alveolar process Alveolar process deficiency 0 1 2 Soft tissue color Color vs. reference tooth 0 1 2 Soft tissue texture Texture vs. reference tooth 0 1 2 Maximum total PES 14 Table 1 Fig. 40 Fig. 41 Fig. 42 Fig. 40: Periapical radiograph showing excellent precision. Fig. 41: Periapical radiograph of 11 after one year. Fig. 42: Periapical radiograph of 22. 22016 012 012 012 012 012 012