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ePaper created 2016-09-20, 16:58:27 | version 1.38.0
Journal of Oral Science & Rehabilitation 54 Volume 2 | Issue 3/2016 I m m e d i a t e l o a d i n g u s i n g g u i d e d s u r g e r y Fig. 5a Fig. 5b Figs. 5a & b Clinical situation after implant treatment at five years of follow-up. (a) Frontal view. (b) Lateral view. diazepam 5 mg (Valpinax, Crinos, Milan, Italy) was given priorto surgery. Local anesthesiawas induced by infiltration of the buccal and palatal regions of the surgical area with a 4% articaine solution with 1:200,000 epinephrine (Ubistes- in, 3M Italia, Bergamo, Italy). Conscious seda- tion with midazolam 0.05–0.15 mg/kg IV (Ipnovel, Roche, Monza, Italy) was performed; ranitidine 100 mg IV (Ranidil, Menarini, Flor- ence, Italy) and ondansetron 4 mg IV (Zofran, GlaxoSmithKline, Brentford, U.K.) were also administered for gastroprotection and preven- tion of nausea and vomiting. A single post- operative dose of dexamethasone 8 mg IV (Decadron, Visufarma, Rome, Italy) and ketoro- lac 30 mg IV (Toradol, Recordat, Rome, Italy) was also given. Hopeless teeth were atraumatically extracted with the aid of a periotome (PT2, Hu-Friedy, Chicago, Ill., U.S.) and the sockets debrided. In cases of multiple-rooted teeth, a rhizotomywas performed, startingfromthe centerofthetooth, followed by careful extraction of the individual roots to prevent damage to the alveolar walls. Upon completion ofthe extraction,the integrity, depth and inclination ofthe alveolarsocketwere checked with a periodontal probe. The surgical templates were positioned using the silicone surgical index derived from the mounted casts, and precise fit was visually and manually as- sessed. The surgical template was then stabi- lized with three to five preplanned anchor pins. All ofthe implantswere placed through metallic sleeves in a fully guided surgery approach. Im- a b