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ePaper created 2017-03-17, 10:24:23 | version 1.38.0
INTERVIEW with — Drs. Rodríguez Ciurana & Vela Nebot Q: Drs. Vela and Rodríguez, you refer to your newest XA abutments, developed with Sweden & Martina, as paradigm shifting. Could you please explain what has led you to this point? A: The main concern of the clinician is to minimize the inexorable bone resorption and apical migration of the soft tissue that involves multiple problems, including esthetics and the survival of the resto- ration in the medium and long term owing to periimplantitis. We consider that our approach is a paradigm shift because using XA abutments and a suitable rehabilitation protocol not only avoids apical migration, but also promotes coronal migration of bone and soft tissue over time. This means esthetic improvements, as well as protec- tion against periimplantitis. Q: And how is that possible? A: Basically, the protocol we apply has been improved and updated to achieve the final objective of the stabilization of the periim- plant tissue. The evolution of the concept reflects diferent phases of our work over the years. The BORG Center was estab- lished in 2012, and the BORG members began their clinical research in 2004, at which time we followed the standard pro- tocol: an implant without platform switch- ing (PS), an abutment with an anatomical profile imitating the shape of the tooth (divergent shape) and a protocol entailing multiple disconnections. However, with this approach, the tissue tended to apical migration. Q: Apical migration means gingival reces- sion. Did this not compromise the esthetics? A: Of course. In fact, gingival recessions gave rise not only to esthetic risk but also to the risk of periimplantitis. We therefore evolved our protocol to an implant with PS, an abutment with an anatomical profile (divergent) and multiple disconnections. The introduction of the PS concept allowed us to reduce periimplant bone resorption 74 — issue 2017 Advanced Implant Esthetics Interview