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ePaper created 2017-11-09, 09:28:26 | version 1.38.0
overview | shown, bones classified as category 3 and especially 4 are defective or even diseased (Fig. 2). Every implantologist knows the phenomenon of “falling” into cavities while drilling. Chronic inflammations in the jaw bone frequently occur as result of wounds caused by tooth extractions in the past, which have not healed properly, tooth development or foreign particles. These inflamma- tions are often not visible on conventional X-ray images. Similar to root-treated teeth, inflammatory mediators (TNF-, IL-1, RANTES) can also cause symptoms in other parts of the body. Neurological (NICO) or joint problems frequently occur. NICO stands for “neuralgia-inducing cav- itational osteonecrosis”, which refers to chronically in- flamed areas in the jaw bone. This osteolysis is also re- ferred to as ischemic necrosis, a typical interference field in the jaw, which is also included in the category of neuro- modulative triggers. Ceramic implants do not heal in bones of category 3 or 4. For this reason, osteolysis needs to be treated before implantation can occur. The bone must be absolutely healthy to ensure a successful implant healing (Fig. 3). The development of osteolysis is caused by a lack of nutrients as stated above. Disinfection and plasma membrane These osteolytic areas of bone contain fat cysts, de- generated trabeculae and allow chronic infections, par- ticularly anaerobes, to feel at home in this area, triggered by the ischemic change in the bone. According to studies conducted by Lechner, increased heavy metals and other environmental toxins become deposited here. This bone area must therefore be cleaned and disinfected during implantation with the utmost precision. technique allows the dentist to carry out procedures even in critical areas, since due to the use of rotating instruments soft tissue injuries are unlikely to occur. – For disinfection we recommend ozone (Fig. 4). Ozone is a proven bactericide, virucide and fungicide. It therefore kills all microorganisms present. This facilitates healing as the immune system does not need to deal with addi- tional infections. The use of ozone is indicated particu- larly after root-treated teeth have been extracted and ceramic implants have been immediately inserted (SCC® Short Cut Concept according to Dr Karl Ulrich Volz). In addition to the ozone production, the voltage formed in the glass vial (OzoneDTA; Fig. 5) stimulates bleeding. – Plasma (A-PRF™, PRGF®, etc.): In the author’s practice, inserting a plasma membrane (PRGF® or Choukroun A-PRF™; Fig. 6) gained from the patient’s own blood has proven to be effective. The blood is freshly ex- tracted from the patient’s vein, centrifuged for around eight minutes and then activated (PRGF®). After 15 to 30 minutes, the membrane is ready for insertion. The plasma membrane technology is 100 per cent autolo- gous and therefore completely biocompatible. Combined with ozone therapy, plasma membrane in- sertion is a key part of all surgical procedures in our prac- tice and is used after tooth extraction, in implants, for bone formation and as an insert following NICO removal. When using endogenic membranes, the regeneration of bone- and soft-tissue is phenomenal. The whole protocol should be followed before and after every tooth extraction and must be followed for every sur- gical procedure on the bone. Thanks to this procedure, dry alveoli belong to the past. Conditions for ideal bone healing: Neural therapy and infusions – The bone must be hard. There must be no “yellow bone”. The blood must be clear (no drops of grease or “foamy” blood). – In addition to implant drilling, piezosurgery has proven to be successful in order to remove diseased bone. Osteolysis frequently affects the N. alveolaris inferior or the upper jaw up to the sinuses—the piezoelectric To further support the body’s own regeneration, the alveolus is rinsed with procaine after disinfection and then infiltrated with Traumeel in the vestibulum. Procaine is an anti-inflammatory local anaesthetic that stimulates blood circulation at the site. This ensures clean bleeding following the vasoconstringent of the anaesthetic. Fur- Fig. 4 Fig. 5 Fig. 6 Fig. 4: Ozone application. Fig. 5: Ozone generator OzoneDTA. Fig. 6: A-PRF™ plasma membrane. implants 1 2017 19