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ePaper created 2017-12-06, 11:14:19 | version 1.38.0
| case report Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 22 Fig. 18: Condition after exposure and prior to dental impression. Fig. 19: To try the definite abutment on, the composite residues were removed from the adjacent teeth. Fig. 20: The abutment was fixed tightly using a new screw according to the manufacturer’s instructions. A new silicone impression was made in filament technique. This impression serves to manufacture the crown with the newly defined contact points to the adjacent teeth. Fig. 21: Buccal view. Fig. 22: Condition right after placement of crown. ably less predictable.14 High biological and technical complication rates had to be expected. Consequently, reliable concepts were required and developed to create optimal initial conditions. Ridge-preserving measures involving different approaches and com- binations were developed. Among others, inserting thick free mucosa grafts into the coronal part of the alveolar extraction site, thickening the soft tissue on the buccal side of the al- veolar extraction site using connective tissue grafts, filling the alveolar extraction site using bone or bone replacement material, and the application of the GBR method are described measures.15 Regarding the filler techniques, Fickl’s workgroup was able to show, when comparing the different methods, that none of the examined techniques prevented the resorption of the buccal bone lamella and the formation of tissue de- fects.16 Likewise, one cannot achieve the complete compensation of the defect formation by means of closing the alveolar extraction site with a free mucosa graft.16, 17 That is why many new concepts in implan- tology still engage in the principle of tissue recon- struction after tissue loss. There is one thing, however, all the described meth- ods, whether mere tissue reconstruction through augmentation or ridge-preserving measures, have in common: The intervention takes place always when tooth was extracted completely. The tissue master concept pursues a whole new approach. Because of the crown replanting, the extraction is incomplete and thus the alveolar fibre structure and periodontal ligament are preserved. The initial resorption pro- cesses do not seem to take place and healing pro- cesses proceed, preserving the alveolar volume al- most completely.9 Other convincing aspects in this regard are the reduced number of surgical interven- tions, the abstinence from bone replacement mate- rial, the shorter treatment time, and the altogether better patient comfort. Conclusion This case report reveals that the intervention im- plementing ridge-preserving measures before the tooth is fully extracted should be taken into consider- ation. This biological approach represents the primary prevention of resorption processes and thus faci- litates the abstinence from time-consuming and cost-intensive augmentation measures._ contact Dr Umut Baysal Dr Arzu Tuna Große Brinkgasse 29 50672 Cologne, Germany u.baysal@me.com www.myveneers.de Author details Author details Literature 16 implants 3 2017