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Dental Tribune Middle East & Africa Edition | 1/2018 ◊Page D2 non-resorbable titanium screws in favour to resorbable screws out of poly (D,L-lactide) acid, was support- ed by the findings of a systematic review of the Cochrane Collabora- tion.6 Thus, resorbable screws seem to have a high susceptibility for frac- ture during fixation of onlay grafts. As the combination of autogenous grafts with guided bone regenera- tion (GBR) is apparently associated with superior outcomes, we decided to use a barrier membrane.9 With the additional application of a PRGF membrane, we aimed to utilise the beneficial effects of platelet-derived IMPLANT TRIBUNE rich plasma for an advanced wound therapy, and the reduced risk of post-operative infection.10 The ves- tibuloplasty with the Edlan-Mejchar method was performed for two pur- poses. Firstly it was done in order to create a sufficient amount of kerati- nised mucosa. According to findings of a systematic review, published by Lin et al., a lack of keratinised mucosa around implants fosters plaque ac- cumulation, inflammation, and soft- tissue recession.11 Secondly we aimed to create enough space for the final overdenture. Fig. 18: Facial view of the bar construction and PS TiBA abutments. Fig. 19: Oral view of the bar. Fig. 20: After an additional healing period of one month after muco-gingival surgery, the bar was inserted. Fig. 21: Final prosthetic restauration of the upper and lower jaw. D3 Conclusion The staged approach with the use of an autogenous bone graft, harvested from the surgical site in the anterior mandible, resulted in a significant horizontal bone gain, and took to a good osseointegration of both, au- tograft and implants. Obviously, the described grafting procedure has not been previously reported in litera- ture. Despite the lack of any experi- ence reports, our method revealed nonetheless a successful rehabili- tation with an implantsupported, screw-retained prosthetic rehabilita- tion, and is still in function without any biological or technical problems after a three-year follow up. Special thanks to Dr Pantelis Petraka- kis. Editorial note: A list of references is available from the publisher. The ar- ticle was originally published in CAD/ CAM Magazine 4/2016, Dr Marko Nikolic Artdental Clinic Tometici 1d Kastav, Croatia Tel.: +385 51 582888 info@artdental.hr Simplicity without compromise with the Astra Tech Implant System® EV from Dentsply Sirona Implants OsseoSpeed® Profile implants Almost 40% of all implant sites pre- sent with a sloped alveolar ridge after healing. The Os- seoSpeed Profile EV implant (Astra Tech Implant Sys- tem) is a uniquely shaped, patented implant specifi- cally designed for just this clinical situation. It is de- signed to follow the natural shape of the bone, supporting the soft tis- sue by preserving marginal bone 360 degrees around the implant. In addition, it can help to eliminate the need for bone augmentation proce- dures; 58% of all sloped implant sites have a reduced need for augmenta- By Dentsply Sirona Implants crown-down Dentsply Sirona Implants presents the next step in the continuous evolution of the Astra Tech Implant System®. The Astra Tech Implant System EV® is designed with a site- specific, approach based on the natural dentition for increased surgical simplicity and flexibility and restorative ease — without compromising the unique Astra Tech Implant System BioMan- agement Complex®. The main objective of the new sys- tem is to further improve system log- ic, robustness and user friendliness, and simplicity without compromise has permeated the evolution of the Astra Tech Implant System EV. The new system is also the result of col- laborative input and insights from dental professionals throughout the global dental industry. “When we develop new implant therapy solutions, it is important that they meet actual clinical needs. With our solutions, clinicians are able to solve these various challenges and, as a result, they can deliver long- term function and aesthetics to their patients. Our focus is to deliver safe, well-documented solutions and the best service to our customers,” says Björn Delin, DDS, and Vice President Global Platform Implant Systems at Dentsply Sirona Implants. The foundation of this evolution- ary step is the unique Astra Tech Implant System BioManagement Fig 1: Astra Tech Implant System BioManagement Complex Complex®, well documented for its long-term marginal bone mainte- nance and aesthetic results provided by the combination of four key fea- tures: the OsseoSpeed surface, Mi- croThread, Conical Seal Design and Connective Contour. Astra Tech Implant System® EV highlights: • Versatile implant assortment • Flexible drilling protocol that al- lows for preferred primary stability • User-friendly surgical tray with three interchangeable overlay op- tions • Colour-coded assortment • Unique interface with one-posi- tion-only placement of Atlantis pa- tient-specific abutments • Self-guiding impression compo- nents • One system—one torque tion when using the OsseoSpeed Pro- file implant. OsseoSpeed Profile EV is the second generation of the uniquely shaped, patented implant specifically de- signed for sloped ridge situations that was first introduced in 2011. The implant is now upgraded with the simplicity and design principles of the Astra Tech Implant System® EV. Newly published results on Osse- oSpeed Profile implants show bone preservation, increased soft tissue volume and regain of keratinized mucosa in patients with compro- mised soft tissue conditions. PD Dr. Robert Nölken, co-author of the study, explains “We have seen a great deal of improvement on the peri- implant soft tissue in our research follow-up. This allows us to achieve a good aesthetic outcome for patients with thin biotypes.” This prospective, 2-year follow-up, multicenter study— investigated OsseoSpeed Profile EV implant survival rate, soft and hard tissue maintenance following placement in healed sites of the posterior man- dible. Twenty-four centers, 184 pa- tients and 238 implants were includ- ed in the study that showed >99% overall survival rate and an average bone level reduction of 0.3 mm.1 The SmartFix® concept SmartFix® is a treatment concept that can provide edentulous patients with an immediate fixed, full-arch prosthesis, supported by only four implants. The SmartFix® concept includes an angulated abutment that comes together with a short and flexible abutment holder for easier handling. The option of angulating the screw access channel through the prosthesis opens up for ideal aes- thetics and function. This concept is an easy and cost- effective treatment that offers im- proved treatment satisfaction for the patient and practice growth for the dental professional. SmartFix® is available for the Astra Tech Implant System® EV, including OsseoSpeed Profile EV. References 1 Schiegnitz E, Noelken R, Moergel M, Berres M, Wagner W. Survival and tissue maintenance of an implant with a sloped configurated shoulder in the posterior mandible-a prospec- tive multicenter study. Clin Oral Implants Res 2016;E-pub May 13, doi:10.1111/clr.12869. For more information and highlights of the new Astra Tech Implant Sys- tem® EV, please visit www.dentsply- implants.com