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ePaper created 2018-04-10, 12:30:21 | version 1.38.0
Fig. 4 Fig. 6 Fig. 5 Fig. 7 Fig. 8 Fig. 9 Case 1 – Fig. 4: Radiograph showing situation before operation. Remaining teeth were periodontally compromised (teeth #35 and #37). Fig. 5: Radiograph showing in situ situation after flapless surgery had been performed. Seven implants were placed in the mandible. Fig. 6: Different link systems of implants were compared: using silicone (left) and patera (right). Fig. 7: Toronto bridge construction. Implant bridge was fixed with screws on the model. Fig. 8: Panoramic radiograph showing the new bridge. Fig. 9: Result. tapered to ensure retention of the crown by using provi- sional cement. Materials and methods Scanning electron microscopy (SEM) investigations were done beforehand in order to evaluate the quality of the implant surfaces. An additional elemental analysis (energy-dispersive spectroscopy—EDS) was performed in order to determine whether prominent contaminations were present on the implant surfaces (Figs. 1–3). Case reports Four patients were treated with a new implant sys- tem (T.A.G. Dental). Two cases will be reported here in detail (Figs. 4–16). In total, 24 T.A.G. implants were inserted in four patients (maxilla and mandible). Ana- tomical conditions were evaluated by panoramic ra- diography in order to provide good information about the jaw size, bone volume and occlusal relationships. In none of the patients was augmentation necessary. The patients were advised to quit or reduce smoking at least two weeks before implant surgery in order to allow for recovery of normal blood viscosity, because smoking is a major reason for loss of dental implants. Periodontal HELBO therapy was performed in order to remove biofilm. Case 1 The first case was a male patient, 57 years of age and a heavy smoker (40 cigarettes per day) who reported hav- ing a great deal of stress at work. Seven implants were in- serted into the mandible (two implants of 10.0 × 3.75 mm; five implants of 10 × 13 mm) with prior consensus of the patient that one implant would be removed later for his- tological analysis (Figs. 17 & 18). Case 2 The second patient, also male, 37 years of age and a heavy smoker (25 cigarettes per day), presented with un- salvageable dentition. Eight implants were inserted in the mandible (six implants of 13.0 × 3.75 mm; two implants of 10.0 × 4.2 mm). 12 1 2018