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ePaper created 2018-04-10, 12:30:21 | version 1.38.0
| case report Surgical technique Implant placement was performed under local anaes- thesia (40 mg of Dexa-ratiopharm, intramuscular, ratio- pharm) after premedication with antibiotics. The bone cavity was extended gradually according to the intended implant diameter. After incision making, cleaning of the oral cavity was carried out and necrotic or inflammatory tissue removed. Osteotomy sites were prepared with a sequential order of drills recommended by the manufac- turer. Implants were inserted in the prepared osteotomy sites with an insertion torque of 45 Ncm. An adequate primary stability having been obtained, PGA RESORBA (RESORBA) was used for suturing. Postoperative treatment Postoperative intraoral periapical radiographs were taken and confirmed the accuracy of the implant place- ment. Postoperative medications included antibiotics. Digital radiographic images were taken at the time of sur- gery, after 24 hours and one month later in order to evalu- ate implant success. Inflammatory processes were found in none of the patients, and all of the implants have re- mained stable until now. Abstention from smoking should be extended to at least eight weeks after the implantation in order to permit the healing phase of the osteoblasts to take place. Discussion Today, immediate implant concepts are gaining in- creasing popularity for replacing missing teeth. For den- tal implants placed at the time of extraction, high success rates have been reported. Depending on the patients’ situation, immediately placed and immediately loaded Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Case 2 – Fig. 10: Unsalvageable dentition before operation. All of the teeth had to be extracted. Fig. 11: Panoramic radiograph of the pre-op situation. Fig. 12: Flapless surgery. Fig. 13: Extraction of tooth #22. Good condition of the peri-implant gingiva. Fig. 14: Replica with Impregum (3M ESPE). Fig. 15: Radiograph of implants. Fig. 16: Final result. 14 1 2018