Scientifica implantology

Numeri Uno 22; 2015, 14-15

Numeri Uno 22; 2015, 10-11

Numeri Uno 22; 2015, 7-10

Numeri Uno, 07; 2016, 8-9

Numeri Uno, 07; 2016, 6-7

Numeri Uno 22; 2015, 29-31

REHABILITATION OF A SINGLE ELEMENT IN AN AREA OF HIGH AESTHETIC VALUE WITH SEVERE PERIODONTAL IMPAIRMENT

International Journal of Oral and Maxillofacial Implants, 2011 May-Jun;26(3):618-30

The authors examined the immunohistochemical relationship between the quality of the receiving bone and peri-implant bone reabsorption at 36 months in sites treated with standard protocol versus switching platform protocol. An individual tendency for reabsorption was observed. The individual bone structure and quality at a local level seemed to be correlated to the level of reabsorption, which was also influenced by the presence of biglycans and the tumour necrosis factor-alpha.

NumeriUno, 1: 6-7, 2008

PLATFORM SWITCHING AND IMMEDIATE SINGLE TOOTH LOADING IN THE AESTHETIC ZONE

Today’s aesthetic requirements force dentists to use immediate rehabilitation procedures in cases of tooth extraction in the front-upper sectors. In these cases, implant treatment is now a valid alternative to traditional fi xed prosthesis because it does not require the preparation of the teeth next to the edentulous site, therefore resulting in greater preservation. Furthermore, immediate loading protocols have contradicted the Brånemark dogma, which requires a 6-month submerged healing period for
implants inserted in type D3 or D4 bone (upper front sectors). Numerous studies have shown that immediate loading has a long-term effi cacy in single-tooth replacement, which forms the basis of the clinical case presented in this article. The report illustrates the implant therapy of a vertical fracture with traumatic aetiology of an element at the same time as the micro-invasive extraction of the tooth, performed by trying to protect the vestibular cortex as much as possible and the mesial and distal bone peaks. For a better aesthetic result, the implant tunnel for inserting the Ø 5.50 mm and 1.13 mm Global prosthesis was prepared, sinking it 3 mm into the basal bone with a torque of 42 Ncm and fi lling the jumping distance with bovine bone matrix mixed with collagen. The alternate use of drills and osteotomes allowed maintaining the vestibular lump preventing the creation of fenestrations or bone defects.
Within 24 hours, a prosthetization was performed with a provisional crown with direct technique using the Platform Switching restoration concept, screwing a fi nal post with a diameter of 3.8 mm to the implant. The patient was re-evaluated after 12 months to check the healing state of the soft tissues and the bone. Clinical and radiographic controls showed no evidence of gingival recession or aesthetic difficulties. The height of the papillae and of the vestibular and oral gingival margin remained constant. Instead, there was an increase in the distal papillae between the mounting of the final prosthesis and the 12-month follow up. The periodontal parameters showed that there was no bleeding on probing and the probing was always below 3 mm. The radiography showed minimal bone reabsorption even
after the 12-month follow up. The ZirTi surface along the entire length of the implant and the coronal micro-grooving seemed to affect the bone maintenance. Therefore, the aesthetic result was as expected and remained constant over time. The elementary surgical and prosthetic technique made it easy to reproduce the method. The micromechanical qualities (ZirTi surface) and the macromechanical qualities of the Global implant make it resistant to micro-movements, which are detrimental for the long-term stability of the bone-implant interface, making it possible to load the fi nal prosthesis after 2 months of insertion. The early interception of the fracture, the presence of a thick gingival biotype, the morphology of the implant platform, the use of the platform-switching concept and the use of a fi nal abutment on the fi rst day of loading are all extremely important conditions for maintaining the bone and gingival architecture in the long term and, consequently, the aesthetics.

Italian Dental Journal, 4: 16, 2010

CLINICAL CASE: AGENESIS OF UPPER RIGHT LATERAL INCISOR

Unlike oligodontia and hypodontia, which are rare, usually related to serious genetic pathologies, single agenesis (i.e. no mono or bilateral dental morphology) is frequent, and has increased exponentially over the last 50 years, connected most likely to the adaptive phenomena of human species. The teeth most frequently affected by this agenetic condition are the upper lateral incisors, therefore, the clinical case studied by Dr Canullo is very important because it can form a valid reference for dentists who have to deal with the diffi cult prosthetic rehabilitation of these patients. In particular, the report briefly illustrates the immediate provisional technique of one abutment - one time and the roll-fl ap technique of treating soft tissues. This clinical case, supports, with results at 2 years, the validity of platform switching, even in the presence of a slight mismatching such as the one between the 4.3 mm platform of a Kohno implant (diameter of 3.80) and the relative abutment of 3.8 mm, and also clarifies the  aesthetic benefi ts of less bone reabsorption around the implant.

Numeri Uno 2014; 01: 20-21

BONE AND GINGIVA REGENERATION WITH IMMEDIATE POST-EXTRACTION IMPLANTS

The perception of success in implantology does not necessarily coincide with the technical concepts involved, but sometimes this must be combined with the expectations and desires of patient.
The case presented here is of a patient seeking implant rehabilitation of her lower frontal sector, although her greatest anxiety was to avoid repeating the experience of a number of implants she had been fitted with many years before, and which, although still satisfactorily functional, had become aesthetically unsightly due to the exposure of metal at the gingival margins.
Given that case presented significant recession at the level of the canines, the professional challenge – apart from the obvious need for functionality – centred on successfully achieving a uniform emergence profile in the forthcoming restoration supported by implants.
The teeth were extracted and the extraction sites and bone defects caused by the infective pathology were meticulously curetted.
Three Sweden & Martina Outlink2 implants with external connections were fitted, with lengths 13 mm and diameter 4.10 mm.
The discrepancies between the implants and sockets and the concomitant bone defects were filled with an insert of a particulate alloplastic material, and the area was covered with resorbable collagen membranes. Similarly, the area of gingival recession was compensated for with a dermal matrix that was sutured together with the membrane and the coronally repositioned flap.
After waiting 3 months to achieve an acceptable maturation of the tissues, a screw-retained ceramic prosthesis was fitted, with gingival emergence profiles that – fortunately – the patient approved.