Scientifica implantology

Il Dentista Moderno, 7 (9): 121-126, 2003

POST-EXTRACTION IMPLANT WITH AUTOLOGOUS BONE GRAFT AND NON RESORBABLE MEMBRANE

Implantologia, 1: 51-59, 2009

Dental Cadmos, 10:79-85, 2002

Immediate implants are currently considered an effective therapeutic option in maxillary and/or mandibular arch rehabilitations of edentulous or partially edentulous patients. Often the bone defi cits around the implant require regenerative therapies. Barrier membranes were often used in these
procedures and in some cases were accompanied by an early exposure in the oral cavity that could explain the poor clinical results recorded as evidence. The paper describes case of an immediate implant with a vestibular bone defi cit treated with the use of an autologous grafting of plasma rich platelet.

30th Annual Congress, American Academy of Osseointegration, San Francisco, March 12-14th 2015, Poster

This seven-year study was carried out on 40 immediate post-extraction Premium implants inserted with the flapless technique in 40 patients, then subjected to immediate non-functional loading. Cumulative survival rate was 97.5% (with confidence interval from 92.7% to 100%). Crestal resorption, which was 0.4±0.5 mm at 1 year, subsequently stabilized, and was 0.6 ±0.5 mm at 7 years. The height of the buccal soft tissues and the papilla index instead showed no significant differences with time. The flapless technique in protocols with immediate implants was therefore found to be effective.

Numeri Uno, 17, 2013, 21-22

REHABILITATION WITH IMMEDIATE POST-EXTRACTION IMPLANT IN THE AESTHETIC AREA: CASE REPORT

A woman aged 44 years and a non-smoker presented with a 1.2 root fracture. This fracture was however observable by OPT X-ray and intraoral X-ray with a parallel technique, to also assess the possible of an immediate post-extraction implant.
There was no history of cardiovascular disease, diabetes, immunodeficiency, bleeding diathesis or bone metabolism disorder that could impair osseointegration or on other ways contraindicate implant insertion. Dental records showed a history of carious processes. Objective examination of the oral cavity confirmed our anamnestic suspicions and also allowed us to observe a satisfactory level of band of attached gingiva. Periodontal probes performed on clinical examination gave negative results. The root of element 1.2 was therefore extracted. Local anaesthesia was performed with plexus infiltration of articaine with adrenaline 1:100,000 (Ubistesin, 3M ESPE, USA). The tooth element was extracted as conservatively as possible, taking particular care to avoid damaging the bony alveolar walls, and in particular the vestibular cortex. A Beaver no. 64 scalpel was therefore used as a syndesmotome to dislocate the root with the aid of a surgical hammer. This ensured the integrity of the alveolar bone and its reparative capacities. During the same session, a Premium 4.25 x 11.5 implant was inserted, with dimensions suitable for the post-extraction socket, with a High Roughness Plasma Spray (HRPS) surface, an apical treatment on DES implants, by Sweden & Martina (Italy), not submerged and with a long healing screw. Given its self-tapping capacities, the implant was inserted in the socket without preliminary milling, and naturally, it was not submerged. The rough part was positioned infraosseously, leaving the smooth part of the collar exposed, respecting the biological width, to provide an attachment for connective fibres. After the implant was inserted, the residual gap of about 1.8 mm was filled with Gingistat collagen (Italy). Sutures were applied by means of interrupted stitches with subperiosteal anchorage. The implant was immediately prosthetically loaded, and follow-up was performed by means of clinical and radiographic examinations at 15, 30 and 90 days and 1 and 2 years. Clinical examination at 30 days showed good tissue healing, with the formation of an excellent emergence profile. The case was timed at 30 days, with a provisional fitting. Clinical examination at 1 year and X-ray evaluation at 2 years, which showed excellent maintenance of crestal bone levels.

Journal of Periodontology, 2014; 85:1537-48, Epub 2014 May 2

This meta-analysis found that implants inserted immediately in post-extraction sites showed less peri-implant bone resorption than implants inserted in healed sites. In addition, use of Platform Switching techniques contributes in further preserving bone levels. The findings must however be interpreted with caution, due to the high heterogeneity between studies.

Journal of Periodontology, 2014; 85:e323-332, Epub 2014 May 16

This study evaluated the maintenance of crestal bone levels, the stability of soft tissues and the subjective satisfaction of patients in 47 single rehabilitations with immediate post-extraction Premium implants in sockets subjected to a preservation technique (flapless surgery and use of bone grafts and collagen membranes). Follow-up at 5 years showed only minimum bone level changes and a gain in soft tissues. It was therefore confirmed again that this socket preservation technique is able to promote aesthetic and functional aspects of immediate post-extraction implants.

The Journal of Craniofacial Surgery, 2014; 25:796-798

Horizontal root fracture normally results in problems with adjacent tissues. This study assessed the immediate insertion of 25 Premium implants in 25 patients, after the removal of teeth affected by this pathology. At 12 months, X-rays and probes demonstrated integration without signs of infection or bleeding. Immediate post-extraction implants are a valid surgical procedure following the extraction of fractured teeth.

Numeri Uno 12 , 2012, 8-9

IMMEDIATE LOADING POST-EXTRACTION WITH SIMPLE TECHNIQUE AND PLATFORM SWITCHING

The extraction of teeth in aesthetically important areas requires the implant dentist to make a serious evaluation of the existing soft tissues. If the soft tissues (papillae, height of the gingival edge) that surround the tooth to be extracted are adequate, the simplest and most predictable method for maintaining them is certainly a post-extraction implant immediately loaded with a temporary prosthesis that adequately supports the existing gingival tissues on three dimensions. If, on the other hand, the soft tissues are insufficient, it is recommended to adopt a two-stage procedure to reconstruct and increase the bone and gingival tissues with Langer or Ice Cream techniques. In this article we deal with the first case (adequate existing soft tissues).
In choosing the most suitable materials to make a post-extraction implant with immediate loading, it appears very important to use strongly self-threading implants with large spires, able to obtain elevated primary stability even inside morphologically complex sockets. On the subject of temporary prosthetic posts, it appears fundamental to choose posts that have the first apical 2 mm (=biological width) of biocompatible material (titanium) so as to facilitate the attachment of the gingival tissues to the post,
thus preventing an anti-aesthetic apical migration of the tissues. Lastly, an implant with platform switching guarantees less reabsorption of the peri-implant bone, thus allowing the aesthetic result obtained to be maintained over time.

Numeri Uno 11, 2012, 15-17

REHABILITATION WITH FIXED PROSTHESIS WITH COMPLETE MAXILLARY AND MANDIBULAR ARCH ON POST-EXTRACTION IMPLANTS. A CASE REPORT

Immediate implants are a treatment method with a high percentage of success. Chen and coll. have examined the literature to compare the success percentages and the clinical results associated with immediate, early and deferred implants, finding that these percentages were similar in the analysed groups. Some of the advantages with respect to deferred implants are: the reduction of bone loss, the decrease of the treatment times and the absence of second operations. It was found that few studies evaluate patient satisfaction concerning the rehabilitative treatment of an edentulous arch. Moreover, there is no homogeneity in the method adopted to evaluate patient perception. Using VAS, Van Steenberghe and coll. evaluated patient satisfaction with the aesthetics, functionality, phonation and tactile sensation
at a distance of 3 months from immediate loading. There was very high satisfaction as regards aesthetics, functionality and tactile sensation; instead, about half the patients expressed only moderate satisfaction as regards phonation. These authors also recorded the doctor’s opinion regarding aesthetics and functionality,
classifying them as excellent, good, acceptable, unacceptable: 18 out of 24 found excellent functionality and 16 excellent aesthetics; only in one case was the prosthesis judged unacceptable from an aesthetic point of view, due to a marked deviation of the median line, and it was repeated.
The aim of this study was to present a case of oral rehabilitation with fixed prosthesis with complete maxillary and mandibular arch on post-extraction implants. Patient satisfaction with the temporary and final prosthesis, success and loss of marginal bone were evaluated 12 months after prosthetic loading.