Scientifica implantology

Journal of Oral Implantology 2014;40:313-319

Implant peri-apical lesion (IPL) is a periapical lesion, usually asymptomatic, in which the coronal portion of the implant achieves a normal bone to implant interface. A case of IPL following immediate implant placement and treated with guided bone regeneration (GBR) principles is described. Five-year clinical and radiographic follow-up with cone-beam assessment showed complete healing of the bone. GBR principles applied to IPL could completely solve the lesion.

Numeri Uno, 19: 12-14, 2014

IMPLANT TREATMENT FOR THIN CRESTS: SPLIT-CREST OR GBR?

Introduction: Surgical treatment on thin alveolar crests for implants has always been a difficult task, even for the most experienced implantologists. The many surgical techniques suggested in literature may confuse clinicians to a certain degree in the choice of the correct surgical technique to be used.
The main surgical techniques found in literature can essentially be divided into two basic groups:

• Split-crest techniques, which aim to divide the thin crest present into two parts to be opened out, thus creating an intraosseous bone defect delimited by the two split cortices.
• Regenerative techniques, which leave the residual thin crest intact and increase the thickness of the crest with the application of a block or particulate graft, protected by a membrane or a titanium mesh.

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

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

Implantologia, 1: 51-59, 2009

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.

Numeri Uno 2014; 01:6-9

RELIABLE IMPRESSION TECHNIQUES: TWO PROPOSALS FOR THE SAME OBJECTIVE

A patient of 45 years, with no medical history of interest, with a totally edentulous mandible. After the clinical and radiographic study, it was decided to plan the insertion of 6 lower implants and the fitting of an temporary immediate screw-retained prosthesis.
After the standard surgical procedure, which consisted in the insertion of 6 Sweden & Martina Premium implants, 3.8 mm x 13 mm, the transgingival healing posts were positioned, with sutures around them. The transgingival posts were later replaced with PEEK transfers, which were then stabilized with a photopolymerizing resin (Conlight, Kuss Dental, Madrid, Spain). The models made previously were subsequently modified to allow them to enclose the fixed structure obtained, then taking an occlusion impression that would give the laboratory technician information on occlusion before the operation. The interior of the model was filled with a polymer (Impregum, 3M ESPE, Seefeld, Germany) and a closed-mouth impression was taken, positioning a material for registration on the occlusal faces of the teeth (Occlufast, Zhermack, Italy). After the polymerization time (3 minutes), the impression was removed and sent to the laboratory to allow the temporary prosthesis to be made.
Three months later, final rehabilitation was commenced, envisaging a hybrid screw-retained CAD/CAM prosthesis with a titanium structure.
The final impression was made using transfers with an open tray fixed with a 1.5 mm titanium bar. This procedure was completed using the Dent Weld intraoral welding machine. This device has a handpiece with forceps that transmits energy capable of generating the heat necessary to melt titanium.
Before starting the protocol, an OptraGate retractor (Ivoclar Vivadent, Schaan, Liechtenstein) was used to facilitate the opening of the patient’s mouth and improve access to the transfers. The Dent Weld device was then configured with the Single programme with a selected power value (54% at 162 joules for a titanium bar thickness 1.5 mm), and the electrodes were connected to the two transfers. The bar was cut with a diamond milling blade at right angles and irrigation, and the procedure continued on the subsequent transfer with a new welding bar. In this way it was possible to avoid the “memory effect” of the titanium bar, which could produce a distortion of the assembled transfers on detachment of the impression.
After all the transfers had been fixed two-by-two, the correct positioning of the custom-made tray was verified. The impression was then taken with the closed-tray technique, using a double mixture of light and heavy silicone (Virtual, Ivoclar, Schaan, Liechtenstein).

Numeri Uno 2014;18:12-14

CHAIRSIDE ELECTRICALLY-WELDED CONOMETRIC IMPLANTOPROSTHESIS WITH IMMEDIATE LOADING ? A CLINICAL CASE

The patient presented with the need to rehabilitate third quadrant in the region of elements 35 and 36, following the avulsion of element 36, seriously compromised. At the patient’s request, we did not proceed with the immediate post-extraction insertion of the implants, but opted instead for deferred insertion. Four 4 months after extraction we therefore used the flapless technique to insert two Shelta implants (Sweden & Martina), respectively of diameter 3.80 mm and length 11.5 mm at position 35 and diameter 4.25 mm and length 11.5 mm at position 36. On both implants an insertion torque of 65 Ncm was used. Two final conical posts with reduced diameter were positioned on the implants, for use with the conometric prosthetic system (Sweden & Martina). In the same surgical phase the preformed conometric caps were positioned (Sweden & Martina). The caps were fixed by intraoral welding (Dent Weld, Sweden & Martina), using a titanium bar with diameter 1.5 mm. The result was an extremely precise removable prosthesis that allowed us to make a temporary prosthesis for immediate loading.
The welded caps were removed to check their passivity and to verify that they could be incorporated into the prefabricated temporary prosthesis. After the electrically-welded structure was repositioned on the posts, the temporary prosthesis was directly relined, so as to be able to incorporate the structure itself to obtain a reinforced removable prosthesis that would also have the advantage of stabilizing the implants.
Conclusions: The case presented shows that with this technique an implantoprosthesis for immediate loading that respects the concepts of platform switching can be made quickly and easily, positioning the final post that will remain in place in the surgical phase, thanks to the availability of posts with different transgingival heights. The use of prefabricated conometric caps allows a very high level of precision to be obtained, and fixing with electric welding makes it possible to stabilize the inserted implants and to proceed with the chairside construction of a temporary prosthesis that is not only extremely resistant, but that can also be easily removed by the dentist at any time. The standardization of the method and its adaptability to the various Sweden & Martina implant systems the reasons for its ease of use and consequent inexpensiveness.

Numeri Uno 2014;18:12-14

CHAIRSIDE ELECTRICALLY-WELDED CONOMETRIC IMPLANTOPROSTHESIS WITH IMMEDIATE LOADING ? A CLINICAL CASE

The patient presented with the need to rehabilitate third quadrant in the region of elements 35 and 36, following the avulsion of element 36, seriously compromised. At the patient’s request, we did not proceed with the immediate post-extraction insertion of the implants, but opted instead for deferred insertion. Four 4 months after extraction we therefore used the flapless technique to insert two Shelta implants (Sweden & Martina), respectively of diameter 3.80 mm and length 11.5 mm at position 35 and diameter 4.25 mm and length 11.5 mm at position 36. On both implants an insertion torque of 65 Ncm was used. Two final conical posts with reduced diameter were positioned on the implants, for use with the conometric prosthetic system (Sweden & Martina). In the same surgical phase the preformed conometric caps were positioned (Sweden & Martina). The caps were fixed by intraoral welding (Dent Weld, Sweden & Martina), using a titanium bar with diameter 1.5 mm. The result was an extremely precise removable prosthesis that allowed us to make a temporary prosthesis for immediate loading.
The welded caps were removed to check their passivity and to verify that they could be incorporated into the prefabricated temporary prosthesis. After the electrically-welded structure was repositioned on the posts, the temporary prosthesis was directly relined, so as to be able to incorporate the structure itself to obtain a reinforced removable prosthesis that would also have the advantage of stabilizing the implants.
Conclusions: The case presented shows that with this technique an implantoprosthesis for immediate loading that respects the concepts of platform switching can be made quickly and easily, positioning the final post that will remain in place in the surgical phase, thanks to the availability of posts with different transgingival heights. The use of prefabricated conometric caps allows a very high level of precision to be obtained, and fixing with electric welding makes it possible to stabilize the inserted implants and to proceed with the chairside construction of a temporary prosthesis that is not only extremely resistant, but that can also be easily removed by the dentist at any time. The standardization of the method and its adaptability to the various Sweden & Martina implant systems the reasons for its ease of use and consequent inexpensiveness.

Italian Dental Journal 2014; 29, agosto

CONOMETRIC TECHNIQUE WITH AN ELECTRICALLY WELDED TEMPORARY PROSTHESIS FOR IMMEDIATE LOADING

In both these articles, Dr. Panadero describes cases treated with a new technique of prosthetic rehabilitation, using an overdenture with a secondary structure anchored by means of horizontal insertion to a primary structure. This solution makes it possible to the recover the horizontal dimension, avoiding the need to resort to invasive reconstruction operations.