Scientifica implantology

Numeri Uno, 4: 6-8, 2009

EARLY LOADING OF DENTAL IMPLANTS SUPPORTING A FIXED PROSTHESIS IN THE POSTERIOR EDENTULOUS MANDIBLE

The case report aims at presenting the clinical results relating to early loading after six weeks of the implant intended to support implant prosthetic rehabilitation in the posterior edentulous mandible. The implants were placed in sites 45-46 and loaded early with signifi cant psychological and functional benefi ts for the patient. This method undoubtedly offers advantages to the doctor by reducing treatment times and discomfort to the patients, thanks to the help of laser therapy, and also advantages to the same patient by reducing psychological and functional discomfort related to being partially edentulous.
The smaller number of failures and stability of the hard and soft tissues around the implant lead to the assumption that this new concept is successful for treatments on the lower jaw.

International Journal of Periodontics & Restorative Dentistry, 30:639-645, 2010.

The extremely wide use of implants leads to more frequent complications and failures. General research and the numerous contributions made by Professor Covani’s research team have highlighted the excellent prognosis of immediate implants and their immediate prosthetization. Therefore, it was obvious that Professor Covani’s team should examine the theme of immediate replacement of the implant, when they meet complications that otherwise could not be treated. This subject has already been dealt with by the author and today, with this new publication, paves the way not only for immediate replacement, but also for immediate prosthetization. Pending large-scale studies, the authors present the case report of a 58 year-old non-smoking male, who had an implant that is no longer osseointegrated due to an infection. Since the patient refused to use a removable provisional prosthesis, the possibility to apply an immediate loading protocol was considered. The implant failed and it was carefully removed. The post-extraction socket was curetted to completely remove any trace of remaining granulation tissue. The prosthetic treatment then began with the patient still under local anaesthetic. By taking advantage of the great initial stability of a Premium implant (Sweden & Martina), excellent results were obtained in
both functional and aesthetic terms. This protocol – which does not require the element to be placed in occlusion in order to minimise the masticatory load until healing – allowed a perfect modelling of the tissues around the implant and a full recovery of the damaged site.

Numeri Uno, 7: 11-13, 2010

CLINICAL SOLUTIONS AND TECHNIQUES FOR CREATING A PROVISIONAL FULL-ARCH ON IMPLANTS WITH IMMEDIATE FUNCTION

Research and clinical experience accumulated over the last decades on prosthetic implants has shown an evolution in the rehabilitative methods of edentulous jaws. Two important results were obtained: an increase of the predictability of the treatments and a reduction in the operating times. Currently, the comparison of the cumulative success rate (CSR) between the traditional protocol and full-arch immediate loading does not show any statistically signifi cant differences, highlighting the predictability of the immediate technique.
With regard to this topic, the creation of a temporary prosthesis in resin equipped with a precise and passive metallic framework seems to be a necessary condition for an implant to be successful. An unsuccessful implant is strongly correlated to the creation of prostheses without a metallic framework, which shows that it is necessary to minimise the deformations of the prosthesis aid in order to prevent harmful and traumatic stress to the fi xtures.
There is much evidence in literature that the precision of the prosthesis is strongly infl uenced by the transferring of data in the laboratory. To remedy this problem, various authors have proposed techniques for transferring the position of the fi xtures onto a master model.
These systematically provide good precision to the detriment of diffi cult protocols and, at times, dependent operators. In our case, the metallic framework is created by means of a protocol that does not require the taking of imprints, thus eliminating one of the most delicate and important steps for the precision and passivation of the fi nal prosthesis. This clinical case describes the creation of an immediate temporary prosthesis with satisfying features in terms of resistance, passivation and accuracy in shorter execution times (within 8 hours). During the clinical phases, the procedures of preparing the metallic framework and its cementing on prosthetic posts are simple and can be carried out with materials easily available on the market.
Radiographic controls show the correct coupling between the mechanical portions splinted between themselves, unlike the cases resolved with the use of single-casting where the most distal elements are often positioned.

Numeri Uno, 7: 17-18, 2010

IMMEDIATE TEMPORARY CROWNS ON GLOBAL IMPLANTS (CLINICAL METHOD)

As part of a series of in-depth studies on prosthetic protocols, two clinical cases are presented that use the mounter from the Global implant line as a temporary abutment to make the  immediate temporary crowns, with signifi cant time and cost saving. The Global implant system is a screw fi xture with conical
body and double octagonal internal connection. The outstanding precision of the abutment and the special patented connection make it an excellent implant for single-tooth replacement. An important feature is that this implant is positioned in the surgical site with a mounter that, if left connected to the actual fi xture, acts as a provisional abutment: it is suffi cient to place it on top of a special dedicated cap in resin and take an impression with traditional materials for obtaining a temporary prosthesis to be
cemented. The immediate temporary prosthesis was  manufactured by following the characteristics of resistance, passivation and accuracy with reduced execution times (within 4 hours). The double octagonal connection revealed to be extremely retentive and no disconnection between the implant and abutment was verifi ed in 300 of the cases treated over a period of 36 months. The final crowns in metal-ceramic or in zirconium-ceramic were cemented with hardening auto/photo composite cement.

TeamWork, 11(6), 63:75, 2009

SOFTWARE-ASSISTED SURGERY WITH THE GUIDE MODEL TECHNIQUE: 3D PROJECT ? PLACING OF THE GUIDED IMPLANT

The use of software for assisted surgery allows the three-dimensional diagnosis of the bone volumes and correct planning of the implant insertion, taking full advantage of the anatomy of the existing bone. This case includes the insertion of highly angled implants on which was constructed a Toronto screwed prosthesis using PAD abutments.

TeamWork, 11(6), 63:75, 2009

SOFTWARE-ASSISTED SURGERY WITH THE GUIDE MODEL TECHNIQUE: 3D PROJECT ? PLACING OF THE GUIDED IMPLANT

The use of software for assisted surgery allows the three-dimensional diagnosis of the bone volumes and correct planning of the implant insertion, taking full advantage of the anatomy of the existing bone. This case includes the insertion of highly angled implants on which was constructed a Toronto screwed prosthesis using PAD abutments.

Numeri Uno, 6, 04-05, 2009

ZIRCONIUM PROSTHESIS ON IMPLANTS AND NATURAL ELEMENTS

The implementation of the Echo prosthetic protocol allowed obtaining an entire meso-structure in zirconium with excellent functional and aesthetic characteristics; the structure is also suitable for maintaining the morphostructural integrity of the remaining teeth.

Numeri Uno, 6, 04-05, 2009

ZIRCONIUM PROSTHESIS ON IMPLANTS AND NATURAL ELEMENTS

The implementation of the Echo prosthetic protocol allowed obtaining an entire meso-structure in zirconium with excellent functional and aesthetic characteristics; the structure is also suitable for maintaining the morphostructural integrity of the remaining teeth.

Numeri Uno, 8, 04-05, 2009

IMPLANT-PROSTHETIC REHABILITATION OF THE TWO ARCHES WITH IMMEDIATE LOADING: WORK PROTOCOL WITH THE USE OF THE SINGLE-MODEL AND P.A.D. SYSTEMATICS

In this clinical case, the single-model technique allowed rehabilitating the patient with one surgery and a minimal number of sessions for fi nalising the screwed prosthesis, obtained with the CAD-CAM Echo protocol on Kohno implants.

Numeri Uno, 8, 04-05, 2009

IMPLANT-PROSTHETIC REHABILITATION OF THE TWO ARCHES WITH IMMEDIATE LOADING: WORK PROTOCOL WITH THE USE OF THE SINGLE-MODEL AND P.A.D. SYSTEMATICS

In this clinical case, the single-model technique allowed rehabilitating the patient with one surgery and a minimal number of sessions for fi nalising the screwed prosthesis, obtained with the CAD-CAM Echo protocol on Kohno implants.