Scientifica implantology

Numeri Uno 12, 2012, 4-6

"CONSERVATIVE IMPLANTOLOGY", USE OF INTEGRAL CERAMIC IN THE COMPLETE REHABILITATION OF THE FRONT SECTOR

Numeri Uno 12, 2012, 4-6

"CONSERVATIVE IMPLANTOLOGY", USE OF INTEGRAL CERAMIC IN THE COMPLETE REHABILITATION OF THE FRONT SECTOR

Numeri Uno 12; 2012, 12-13

PROSTHETIC IMPLANT REHABILITATION WITH ONE-STAGE TECHNIQUE AND SCREWED PROSTHESIS OF COMPOSITE MATERIAL

Numeri Uno 12; 2012, 12-13

PROSTHETIC IMPLANT REHABILITATION WITH ONE-STAGE TECHNIQUE AND SCREWED PROSTHESIS OF COMPOSITE MATERIAL

Journal of Clinical Periodontology, 2011; 38: 86?94

This histological study in humans analysed the characteristics of soft tissues around the implant at 48 months, and compared implants rehabilitated with the switching platform concept to the traditional prosthetic protocol. The results showed that the switching platform protocol does not alter the soft tissues and that bone peaks are maintained.

Clinical Oral Implant Research 22, 2011; 438?444

This study demonstrated that implants restored according to the switching platform concept with mismatching of 0.25 mm maintained the same level of bone crest as traditional implants if the smooth part of the neck of traditional implants is left to emerge from the bone.

Italian Dental Journal, 2012; 08: 24

SURGICAL AND PROSTHETIC SWITCHING PLATFORM

One of the primary objectives of modern implantology is to maintain the crestal bone, so as to improve the aesthetic result and reduce the risk of late peri-implantitis. In comparison with traditionally designed implants, switching platform implants reduce early crestal bone loss in proportion to the size of the switch.
Switching platform implants are divided into two groups: implants with surgical switching (implants with a specially widened neck) and implants with prosthetic switching (implants with a standard neck with prosthetic posts having a reduced diameter). Both types of switching have proved to be effective and, in order to maximize the obtainable switch, for some years we have been using a switching platform protocol which combines the use of implants with surgical switching (Sweden & Martina Premium 3.80 SP implants) prosthesized with posts with a reduced diameter (posts for Premium 3.30). The combination of surgical and prosthetic switching has proved to be a valid and predictable protocol for minimizing crestal bone loss.
The clinical case illustrated below concerns the insertion of a single immediate post-extraction implant with immediate loading. Prosthetization was carried out according to the protocol described above.

Dental Cadmos, 77(9): 31-39, 2009

Two groups of 20 patients received single implant in an edentulous site, which was rehabilitated in a second surgical procedure with a standard abutment (control group) and with the Switching Platform technique (test group). One year after the loading of the prosthesis, the test group showed a significantly lower loss of crestal bone compared to the control group.

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.