International Poster Journal of Dentistry and Oral Medicine, Supplement ANKYLOS/2016

Immediate implant placement and immediate loading of single-tooth implants are reliable treatment options with high implant survival rates and good long-term results. Because of the anatomy of the roots immediate implant placement is usually performed in incisors, canines and premolars. If performed in molars the authors usually suggest to place the implant in the septa between the roots. In the majority of cases the vertical height in between the roots is insufficient for implant placement. In those cases a sinus-lift procedure after the healing of the socket is inevitable. The aim of the described workflow is to avoid a second invasive surgical intervention to place an implant together with sinus grafting procedures by immediate implant placement in the palatinal root. Parole chiave: Immediate implant placement, immediate reconstruction, sinus grafting, dental implant

Impantatgetragener Zahnersatz hat sich heutzutage als eine gute Versorgungsalternative zur Wiederherstellung von Funktion, Phonetik und Ästhetik bewährt. Insbesondere bei Patienten mit hochartrophen Kiefern wird eine weitere Knochenresorption verlangsamt und Komplikationen Vermindert, wie zum Beispiel ein Unterkieferbruch. Neben hybriden Elementen wie Druckknopfankern, Stegversorgungen und konventionellen Teleskopen stellen präfabrizierte Konusabutments eine adäquate und preisgünstige Alternative Verankerungsform dar1). Der hier vorliegende Fall zeigt den klinischen und labortechnischen Ablauf zur Anfertigung einer implantatgetragenen Totalprothese mit präfabrizierten Abutments. Parole chiave: Implantate, Ankylos, unbebezahnter Kiefer

Umsetzung der 3D-Planung eine CAD/CAM-Schiene produziert werden. Das Ziel dieser Studie war es ein neues auf Ultraschall basierendes Navigationssystem klinisch zu testen. Parole chiave: 3D-Ultraschall navigierte Implantation

Die Fallbeschreibung schildert die Einbeziehung eines seit über 10 Jahren osseointegrierten Implantats in eine Neuversorgung mit einer Teleskopierenden Totalprothese ("Cover denture"). Diese einfache Versorgungsform berücksichtigt die verminderte Adaptations- und Inkorporationsfähigkeit der betagten Patientin. Insbesondere wird die muskuläre Stabilisierung des subtotalen Zahnersatzes durch die funktionelle Ausformung nach dem All-oral Verfahren verbessert. Parole chiave: Gerontoprothetik, Hybridprothetik, Muskuläre Stabilisierung der Prothese, Resilenzteleskope

Die Rehabilitation im Seitenzahnbereich gehört zu den schwierigeren Implantatplanungen aufgrund vieler zu berücksichtigender Faktoren wie dem residualem Knochenangebot und der Weichgewebssituation. Ziel von diesem Fallbericht ist die Präsentation einer funktionellen Rehabilitation im Seitenzahnbereich. Parole chiave: Implantat, posterior, Raucher, Risikopatient

Introduction: The rehabilitation of the posterior area can be difficult, if due to inflammation a hard and soft tissue deficit exists. The aim of this case report is to present the aesthetic and functional rehabilitation of a posterior single tooth gap. Material and methods: A 25-year-old patient presented with a request of the rehabilitation of the gap in region 36 in the clinic for dental surgery and implantology. After clinical and radiographic examination, a hard and soft tissue deficit was present. The width of the keratinized, attached gingiva was reduced. There was an in-depth clinical and radiographic examination (Fig. 1-4). The view of the surgical area was realized with a crestal incision in region 36 and each mesial and distal marginal releasing incisions (Fig. 5). After marking the implant position, it was carried out to prepare the implant site with bone spreaders to avoid a lateral augmentation. It was followed by the implant bed preparation and implantation in region 36 with transgingival healing with a sulcusfomer (Ankylos C / X^®, 11mm length and 3.5mm diameter, Dentsply Implants, Germany) (Fig. 6-8). Wound healing was timely and the monofilament sutures were removed eight days later. There was a mucosal transplant from the palate to improve soft tissue 6 weeks before the start of the prosthetics. As part of the prosthetic restoration it was carried out by the fitting of hybridabutments with the inclusion of an all-ceramic crown (IPS e.max, Ivoclar Vivadent, Germany) (Fig. 10-11). Treatment outcome: The clinical and radiological outcome was stable (Fig. 11-12). The patient was very pleased with both the restoration of aesthetics and the chewing function. Conclusion: The primary stability of the implant is extremely important with a transgingival healing in terms of immediate loading. The success rate and survival rate is better for implants with good primary stability. Furthermore, the presence of a zone of keratinized soft tissue in the area of the implant is associated with a lower susceptibility to peri-implant disease. Ultimately, the close cooperation between dentist and dental technician is of utmost importance for a successful outcome. In conclusion, it can be said that the aesthetic and functional rehabilitation in the posterior region is predictable. Parole chiave: dental implant, posterior, treatment

Introduction: A twenty seven years old male patient arrived in our clinic (dental emergency) in 2009 with a root fracture in cervical part with dislocation of the tooth 21 after an injury . A CBCT (Cone Beam Computed Tomography) was performed to identify the bone formation at this region. The patient was informed on different treatment options. As example orthodontic extrusion, Maryland bridge, surgical crown lengthening and immediate implantation. He chose an immediate implant insertion. Schulte und d'Hoedt described in 1974 immediate implantation with Tubingen Implants in the upper jaw. Later 1977 Ledermann published about immediate loading of implant in lower jaw. Treatment: Four days after the accident the immediate implant insertion took place. After the extraction with the Benex^® extraction system, implant was inserted. The implant was inserted in the right dimensional position, because that is necessary for the aesthetic outcome . The torque of the implants was about 35 Ncm, so an immediate non-occlusal loading was performed. Discussion: The functional and aesthetic treatment was made 4 month later. In this patient a thick gingival biotype, thicker than 1,5 mm ensured the stability of the tissue. This leads to a good forecast of the late aesthetic outcome. Seven years after the surgery a stable soft tissue without any inflammation and recession was present. The peri-implant gingiva was rose and healthy with a textured surface like that seen on the surface of an Orange Peel which is called as Stippled. Conclusion: There are a lot of factors which can influence the success of implantation in the aesthetic zone. High risks for aesthetic failure are patients with gummy smile and patients with thin gingiva type. Our patient had thick gingiva type and low smile line. Chen and Buser showed that immediate or early implantation with simultaneous bone augmentation is more successful than late implantation. The three-dimensional (3D) position of the osseointegrated dental implants provides favorable esthetical results and preserves the surrounding soft and hard tissues architecture. Parole chiave: immediate, implantation, fracture, root

With a during the implant surgery intraoraly manufactered "WeldOne" titaniumframework and the encoding of this framework with the neighbouring teeth it is possible, also in the aesthetic zone of the maxilla to produce the definitive customized abutments and the final ceramic bridge while the period of osseointegration. With the consideration of the well known biological width these components are already present for the second stage surgery. So the advantages of the "One Abutment at one time" concept can be perfectly used. After Insertion of the implants the passive fit framework is produced with the "WeldOne" unit. This titanium frame will be encoded with the teeth nearby by using composite. Then it will be removed and the surgery ends with suturing. With this key the technician can easily produce a plaster model and the cad/cam process to gain the individual abutments and the final bridge can be started. After the osseointegration with a covered healing period the definitive prosthetic respectiveley the abutments and the bridge is inserted during the reopening session. The abutments will never be removed. The undisturbed regeneration of the mucosa without changing of any prosthetic parts leads to a successful emergence profile and stabile resistant conditions. This treatment saves time and can avoid periimplantitis. With the knowledge of the biological width it is possible to reach a successful and durable aesthetic. The final bridge and abutments are already present before the reopening and can be inserted definitely in exact this session and do not have to be removed at any time. The perio-prosthetic area stays stabile. Parole chiave: Aesthetic, One Abutment at one time, WeldOne unit, Biological

Fallpräsentation: Einfluss von Implantatposition und Emergenzprofil auf das ästhetische Ergebnis unter Berücksichtigung von guided surgery und individuellen Abutments. Parole chiave: Emergenzprofil, Implantposition, guided surgery, individuelle Abutments

Few studies currently exist evaluating the outcome of short-length dental implants in immediate loading. When immediate loading is planned, adequate stability of implants is essential to prevent the risk of micromovements and loss of implants. The intraoral welded bar technique has been proven to offer a solution for the stabilisation of the immediately loaded implants. In this report, an immediate loading was digitally planned for the rehabilitation of a partially edentulous mandible using the Simplant^® software. Two short Ankylos implants (6.6 mm) and one long Ankylos implant (14 mm) were welded together intraorally and immediately loaded. During implant placement, final insertion torque (FIT) was digitally recorded. The welding abutments were connected, and a 2-mm diameter titanium bar was shaped and intraorally welded to the abutments using the WeldOne™ welding unit. Then the temporary prosthesis was relined and screwed into place. 4 months after the implant placement, the provisional restoration was removed and final impressions were recorded. A definitive metal-ceramic restoration was screwed on the posterior abutments and cemented on the anterior abutment. Implants presented a FIT of 18, 36, and 30 Ncm respectively, from posterior to anterior. Clinical status at 1 year after implant placement demonstrated remarkable soft tissue stability. 1-year follow-up radiograph showed stable peri-implant tissues. The absence of micromotion at the bone-implant interface is fundamental for osseointegration during the healing period. The present case report seems to suggest that intraoral welding technique can limit the micromovements of short-implants even when inserted with low torque values providing predictable osseointegration results. Parole chiave: immediate loading, short implants, intraoral welding, dental implants, digital planning, low torque