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. Keywords: Immediate implant placement, immediate reconstruction, sinus grafting, dental implant

Implant-supported dental restoration are considered nowadays as a reliable treatment option to restore function, esthetics and phonetics of missing teeth. Especially with patients having excessive jaw atrophy, bone augmentation will hinder further bone resorption and complications such as jaw fractures. Prefabricated conical abutments are considered an adequate and affordable attachment type, in addition to Ball-and-Socket, bar, and conventional telescopic attachments. This case report shows the clinical and laboratory process of producing an Implant-supported denture supported with prefabricated abutments. Keywords: Implant, Ankylos, edentulous jaw

Until yet in implantology 3D-CT data or -DVT data were used for implant planning. In dependence of the quality of the scans only a maximal accuracy between 1-2 mm is possible. Especially in the molar region the deviation of the real situation is possible caused on the deformation by moving the mandible. Another disadvantage is that for the correct positioning of the implants a CAD/CAM splint has to be produced. Therefore it was the goal of the study to test a new navigation system called PILOT MDS, based on 3D ultrasound. Keywords: 3D ultrasound implant placement

This article describes a case where an implant osseointegrated for more than 10 years was integrated into a new telescopic coverdenture. This straightforward type of prosthetic restoration takes into account the elderly female patient's reduced ability to adapt to and place the denture. Particular attention was paid to enhancing muscular stabilisation by designing the subtotal denture functionally according to the All-Oral procedure. Keywords: Gerontoprosthetics, hybrid-prosthetics, muscular stabilisation of the denture, resilience telescopes

The rehabilitation in the posterior region is one of the more difficult implant planning situations because of many factors to consider such as the residuale bone and soft tissue. The aim of this case report is to present a functional rehabilitation in the posterior region. Keywords: dental implant, posterior, smoker, risk patient

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. Keywords: 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. Keywords: immediate, implantation, fracture, root

Case presentation: Impact of implnat position and emergence profile on aesthetic outcome in implant treatment using guided surgery and customized abutments. Keywords: emergence profile, implant position, guided surgery, customized 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. Keywords: immediate loading, short implants, intraoral welding, dental implants, digital planning, low torque