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Implant placement post single tooth extraction in the esthetic zone is an important and frequent indication for implant therapy. Today, the clinician can choose from four different treatment approaches for the timing of implant placement. The decision for the most appropriate treatment plan should be based on a thorough clinical and radiographic examination and well-defined selection criteria. Early implant placement after soft tissue healing is one of the treatment options available. This approach is applied by our team in the case of a thin bone wall phenotype (< 1 mm) or a missing facial bone wall at the extraction site, and sufficient bone volume available in the palato-apical area to allow good primary stability of the implant. The surgical procedures include a flapless tooth extraction, a 4-to-8 week soft tissue healing period, implant placement in the correct 3-dimensional position, a simultaneous contour augmentation on the facial aspect with the GBR technique using a 2-layer composite graft with locally harvested autologous bone chips and a low-substitution bone filler, application of a double-layer collagen membrane, and a tension-free primary wound closure. Following 8 weeks of healing, the implant site is reopened with a punch technique, and the implant can be restored with a screw-retained single crown. The rationale for this surgical approach is presented including inclusion criteria, surgical procedures, case reports and long-term documentation.
Schlagwörter: Implant placement post extraction, immediate implant placement, early implant placement, late implant placement, GBR technique, contour augmentation, 2-layer composite graft
At the 6th ITI Consensus Conference in 2018, a new classification system that combines the implant placement time and the anticipated loading protocol was introduced by Gallucci and co-workers (Gallucci et al. 2018). For immediate (type 1) implant placement, three implant placement/loading protocols were defined. These are: type 1A (defined as immediate placement and immediate restoration/loading), type 1B (defined as immediate placement and early loading) and type 1C (defined as immediate placement and conventional loading). The levels of evidence and weighted mean and median survival rates for each of the three protocols is reproduced from the publication. The indications, and surgical and prosthodontic procedures for the three protocols are described and illustrated by case reports.
Schlagwörter: Immediate implants, type 1 placement, loading protocols, outcomes, case reports
Tooth extraction and unassisted socket healing are followed by a marked reduction in the alveolar contour in the orofacial dimension in particular. Therefore the correct timing of the implant placement is very important. According to the ITI Consensus Conference, the clinician can choose between four different treatment approaches to accommodate various clinical indications (type I-IV). This review article discusses late implant placement (type IV). In type IV interventions alveolar ridge preservation or socket grafting should be performed in order to counteract dimensional ridge alterations. With respect to surgical techniques to date, it is rather unclear which technique and which material is superior over another in terms of ridge preservation. Combinations of socket filling with various biomaterials and use of barrier membranes can be used in different indications. Additional measures to improve soft tissue conditions at the time of tooth extraction, such as socket sealing, might also be indicated in specific clinical scenarios. This clinically based analysis of the literature shows different cases to illustrate the potential applicability of alveolar ridge preservation techniques in various indications.
Schlagwörter: Alveolar ridge preservation, xenograft, dimensional alteration, barrier membranes
Immediate implant placement is often accompanied by tissue resorption and mucosal recession. A key factor in this context is the loss of bundle bone in the area of the buccal bone lamella after tooth extraction. To preserve the buccal bone and the periodontal ligament in the facial area, the "socket shield" technique for implant bed preparation was developed, where part of the root is retained. After the potential of the technique had been demonstrated in animal studies, it was also evaluated scientifically in clinical application for long-term complications and esthetic outcomes. According to the currently available clinical experience and scientific data, high esthetic results can be achieved with reduced invasiveness compared to conventional treatment protocols. Before a general treatment recommendation can be given, higher-level evidence in the form of prospective clinical trials with long-term follow-up must be performed. Increasingly available documentation in the literature indicates that the "socket shield" technique is a promising treatment approach for the esthetic zone.
Schlagwörter: Socket shield, immediate implant, esthetic zone, buccal bone, tissue preservation
In this issue Forum Implantologicum talks to Prof. Dr. Asbjørn Jokstad about his ITI-funded study "Benchmarking outcomes in implant prosthodontics: Partial fixed dental prostheses and crowns supported by implants with a turned surface over 10 to 28 years at the University of Toronto".
Welcome to the Forum Implantologicum's feature series "Ask the Experts". In each issue, the Editorial Board approaches a number of experts for their opinion on a particularly topical question in less than 250 words.
In this issue, weask the experts "Do You Use the Socket Shield Technique and What is Your Opinion?" Claude Androni & Julien Kirchhoff, Howard Gluckman, Hideaki Katsuyama and Dennis Tarnow explain their view and summarize the principles they follow.
This complementary article was prepared by Bernd Stadlinger, Søren Jepsen and Hendrik Terheyden and presents an overview of the content of the 6th volume of the "Cell-to-Cell Communication" series. The 6th volume of the series entitled "Peri-implantitis and its prevention" was prepared by a collaborative team of authors - Tord Berglundh, Søren Jepsen, Bernd Stadlinger, Hendrik Terheyden - and an advisory board. This computer-animated scientific film was launched at the EuroPerio meeting in Amsterdam in June 2018, providing a novel way to visualize the complex processes of peri-implant inflammation. It visualizes the biological background of the development and progression of peri-implantitis and highlights the importance of the microbiome and host immune defense. In addition, a perspective article has recently been published in the leading implant journal Clinical Oral Implants Research (Berglundh et. al. 2019). It is hoped that this complementary article will bring the film to the attention of the many ITI Fellows and Members who enjoy reading Forum Implantologicum. Please look for the Q reader at the end of the article and enjoy this captivating film.
Portrait photography or portraiture is a photograph of a person or group of people that captures the personality of the subject by using effective lighting, backdrops, and poses. A portrait picture might be artistic, o r i t m ight b e c linical, a s p art o f a medical study. A head shot or headshot is a modern (mostly digital files) portrait where the focus is on the person. The term is usually applied for professional profile images on social media, the 'about us page' or a corporate website and promotional pictures of actors, models, and authors (https://en.wikipedia.org).
In my opinion, the ITI is one of the rare organizations in our field that consistently grows and develops, covering all the disciplines involved, both scientific and clinical, emphasizing individual and institutional improvement, and providing important practitioner guidelines.
Everybody says that being an ITI Scholar is a lifechanging experience. Indeed, my Scholarship year not only showed me a different world of implant dentistry, but also helped me become a better professional. And the opportunity to share this experience with fellow Brazilian Lauren Bohner in Germany at the Center where she was an ITI Scholar was also extremely valuable.