This book concisely elucidates the science underlying implant treatment in the aesthetic zone in partially edentulous patients and clearly describes the techniques and protocols used by world-leading experts in the field. The book is divided into four parts that address treatment planning; site preparation (hard and soft tissue augmentation); immediate implant placement and provisional restoration; and the design, fabrication, and delivery of the definitive implant prosthesis. Complex cases of this nature present a significant challenge to even the most well informed and experienced of doctors. Implants in the Aesthetic Zone has been specifically crafted to meet all the needs of the clinician involved in their management, providing a reliable road map for interdisciplinary implant treatment in clinical practice. The authors have been carefully selected from a wide range of fields for their expertise in particular areas of implant science or treatment.
With contributions from: R. Gruber, Th. Hanser, Ph. Keeve, Ch. Khoury, J. Neugebauer, J. E. Zöller Bone and Soft Tissue Augmentation in Implantology addresses useful methods of bone grafting procedures in implant treatment based on current biologic principles and constitutes a unique reference in this field. The book describes, in over 760 pages and 2837 mostly color illustrations, the different possibilities available to augment the bone volume in width and height. The information presented includes not only the underlying scientific concepts of the different augmentation techniques with autogenous bone, but also the associated soft tissue management, from safe approaches to different possibilities for soft tissue augmentation and papilla reconstruction techniques. The book provides surgeons with a basic understanding of the biologic response to bone grafting procedures. Experienced implantologists will benefit from the in-depth background information, details of high-level surgical techniques, and scientific results, which will enable them to optimize their surgical procedures. Each chapter offers a wealth of information on the specific topic covered, with much attention given to the scientific concepts behind each one. Extensive case reports with step-by-step documentation allow readers to gain an impression of what is possible today in the 3D reconstruction procedures of the alveolar crest. Important criteria for success are presented as well as possible complications and their treatment. Bone and Soft Tissue Augmentation in Implantology is a must-read for every implantologist, oral and maxillofacial surgeon, and any dentist interested in surgery.
Comprehensively describes bone augmentation techniques and their application to the different anatomical regions of the upper and lower jaws. Bone Augmentation by Anatomical Region is a unique, evidence-based guide focusing on each specific anatomical region – anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible – in order to emphasize the correct implemented procedures needed to successfully perform oral osseous reconstruction. Numerous ridge augmentation techniques are covered, including: horizontal and vertical guided bone regeneration, autologous block transplantation, interpositional bone grafting, allogeneic blocks, sandwich technique, split-expansion ridge technique, and sinus floor grafting. Non-augmented approaches such as forced socket site extrusion and the installation of digitally printed implants are also presented and discussed. Guides readers on tackling bone augmentation via anatomical region of the jaws and their related surrounding muscles, vascularization and innervation Presents innovative augmentation techniques for the anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible Includes clinical photographs in each section and a decision tree to help readers select the appropriate surgical modality Bone Augmentation by Anatomical Region is a specialist resource suitable for dentists who practice implant dentistry, oral surgeons, oral and maxillofacial surgeons, periodontists, and postgraduate dental students in the above-mentioned disciplines. Please note Due to recently developments, part of Chapter 2 Biologic Conditions for Bone Growth and Maintenance: Managing the Oxidative Stress has been amended which will be available in all future reprints. All electronic versions have been updated.
With the desire for dental implant therapy ever escalating, clinicians are faced with the challenge of augmenting deficient natural physiology to provide effective sites for implantation. Implant Site Development helps the clinician decide if, when, and how to create a ridge site amenable to implantation. This practical book offers solutions to many implant site preservation scenarios, discussing different treatment options, timing, a variety of materials and techniques, and their application to the clinical practice. With a unique integrated clinical approach, Implant Site Development covers a range of site development techniques. Highly illustrated, Implant Site Development presents diagrams and clinical photographs to aid with clinical judgment and will prove useful for any dental professional involved in implant therapy, from general practitioners to prosthodontists, but especially surgeons. This literature-based, yet user-friendly, reference will be indispensable to the novice or veteran clinician.
IntroductionReplacing missing teeth in the aesthetic zone with dental implants remains a challenge. In order to maintain or restore bone and soft tissue, many procedures have been recommended, varying from the immediate placement with minimal tissue grafts to an extensive treatment procedure with bone grafting, possibly in combination with connective tissue grafts. Orthodontic extrusion is another treatment option, that enables the regeneration of bone and soft tissue both in horizontal and vertical dimension. Moreover, the use of pink-colored ceramics can offer an effective method of providing an aesthetic outcome when the aforementioned techniques are not applied or have failed.AimThe purpose of this presentation is the description of a complex case where an interdisciplinary treatment plan was applied in order to restore severe alveolar bone loss that resulted in tooth loss in the aesthetic area. Materials and MethodsA 23-year-old female patient, which was referred to the Department of Periodontology, presented with a severe osseous defect in teeth #22, #23 due to previous orthodontic treatment. In particular, #23 was impacted and after surgical exposure and orthodontic traction, bone surrounding #22 and #23 was destroyed and root resorption was noticed. Both teeth had third degree mobility and extensive attachment loss was recorded. ResultsAfter initial impressions and diagnostic wax up, the treatment plan was made, and different options were presented to the patient. The definitive treatment plan included the extraction of teeth #22, #23 and placement of two implants. Because of the extensive bone deficiency both in vertical and horizontal level, orthodontic extrusion of the teeth was applied . After the orthodontic extraction, extensive Guided Bone Regeneration-GBR was applied using double layer technique (allograft, xenograft, collagen membrane and pins) and a resin-bonded metal-acrylic prosthesis was placed as a temporary restoration. Six months later, two implants (straumann) were placed and xenograft was also applied covered with Mucograft for tissue gain. After six months, second stage surgery was conducted and connective tissue graft was placed in order to augment soft tissue volume. Three months later, when soft tissue healing was completed, the steps for the definitive procedure were followed. Two multi-unit (straumann) abutments were used, with 17o angle to restore implant angulations, and a metal-ceramic Fixed Partial Denture-FPD was fabricated, that was screw-retained to the abutments. Pink-colored porcelain was used aiming to replace the tissue loss in vertical dimension. The patient was fully satisfied with both the aesthetic and functional result.DiscussionImplant placement and restoration in the aesthetic zone is highly demanding in terms of aesthetic outcome and patients' satisfaction, especially in cases with extreme deficiencies in soft tissue and bone. In such cases, careful treatment planning and collaboration among different specialties is mandatory, while the use of pink-colored porcelain can provide an aesthetic outcome without the application of extensive bone grafting procedures.
Comprehensively describes bone augmentation techniques and their application to the different anatomical regions of the upper and lower jaws. Bone Augmentation by Anatomical Region is a unique, evidence-based guide focusing on each specific anatomical region – anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible – in order to emphasize the correct implemented procedures needed to successfully perform oral osseous reconstruction. Numerous ridge augmentation techniques are covered, including: horizontal and vertical guided bone regeneration, autologous block transplantation, interpositional bone grafting, allogeneic blocks, sandwich technique, split-expansion ridge technique, and sinus floor grafting. Non-augmented approaches such as forced socket site extrusion and the installation of digitally printed implants are also presented and discussed. Guides readers on tackling bone augmentation via anatomical region of the jaws and their related surrounding muscles, vascularization and innervation Presents innovative augmentation techniques for the anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible Includes clinical photographs in each section and a decision tree to help readers select the appropriate surgical modality Bone Augmentation by Anatomical Region is a specialist resource suitable for dentists who practice implant dentistry, oral surgeons, oral and maxillofacial surgeons, periodontists, and postgraduate dental students in the above-mentioned disciplines.
This handbook describes several current trends in the development of bioceramics and biocomposites for clinical use in the repair, remodelling, and regeneration of bone tissue. Comprehensive coverage of these materials allows fundamental aspects of the science and engineering to be seen in close relation to the clinical performance of dental and orthopaedic implants. Bioceramics and biocomposites appear to be the most dynamic area of materials development for both tissue engineering and implantable medical devices. Almost all medical specialties will continue to benefit from these developments, but especially dentistry and orthopaedics. In this Handbook, leading researchers describe the use of bionanomaterials to create new functionalities when interfaced with biological molecules or structures. Also described are technologies for bioceramics and biocomposites processing in order to fabricate medical devices for clinical use. Another important section of the book is dedicated to tissue regeneration with development of new matrices. A targeted or personalized treatment device reduces drug consumption and treatment expenses, resulting in benefits to the patient and cost reductions for public health systems. This authoritative reference on the state-of-the-art in the development and use of bioceramics and biocomposites can also serve as the basis of instructional course lectures for audiences ranging from advanced undergraduate students to post-graduates in materials science and engineering and biomedical engineering.
This book, written by acknowledged experts with international reputations, provides clinicians with detailed guidelines on the nature of the ideal anterior dental implant and, more importantly, how the desired aesthetic outcome is to be achieved. It reflects the incredible paradigm shift that has taken place within implant dentistry during the past 5 years, with recognition of the importance of a ‘crown down’ approach to diagnosis, planning, and treatment, especially in the anterior zone. In order to ensure reproducibility and predictability of treatment outcomes, the fabrication of an aesthetic dental implant must follow a complex algorithm, which is reviewed in a stepwise approach. Sections are devoted to evaluation of the aesthetic implant patient, immediate implant placement, staged implant placement, and restoration. Readers will come to appreciate how the final emergence profile of the definitive restoration reflects the complex interplay of components below the visible smile zone. Helpful flow charts are included that will assist in optimal performance of the described procedures.
Objectives: The aim of the present study is to evaluate the dimensional changes of peri-implant labial tissue contour in the esthetic zone obtained by implant placement with or without guided bone regeneration.Material and methods: Ten Bone Level implants (Institute Straumannu00ae AG, Basel, Switzerland) were placed in a healed single tooth gap from maxillary central incisor to second premolar. Five implants were completely surrounded by native bone, and no bone augmentation was performed. In five implant sites, bone defects and thin bone plates were grafted with deproteinized bovine-derived bone mineral and covered with collagen membrane. Impressions were taken prior to implant placement (baseline),1 week after crown connection (at 6 months) and 6 months after crown connection (at 1 year). Models were optically scanned and 3D images were superimposed for the evaluation of peri-implant labial tissue contour changes at two points, A and B located 3 and 6 mm apical to the crest of the ridge respectively.Results: From baseline until 1 week after crown connection the peri-implant labial tissue contour gain at the points A and B was more pronounced in the GBR group compared to control. From 1 week till 6 months after crown connection the labial contour reduction was similar in both groups.. At 6 months after crown connection the total gain of labial tissue contour was higher in GBR group and exhibited similar stability compared to the group of implants placed in native bone.Conclusion: Within the limitations of this study, Implant placement with simultaneous GBR seems to result in more gain of peri-implant labial soft tissue contour in comparison with implant placement without GBR. Abutment connection increases and stabilizes the labial contour specially in the most coronal region of implant site. The stability of the gained labial contour of the augmented sites was comparable to that of the control sites 1 year after implant placement.
