Geistlich - Indication sheets PIR3 - Periimplant Augmentation

Peri-implant Augmentation References Araujo MG, Sukekava F, Wennstrom JL, Lindhe J (2005). Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol 32:645-52. 1 Araujo MG, Sukekava F, Wennstrom JL, Lindhe J (2006). Tissue modeling following implant placement in fresh extraction sockets. Clin Oral Implants Res 17:615-24. 2 Buser D, von Arx T (2000). Surgical procedures in partially edentulous patients with ITI implants. Clin Oral Implants Res 11 Suppl 1:83-100. 3 Buser D, Martin W, Belser UC (2004). Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants 19 Suppl:43-61. 4 Fig. 19 The occlusal view clearly shows the tensionfree primary closure with no evidence of ischaemia in the soft tissues. As is customary, 5-0 sutures are used in the region of the ridge. Fig. 20 The clinical findings one week following the implantation operation show normal wound healing and the temporary partial prosthesis in situ. Buser D, Bornstein MM, Weber HP, Grutter L, Schmid B, Belser UC (2008a). Early Implant Placement With Simultaneous Guided Bone Regeneration Following Single-Tooth Extraction in the Esthetic Zone: A Cross-Sectional, Retrospective Study in 45 Subjects With a 2- to 4-Year Follow-Up. J Periodontol 79:1773-1781. 5 Fig. 21 Clinical findings after 8 weeks. The submerged healing phase of the implant is complete and the implant can now be uncovered for the temporary restoration. 6 Buser D, Chen ST, Weber HP, Belser UC (2008b). Early implant placement following single-tooth extraction in the esthetic zone: biologic rationale and surgical procedures. Int J Periodontics Restorative Dent 28:441-51. Buser D, Hart C, Bornstein M, Grütter L, Chappuis V, Belser UC (2009). Early implant placement with simultaneous GBR following single-tooth extraction in the esthetic zone: 12-month results of a prospective study with 20 consecutive patients. J Periodontol 80:152-162. 7 8 Buser D, Wittneben J, Bornstein M, Grütter L, Chappuis V, Belser UC (2011). Stability of Early Contour Augmentation and Esthetic Outcomes of Implant Supported Single Crowns in the Esthetic Zone. 3-Year Results of a Prospective Study with Early Implant Placement Post Extraction. J Periodontol 82:342-349. 9 Buser D, Chappuis V, Bornstein M, Wittneben J, Frei M, Belser UC (2013). Long-term Stability of Contour Augmentation with Early Implant Placement following Single Tooth Extraction in the Esthetic Zone: A prospective, cross-sectional Study in 41 Patients with a 5-9 year Follow-up. J Periodontol (e-pub). Chen ST, Darby IB, Adams GG, Reynolds EC (2005). A prospective clinical study of bone augmentation techniques at immediate implants. Clin Oral Implants Res 16:176-184. 10 11 Fig. 22 The peri-apical X-ray shows the implant normally integrated in the bone. Fig. 23 Status following exposure: the mucosa has been punched and a longer titanium healing cap introduced. Fig. 24 One week later, the soft tissues have healed well around the titanium cap. The prosthetic phase now commences and the soft tissues are conditioned using the temporary crown.  Chen ST, Buser D (2008). Implant placement in post-extraction sites: A literature update. In: Buser D, Wismeijer D, Belser U (eds). Implant placement in post-extraction sites. Treatment options. ITI Treatment Guide, Vol. 3, Quintessence Publ. Dawson A, Chen S (eds) (2009) The SAC Classification in Implant Dentistry. Quintessence Publ. 12 Early implantation with simultaneous GBR for contour augmentation using the technique by Prof. Daniel Buser and Prof. Urs Belser, University of Berne, Switzerland > Implantation 4 to 8 weeks following extraction >  mplantation with simultaneous contour augmentation for a stable long-term I result Evans CJD, Chen ST (2008). Esthetic outcomes of immediate implant placements. Clin Oral Implants Res 19:73-80. 13 14 Fickl S, Zuhr O, Wachtel H, Bolz W, Hürzeler M (2008). Tissue alterations after tooth extraction with and without surgical trauma: a volumetric study in the beagle dog. J Clin Periodontol 35:356-63. 15 Hämmerle CH, Chen ST, Wilson TG, Jr. (2004). Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. Int J Oral Maxillofac Implants 19 Suppl1:26-28. 16 Kan JYK, Rungcharassaeng K, Sclar A, Lozada JL (2007). Effects of the facial osseous defect morphology on gingival dynamics after immediate tooth replacement and guided bone regeneration: 1-year results. J Oral Maxillofac Surg 65:13-19. 17 Martin WC, Morton D, Buser D (2006). Diagnostic factors for esthetic risk assessment. In: Buser D, Belser U, Wismeijer (eds). Implant Therapy in the Esthetic Zone: SingleTooth Replacements. ITI Treatment Guide, Vol. 1, Quintessence Publ., Pp. 11-20. 18 Martin WC, Morton D, Buser D (2006). Diagnostic factors for esthetic risk assessment. In: ITI Treatment Guide Vol 1: Implant therapy in the esthetic zone - single-tooth replacements. D Buser, U Belser and D Wismeijer editors. Berlin: Quintessence Publishing Co, Ltd, pp. 11-20. Wood DL, Hoag PM, Donnenfeld OW, Rosenfeld LD (1972). Alveolar crest reduction following full and partial thickness flaps. J Periodontol 43:141-4. 19 Fig. 25 Clinical findings after completion of the softtissue conditioning with the temporary crown. The peri-implant soft tissues now exhibit good aesthetic progress. Fig. 26 Clinical findings at the 1-year follow-up after the definitive metal ceramic crown was placed. The aesthetic treatment result is excellent. Fig. 27 X-ray findings 1 year following implantation. The dental X-ray shows the implant optimally integrated in the bone. Suppliers > Impla nt: Straumann Standard Plus, Tissue Level SLA; Institute Straumann, Basle, Switzerland. > Suture material: Polypropylene, monofilament, 5-0; Hu Friedy, Rotterdam, Holland. > Medication: Antibiotic prophylaxis 2 hours before the surgical procedure. Up to 3 days post-operatively: amoxicillin, 1g, 2x daily, orally. Concurrent rinsing with chlorhexidine digluconate (0.1%) 3x daily. > Biological materials: Geistlich Bio-Oss® 0.5 g (0.25 mm–1 mm), Geistlich Bio-Gide® 25 x 25 mm. 1. Indication Profile Fig. 28 Clinical findings at the 4-year follow-up. The aesthetic result is stable. Only a small difference is evident in the incisal edge, which suggests that the 29-year-old patient is still exhibiting residual growth in the alveolar process. Fig. 29 X-ray findings at the 4-year follow-up. The peri-implant bony conditions are absolutely stable. Fig. 30 The clinical findings at the 7-year follow-up exhibit an aesthetically attractive long-term result with intact papillae and no indication at all of softtissue recession. The convex soft-tissue contour in the region of the implant crown is noted. The incisal edge has not increased further. Region Bone Situation Soft Tissue Situation Bone Augmentation Indicated Implantation Fig.  31 The oro-facial DVT section shows a completely intact facial wall approximately 2 mm in thickness. This is the result of a GBR contour augmentation using autogenous bone chips and Geistlich Bio-Oss®, covered by a Geistlich Bio-Gide® membrane and primary soft-tissue closure. 5 Fig. 32 The horizontal DVT section shows the completely intact facial bone structures in a 3-dimensionally correctly placed implant. The slightly palatal position of the implant here is important: this allows adequate space facially for the bony ­ egeneration. r n Aesthetic region n No bony defect present n Primary wound closure quite feasible n Yes, immediately n Yes, on implantation n No n Yes, 4 – 8 weeks following the extraction n Non-aesthetic region n Crater-shaped defect in the facial bony wall n Primary wound closure difficult n No Contact >  Prof. Daniel Buser, Oral Surgery and Stomatology Clinic, University of Berne, Freiburgstrasse 7, 3010 Berne, Switzerland. Telephone: [phone], Fax: [phone], e-mail: [email protected]. Further Indication Sheets >  free copies, please go to: www.geistlich.com/indicationsheets. For >  you would like to stop receiving Indication Sheets, please advise your local distributor. If Geistlich Pharma AG Biomaterials Business Unit CH-6110 Wolhusen Telephone [phone] Fax [phone] www.geistlich-pharma.com © Fig.  33 The aesthetic treatment result is excellent as seen in the clinical image with a distinct high smile line. 1 6 31605.1/1304/e Indication Sheet PIR3