DTME0710

R estoring the anterior aesthetic zone using implant-supported resto- rations is one of the most chal- lenging tasks. Knowledge of related literature, impeccable skills, a lot of experience and a well-trained team compliment a successful treatment. Diffe- rent implant systems claim to offer the only technology lead- ing to success. The author de- scribes a case where an “out- dated” system, external hex implant system offers a similar success rate, by only following a correct protocol. Aesthetic 3-dimensional requirements For optimal aesthetics, some literature suggests some key factors to be respected as they play an important role for long- term success: • Availability of two mm buccal bone plate • Implant tooth distance should be 1.5mm • Implant to implant distance three mm • Biologic width is indicated with two-three mm Clinical case A 45-year-old male has been referred to the practice for reha- bilitation of the anterior aesthet- ic zone. His medical and dental history, as well as his treatment desires, were recorded. Dental history The patient lost tooth 11 due to trauma about 17 years ago. He was advised to restore the gap with a PFM bridge. He also reported multiple rece- mentation sessions. Later, in- sufficient root canal treatments (X-rays) seemed to have weak- ened the remaining tooth struc- ture. The clinical picture below demonstrates also fractured adhesive posts. X-ray diagnosis proved ver- tical root fracture of both teeth. Poor prognosis led to immediate extraction recommendation, to avoid further infection (leakage) and optional bone loss. Treatment plan The following treatment options were identified and discussed with the patient: • Extraction and no treatment • Extraction and restoration with a removable device. • Extraction and immediate implant placement. Benefits and disadvantages of different treatment options Extraction and no treatment Benefits • Fast • No cost implication Disadvantages • Aesthetic breakdown of the anterior area • Function and speech alteration Extraction and restoration with a removable device Benefits • Fast • Minor cost implication Disadvantages • Aesthetic breakdown of the anterior area • Function and speech alteration. • Removable device acts as an impediment Extraction and immediate implant placement Benefits • Preservation of bone • Optimal functional and aesthetic rehabilitation Disadvantages • Cost implication • Extended treatment need Patient decided to go for the extraction and have im- A challenging task Prof Dr Liviu Steier discusses how to restore the aesthetic zone with implant-supported restorations DT! Direct clinical view of fractured teeth 12 and 21 (including adhesive posts). DENTALTRIBUNE Middle East & Africa Edition Trends & Applications 3 EMS-SWISSQUALITY.COM Three horizontal nozzle apertures for the air-powder mixture, a separate vertical water nozzle aperture for rins- ing: what used to be off limits is now easily reachable, through gentle action and without any risk of emphysema. And since the Air-Flow Powder Perio is particularly fine, the tooth surface is not damaged. DEEP DOWN, between tooth and gin- giva, billions of bacteria managed to proliferate under the cover of malicious biofilm – until now. Together with the Original Air-Flow Powder Perio, the new Air-Flow handy Perio with its unique Perio- Flow nozzle tracks down biofilm, even in the deepest periodontal pockets. For more information> welcome@ems-ch.com With its new Air-Flow handy Perio, Air-Flow has assigned its latest family member to combat – right on target for subgingival pro- phylaxis in your practice. AIR-FLOW KILLS BIOFILMTHE NEW AIR-FLOW HANDY PERIO GETS RID OF THE ENEMY – WITH GENTLE ACTION AND UTMOST PRECISION Grain size ~ 25 µm AD Page 4