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implants - international magazine of oral implantology

I user report _ augmentation Fig. 1_Situation before operation, vestibule area is relatively broad, flat ridge regions # 14 to 16, 6 weeks after extraction of tooth #14. Fig. 2_Surgical site after surgical flap preparation shows fully ossified alveolus of tooth #14, 6 weeks after extraction. Fig. 3_Pre-preparation of the bone window in region #16 with large Rosecutter to mark the finish line under continuous cooling. _In recent years new issues have arisen in the fieldofimplantdentistry.The1980swasthedecade of osseointegration; the 1990s, the era of guided bone regeneration. Recently, the focus has mainly been on the improvement of dental aesthetics and methods of improving the aesthetic and functional results, the load-carrying capacity and the simplifi- cation of surgical techniques. These aspects should not be considered separately from each other, as they overlap. In 1980, Philip Boyne first described procedures for sinus floor augmentation. Since then more than 1,000scientificarticlesonsinusflooraugmentation have been published. Today, the use of osseointegrated dental im- plants is an effective and reliable method for long- term treatment of patients with partial and total toothloss.Thesuccessrateandpredictabilityofim- plant treatment depends on several factors but are generallyhigh.Thegoalistomakethisrehabilitative process accessible to as many patients as possible, even those with poor bone quality and/or low bone mass.Untilnow,aninsufficientamountofboneand poor bone quality have been unfavourable or even a contra-indication for implant treatment. Because ofpoorbonequalityandoften-progressivebonere- sorptionaftertoothloss,theposteriormaxillaespe- cially is a high-risk area for the placement of dental implant restorations. If atrophic maxillary bone or a large maxillary sinus is present, the implant treat- mentismoredifficult.Asolutioninsuchcasesisthe use of shorter implants. However, certain clinical conditions must be met so that an unfavourable relationship between the implant and the restora- tion length (implant–crown ratio) does not lead to biomechanical problems, improper loading or pre- mature implant loss. In such cases, the implant treatmentmustbeplannedcarefullyandadditional surgical procedures before dental prosthetics, such as a bone graft in the maxillary sinus, are often requiredtocompensateforinadequatebone.Inthis way, optimal conditions for the insertion of im- plants in the posterior portions of the alveolar process of the maxilla are created. In the past, dentists and maxillofacial surgeons avoidedcomplexproceduresthatrequiredaccessto themaxillarysinusthroughtheoralcavity,provided such were not necessary. As early as 1984, Bråne- mark demonstrated with clinical and experimental data that the apical end of an osseointegrated im- plant can be placed in the maxillary sinus without adverselyaffectingthehealthofthesinusareaifthe Schneiderian membrane remains intact. Augmentation— one important basis in implant treatment concept Authors_Prof Dr med Frank Liebaug, Dr med dent Ning Wu, Germany 36 I implants2_2011 Fig. 2 Fig. 3Fig. 1