Prof. Niklaus Lang provides you with the background knowledge of osseointegration, the basis of implant dentistry. He presents and summarizes the relevant animal and human studies on osseointegration, discusses histological evidence and shows impressive documentation of bone formation around dental implants.

This patient treated by Dr. Büchi came to our office because he was bothered by the low esthetics and masticatory performance of his dental works.

A comprehensive case treated by PD Dr. Ronald Jung at the University of Zurich.

Missing posterior teeth and old unesthetic reconstructions - see how this case was solved by Dr. Christian Leutert at the University of Zurich.

Description of baseline situation; Exposure of underlying bone; Insertion of four implants; Impression-taking; Bar construction; Welding the individual components, Correction of tension; Finishing the bar; Adjusting the prosthesis; Implant placement.

Overview: Part 1 - Incision and mobilization of the mucoperiosteal flap - Cleaning the bony defect - Screw insertion for support, membrane application and fixation - Suture closure Part 2 - Opening of the mucosa above the region of augmented bone - Preparation of tunnel and bone bed for an open screw-type endosteal implant (Straumann® implant) - Use of single button sutures for tension-free wound closure Contents: This female patient presented with bone loss due to a radicular cyst at tooth 27 and peri-implantitis at tooth 26. Four months after extraction of the respective tooth and implant, guided bone regeneration (GBR) was carried out using supporting screws and an e-PTFE membrane for augmentation of the posterior tooth region of the maxilla. Four months after GBR the insertion of an implant took place.

Procedure: - Case evaluation - Incision technique - Implant placement - Membrane adjustment and fixation - Introduction of replacement material - Flap mobilization - Suture technique Contents: Implantation was desired for replacement of a missing upper canine tooth and the adjacent lateral incisor tooth. The initial case evaluation revealed a relatively narrow gap between these two teeth in addition to extensive hard and soft-tissue defects. We selected an incision technique that made it possible to do the augmentation work yet subsequently achieve a tension-free flap closure. Since the bony defect was large while the available space was limited, we had to go for the best possible compromise in regard to implant insertion. After the implants had been inserted, augmentation was carried out using a non-absorbable, titanium-reinforced membrane, bone replacement material, and an absorbable membrane. Extreme flap mobilization was needed to achieve flap closure. An optimal suture technique was used to complete the surgery.

Procedure: - Extraction - Implant Site Drilling and Implant Placement - T-Adapt Insertion Contents: This live operation starts with the extraction of tooth 12, which was loosened and damaged by trauma. Pin fixation was not possible, and a significant loss of distal papillary substance was observed. We therefore elected for placement a 4.5 mm conical Astra implant. After completion of the implant site drilling and the implant placement, a T-Adapt was inserted to shape and support the mucosa. A temporary crown was inserted chairside and left in place for 3 months.

Procedure: - Extraction of upper front teeth not suitable for preservation - Immediate loading of four NobelPerfectTM implants - Intraoperative registration of implant position - Flap-free Vestibular Bone Augmentation - Connective Tissue Graft for Periodontal Regeneration - Immediate Loading of temporary implants on the day of surgery - Definitive restoration 6 months later Materials: NobelPerfect Groovy Implants RP and NP; NobelPerfect Temporary Abutments RP and NP; NobelPerfect Implant Replicas RP and WP; Ribbond, Bondable Reinforcement Ribbon; Ethilon 5-0 FS3 Suture Material; Astra Bonetrap Bone Collector.

Contents: - Periodontal regeneration and alveolar -ridge augmentation using a connectivetissue graft - Implant insertion and augmentation - Implant re-entry and prosthetics Materials Checklist Emdogain, Bio-Oss, BioGide, Block fixating screw for autologous bone cylinder, 4/0 and 5/0 sutures, Resolut membrane Titanium pins, Autologous bone chips, 2 Replace Groovy Tapered 4, 3x13 mm implants