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Guided Bone Regeneration in Posterior Maxilla with Membrane Technique. Insertion of an Implant - The entire case
Mengel, Reiner / Foitzik, ChristianOverview: 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. -
Anterior implant with concurrent bone augmentation (GBR)
Grunder, UeliOutline: - Incision technique/flap mobilization - Implant insertion - Membrane adaptation - Introduction of the replacement material - Attachment of the membrane - Introduction of the second membrane - Flap mobilization - Flap closure List of materials: Titanium implant (Thommen Medical, Waldenburg, Switzerland); e-PTFE membrane (Gore-Tex® reinforced, WL Gore, Flagstaff, AZ, USA); Mineralized collagen bone replacement material (Bio-Oss® Collagen, Geistlich Pharma, Wolhusen, Switzerland); Collagen membrane (Biogide, Geistlich Pharma, Wolhusen, Switzerland) -
Bone augmentation in the anterior region in preparation for implants
Grunder, UeliOutline: - Incision technique/flap mobilization - Bone removal with trephine cutter 6 mm - Bone bed preparation with trephine cutter 5 mm - Fixation of the autologous bone - Membrane adaptation - Introduction of the replacement material - Attachment of the membrane (with nails) - Introduction of a second membrane - Flap mobilization - Flap closure List of materials: - Trephine cutters (Biomet/3i, Palm Beach Gardens, Florida, USA) - Fixation screws (Biomet Microfi xation, Jacksonville, FL, USA) - e-PTFE membrane (Gore-Tex® reinforced, WL Gore, Flagstaff, AZ, USA ) - Mineralized collagen bone replacement material (Bio-Oss® Collagen, Geistlich Pharma AG, Wolhusen, Switzerland) - Collagen membrane (Biogide, Geistlich Pharma, Wolhusen, Switzerland) -
Cocoon-technique containment and contouring
Gellrich, Nils-Claudius -
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Implant placement in the anterior mandible with bone augmentation
Hürzeler, Markus B. -
Immediate placement and all-ceramic restoration in the anterior maxilla - a customized interdisciplinary treatment approach
Happe, Arndt / Nolte, AndreasContents: - Patient presentation and esthetic analysis - Careful extraction of a non-salvageable tooth - Miniplast splint as a surgical template - Harvesting bone from the implant bed - Placing a CONELOG® implant at site 11 - Obtaining a corticospongeous bone cylinder at site 48 - Alveolar augmentation and reconstruction of the buccal bone lamella - Harvesting a connective-tissue graft - Tunneling the vestibular mucosa, various suturing techniques - Insertion of the provisional restorations - 3 months later: Preparing, impression and arbitrary transfer with a bite fork and facebow, temporary restoration - Master cast, new wax-up, determine the emergence profile - Fabricating a hybrid abutment, Scanning the custom abutment, on-screen crown design - Fabricating a zirconia abutment and a feldspathic ceramic veneer - Conditioning and adhesive attachment of the components, final intraoral check - Try in and adhesive cementation -
Immediate placement and all-ceramic restoration in the anterior maxilla - a customized interdisciplinary treatment approach - Clinical procedure
Happe, ArndtContents: - Patient presentation and esthetic analysis - Careful extraction of a non-salvageable tooth - Miniplast splint as a surgical template - Harvesting bone from the implant bed - Placing a CONELOG® implant at site 11 - Obtaining a corticospongeous bone cylinder at site 48 - Alveolar augmentation and reconstruction of the buccal bone lamella - Harvesting a connective-tissue graft - Tunneling the vestibular mucosa, various suturing techniques - Insertion of the provisional restorations - 3 months later: Preparing, impression and arbitrary transfer with a bite fork and facebow, temporary restoration - Master cast, new wax-up, determine the emergence profile - Fabricating a hybrid abutment, Scanning the custom abutment, on-screen crown design - Fabricating a zirconia abutment and a feldspathic ceramic veneer - Conditioning and adhesive attachment of the components, final intraoral check - Try in and adhesive cementation -
Microsurgical lateral sinus floor elevation (LSFE)
Nölken, RobertOutline: - Incision - Flap mobilization - Lateral sinus fenestration - Elevation of the Schneiderian membrane - Implant bed preparation - Bone chip harvesting at the mandibular angle - Filling of sinus lift lumen with autologous bone chips - Implant insertion - Covering the lateral sinus cavity with collagen membrane - Wound closure List of materials - Zeiss Pro Dent microscope with beam splitter and Panasonic 3 CCD camera - Scalpel holder (Ustomed) with Swann-Morton blades 15C and 12D - Narrow rasp (Hu-Friedy) - Micro-vacuum (Luer Lock Suction Tip, American Dental Systems) - Disposable vacuum tube set (Bexamed) - Disposable draping, Lindau (Aescologic) - Piezosurgery with diamond ball (Mectron) - Microforceps (Hu-Friedy) - Excavator (Martin) - Periodontometer, 1-mm gradation (Hu-Friedy) - OsseoSpeed implant set, Dentsply Implants: Marking drill; Twist drill, 2 mm; Depth gauge; Pilot drill, 2/3.2 mm; Twist drill, 3.2 mm; Tapered drill, 3.2/5 mm; OsseoSpeed TX implant, 5.0 × 11 mm; Closure screw, 4.5/5 mm - Columbia curette (Ustomed) - Micross scraper (Meta) - Needle holder (Ustomed) - Langenbeck wound retractor (Ustomed) - Kelly scissors (Ustomed) - Buchanan endodontic hand plugger (American Dental Systems) - Resorbable collagen membrane (Resodont, Resorba) - Ethilon 5-0 FS-3 (Ethicon) - Prolene 6-0 DA-2 (Ethicon) -
Regenerative Procedures for Optimized Esthetics at Tooth 11
Schlee, MarkusContents: - Exploration - Incision and Flap Mobilization - Palatal Flap Preservation with Interdental Tissue Preservation - Detoxification and Concrement Removal at 11 - Harvesting of Autogenous Bone Chips from the Spina Nasalis - Conditioning of the Root Surface with EDTA-Gel - Application of Emdogain and Filling of the Bone Defect - Wound Closure Synopsis After Finishing the Initial Treatment for Aggressive Periodontitis, Regenerative Treatment of a Tunnel-Shaped Pocket at Tooth 11 was attempted. Rotation and Crowding of the Buccally Inclined Tooth represented a favorable Etiological Factor. The patient did not wish to receive Orthodontic Treatment to eliminate this Causal Factor after Completion of Primary Treatment. Treatment was therefore limited to the Surgical Regeneration Attempt. The Interdental Space was larger than 3 mm and the Bone Pocket was a mostly Three-Walled Structure, so the Chances of Success were considered to be good. Exploration was first performed to identify the Course of the Defect Margins. Exact knowledge of the Bone Anatomy in all three Planes is essential to successful Incision Planning. A Tunnel-Shaped Defect delimited by Bone in the Region of Tooth 11 with good chances of Periodontal Regeneration was found. A major Challenge of this Procedure is the need to keep the Defect completely covered with Soft Tissue throughout the Healing Process. Cortellini's Papilla Preservation Technique was used for this Purpose. After Incision and Flap Mobilization, it became evident that the Defect only had two Walls in the Coronal Region and that Bone was lacking in the Buccal Region. According to the current Data on Periodontal Regeneration, the Attachment Gain achieved using an Enamel Matrix Protein (Emdogain®) alone can be just as good as that achieved using Emdogain and Bone Graft Material combined. Still, we elected to use a Combination Technique in the Present Case because it provides better Papillary Support. The Graft Material consisted of Autogenous Bone Chips from the Spina Nasalis, which can easily be harvested by Means of the Piezo Technique After gentle Detoxification, the Root Surface was treated with Emdogain. The Defect was then filled with Autogenous Bone Chips and closed by Microsurgical Suture Techniques. Six months after Surgery, Partial Regeneration of the Papilla can be seen. -
Immediate placement of a NobleActive implant in a patient with a pronounced hard-tissue and soft-tissue defect
Nölken, RobertOutline - Modified tubed flap - NobelActive implant placement - Flapless facial bone augmentation - Immediate provisionalization Materials Checklist: NobelActive™ Surgery Kit Twist drill ø 2, 7-15 mm Twist drill ø 2, 10-18 mm Twist step drill ø 2.4/2.8, 7-15 mm Twist step drill ø 2.4/2.8, 10-18 mm Twist step drill ø 3.2/3.6, 7-15 mm Twist step drill ø 3.2/3.6, 10-18 mm Surgical driver NobelActive™ Man torque wrench, surgical NobelActive™ Internal RP implant Procera® esthetic abutment, NobelActive™ Internal Implant replica, NobelActive™ Internal RP Impression coping, open tray, NobelActive™ Internal RP Protect analog, NobelActive™ Internal.





