EL Clinical Study • February 2015

How to combine bone stability and aesthetic benefits through innovative implant design Treatment of a 65-year-old patient

Henriette Lerner HL DENTCLINIC, Dentist, Baden-Baden, Germany

We present a clinical case with extensive aesthetic requirements, illustrating the treatment of a 65-year-old patient with a partial edentular situation with all the teeth having a mobility grade of 2. All the maxillary teeth were extracted and the implants were immediately set.

Introduction
It has been demonstrated that the cone Morse connection is the most stable type of connection. It has been scientifically proven that bone loss is caused by micro-movements and not by the size of micro-gaps (Hermann et al.). It has been reported that normally the micro-gap in implant connections, which allows accumulation of bacteria, measures 21 to 60 μm, facilitating the development of local inflammations and bone loss. The cone Morse connection is distinguished by an inner wall angle of the connection that is less than 25°. Consequently, this is the safest connection against bacterial accumulation since the size of the micro-gap (1.1-1.5 μm) is smaller than that of a bacterium (2-6 μm).
It is also the most stable connection known to date, as well as having the lowest incidence of screw loosening (0.37%). Furthermore, it has shown high resistance to bending during shear tests at 800 N at 30 degrees.

Discussion and conclusion
For this clinical case an innovative implant and prosthetic concept was implemented, allowing the dentist to create and stabilise the peri-implant bone and gingival structure. This implant design and treatment method seems to allow a better aesthetic result in situations where there are adjacent implants.