Dr. Aldo De Blasi, Italy
Conventional mini implant surgery in the edentulous mandible is in most cases, a very quick and minimal invasive procedure. The implants are usually placed trans gingivally and if initial primary stability is achieved then they can be loaded immediately following the surgery.
Dr. Luigi Ciacci, Odt. Andrea Sessa
Introduction:
Modern dentistry depends on comprehensive diagnostics and careful planning to achieve the desired result and meet the expectations of both the patient and the dentist.
Digital planning and guided surgery based on three-dimensional X-ray data and digitized intraoral recording are of great help. They provide valuable information and allow for accurate backward planning to optimize the implant-prosthetic outcome, making the restoration more predictable in terms of function, aesthetics and biology.
Dott. Alexandre Minis, France
Patient is a 56 years old male without a previous medical history. Tooth # 36 has been missing for several year.
Despite a satisfactory bone height on the panoramic, the CBCT reveals a thin bone at the level of the crest which does not allow the available height to be exploited.
In order to obtain an ideal prosthetic axis and to use the available bone to the maximum, the surgery is performed using a surgical guide, design on 3Shape Implant Studio, a classic dentition supported guide, 3D printed on a Phrozen Shuffle printer.
Dott. Alexandre Minis, France
Case description:
The 55 years old female patient has a lack of prior medical history and is a non-smoker.
There is a fracture under the crown of #12 with infection and vestibular fistula for which a temporary extraction with a valplast for 3 months is performed.
On the control CBCT, low bone volume and evidence of a radiolucent vestibular image initially suggesting fenestration linked to the fistula present before the extraction, or, of the bone being formed.
Surgical dental history:
The surgery is performed using a surgical guide, designed on 3Shape Implant Studio, dentition supported guide 3D printed on a Phrozen Shuffle printer.
Dr. Alexandre Minis, France
Case description
68-year-old man, fully edentulous, smoking patient, lack of medical history.
Surgical dental history:
– maxillary rehabilitation by full implant-supported bridge
– failure of 2 mandibular implant surgeries
In which ways has Covid-19 affected implantology?
Covid-19 has influenced and will affect both the private and working lives of many of us. From a working point of view, we have to develop new protocols for patient management, disinfection and operator protection.
For what concern implantology, it is not clear how much it will affect this type of treatment offered to our patients.
What are mini implants?
Mini implants are in all respects implants, but with a small diameter, not exceeding 3 mm.
They are produced in a titanium alloy, which is classified as grade 5, and has excellent mechanical properties. They have a sandblasted and etched surface which once inserted into the bone undergoes osseointegration such of that of implants with a larger diameter.
How dentistry and implantology has changed in your office in phase 2?
There is no phase 1 or phase 2, there is a behavior and approach which we’ll respect in the office in the couple of years coming. Let’s start with the scheduling of the appointment of the patient: the receptionist is asking the patient about sicknesses, illnesses, cough, fever, smell alterations. The same questions she will ask 24 hours before the scheduled appointment when she calls all the patient for the next day.
In which ways has Covid-19 affected implantology?
We dentists have an advantage, that is our hygiene protocols are adequate and safe; the only real news is this bad virus, Covid-19. We have thus equipped ourselves with systems for air sanitization and aerosol control.
Dr Fabrizia Luongo, DDS, MS, Periodontist, Rome, Italy
Introduction
The evolution of digital dentistry and the development of a digital workflow has concentrated on digital planning with the use of Cone Beam CT scanning as well as using digital restorative tools to combine DICOM (Digital Imaging Communication in Medicine) and .stl (stereolithography) files to virtually plan, place and restore implants before using this plan to treat patients. The resulting benefits are reduced chair time, high precision and predictable aesthetic results often with immediate fixed provisional restorations available at time of surgery and corresponding high levels of patient satisfaction.
Intra-oral scanning to create digital ‘virtual impressions’ is also becoming more prevalent with the information being stored in the .stl file format. This information can be utilised by appropriate CAD/CAM (computer-aided design and computer aided manufacturing) software to design and manufacture a dental restoration (either by milling or 3D printing).
One area that is sometimes overlooked is the use of digital technology in occlusal analysis and adjustment of the restored dental implant. The following case study examines the occlusal management of a conventionally placed implant.
Dr Fabrizia Luongo, DDS, MS, Periodontist, Rome, Italy
Introduction
The use of Cone Beam Computerised Tomography (CBCT) scanning is becoming more commonplace in today’s implant dentistry. These scans combined with increasingly sophisticated software technology has led to greater accuracy in digital planning and guided surgery and is gradually being adopted across general practice. Furthermore, the restorative planning can be digitised and combined with the CBCT data in appropriate planning software.
In conjunction with these technology advances, dental implant design has evolved to incorporate the latest concepts of biomechanical design, which include sophisticated thread profiling, platform switching and a Morse locking taper on the implant/abutment interface.
The following case details brings these advances in implants and digital technologies together.
