Optimal aesthetic results for implant-prosthetic restorations in the aesthetic area: anatomical and surgical considerations

Aesthetic effect of prosthetic suprastructures is the most important aspect of oral rehabilitation. To ensure satisfactory aesthetic when performing implant treatment, different anatomical and surgical considerations should be taken into account. Aim: Taking into account the growing importance of aesthetics in modern society, the main goal of this research was set - to make an analysis of the relevant anatomical and surgical factors that affect the aesthetics of implant superstructures. Material and method: Adequate literature research was performed to fulfill the main goal. Sources of information used in this study were obtained from the most used of all scientific databases- Pub Med. All of the used literature data was previously published in peer- reviewed publications and journals. Results: Numerous anatomical factors have been identified as influencing on the satisfactory aesthetics of definitive work such as: gingival aspects and positioning, periodontal biotype, position of the lower lips and interocclusal space. The second group of factors is connected to the surgical interventions such as: regeneration ability of soft tissues and alveolar bone, placing the implants in the proper position and flaph aproach. Prosthetic rehabilitation depends also from the morphology and correlation of superstructures, the correlation of prosthetic devices with the surrounding soft tissues and proper planning of prosthetic devices. Adequate handling of soft and bone tissues during implant therapyis of great importance. At the end of the surgical procedure, all the bony parts of the alveoli that protrude should be removed or covered with mucous membrane, which should then be sutured. Also traumatized and thermally unprotected bone should be removed. Conclusion: In conclusion we can note that the establishment of proper aesthetics of superstructures depends on the knowledge of anatomical and surgical aspects

Prevalence of peri-implant diseases

Background: Peri-implantitis is inflammatory condition caused by a bacterial origin and characterized by inflammation in the peri-implant soft tissues and a progressive loss of supporting bone. Mucositis is inflammation of the peri-implant mucosa without any bone loss. This main aim of this study was to determine the prevalence of peri-implant diseases, mucositis and peri-implantitis in two different types of implant systems. Material and method: Total number of 44 implants placed in 30 patients was examined. Clinical examination of all placed implants was done. Clinical pocket depth and bleeding upon probing, plaque index, implant mobility, presence of suppuration and radiographic bone loss, were analyzed for every implant. We have compared two types of implants- conventional (20 implants) and platform switching (24 implants) after one year of loading. Results: 70.45 % from all implants presented as healthy, 20.45 % from all implants presented peri-implant mucositis and 9.1 % of all implants showed signs for peri-implantitis. Platform switching implants showed lower incidence of mucositis and peri-implantitis, but there was not significant difference (p = 0.575) Conclusion: Within the limitations of the current study, we have noted lower prevalence of peri-implantitis with platform switching Implant

Историја на оралната имплантологија

Досегашните реализирани археолошки откритија докажуваат постојана преокупација на луѓето за замена на изгубените заби. Како главни материјали за замена се користат заби од животни, луѓе и минерали

Resolving of deficit alveolar ridges by induced bone regeneration- case report

The aim was to show illustrative, indication of alveolar augmentation before insertion of endoosseous dental implants. In our case report we have shown the indication for ridge augmentation prior to the placement of endoosseous dental implant. The local process of bone regeneration was thus stimulated and the chances of a good clinical output were increased. Case report: Female patient (27 years old) visited our clinic. Diagnosis was periodontitis of 46 and indication to remove the tooth, and reconstruction of alveolar ridge in order to place the implant in a sufficient volume bone. Implant placement occurred 8 months after extraction of the tooth. After 4 months implant placement prosthetic restoration was made. In conclusion, surgical reconstruction of the tissues and the procedure of ridge augmentation and subsequent placement of dental implant are necessary

Принципи на коскено – ткивно ремоделирање во оралната хирургија – презентација на клинички случаи

If we would like to obtain biological and functional bone tissue after extraction and if we planning to make insertion of dental implants, their success would be compromising, because the place of extraction as one, especially the more teeth is desirable to be treated with bone bovine or synthetic substituents. However, not only the places after extraction should be treated, especially here include clinical cases when we need to make extraction of mobile tooth, that will result in significant loss of bone in horizontal and vertical direction of the alveolar ridge

The use of diode laser in dentistry - two cases report

Introduction: We present our clinical cases, the use of diode laser in patients with gingival hypertrophy and lower semi impact third molar. An indication for application of our diode laser as in our cases is: At first – periodontal surgery, gingival depigmentation and decontamination and curettage of the sulcus, In the other case, in the area of the third molar, we made operculectomy, circumcision and we got excellent hemostasis. Methods: The patient, a 64 year old man, was a good general health for his age. He presented with a conventional bridge in the maxilla supported by natural abutments and gingival frontal upper hypertrophy. Since the bridge was removed, used the diode laser we made a new gingival contour, following only contact anesthetic. The other patients, a 23 year old woman, right lower semi impact third molar where we make operculectomy with diode laser, like the previous case only with contact anesthetic. Conclusions: The diode laser as a modern therapeutic method helped us to a very fast and simple way, elegant, clean – without bleeding, and in a short time period for treatment and resolution of such situations

Resonance Frequency Analyze of the primary and secondary implant stability of dental implants

Background: One of the most important factors for the longevity of dental implants is their primary and secondary stability. Primary stability is related to the quality of the local bone and the quantity of bone, the type of implant and the technique of placement. Secondary stability is increased by bone formation and remodeling between the implant / tissue interface and surrounding tissue. Aim: The main goal of our study was to determine the primary and secondary stability of dental implants in patients with Ankylos® dental implants. Material and methods: This clinical study will be performed in a private dental office “Dent estet” in Stip, Republic of N. Macedonia. The implants were surgically implanted by a specialist oral surgeon. The stability of the implants will be measured by analyzing the resonant frequency using the instrument, called PenguinRFA(Integration Diagnostics, Sweden AB). Implant Stability Quotient - ISQ is the measurement unit of this diagnostic tool, the measurement units range from 1 to 99 and higher values show better stability of the implants. The implants will be positioned according to the two-phase protocol of implantation, where the implant was implanted in the first phase, and then we will determine the primary stability with the PenguinRFA (Resonance Frequency Analyze). In the second phase after three months, the second measurement was carried out and the secondary stability was determined. Statistical processing was performed in statistical program Statistica 7.1 for Windows. Results: The average values for ISQ for primary stability in subjects with Ankylos® implants vary in the range 63.84 ± 9.6 units, while for secondary stability the values vary in the interval 75.56 ± 10.7 units. The secondary stability of these implants is significantly higher than the primary stability (for p <0,01 precisely for p = 0.00).It should be noted is that the determined relationship between the ISQ values of the primary and secondary stability of Ankylos® implants showed a high positive correlation. Also it is noted that, the increasing of ISQ values for primary stability were accompanied by an increasing of the ISQ values for secondary implant stability. Conclusion: Determining primary and secondary implant stability has greatly influence on the longevity of the dental implants. Based on our research, it was noted that the increasing the ISQ values measured for primary implant stability was accompanied by an increased ISQ values related to secondary implant stability. Because of this, it can be concluded that the increased primary stability of the implants goes along with increased secondary stability of the implants

Естетска улога на остеоинтеграцијата на денталните импланти и алвеоларна коскена презервација и аугументација – неопходни денес

Цел: Целта на овој труд е да се презентираат перспективите од апликацијата на BioOss за зголемување на алвеоларните гребени како и остеоинтеграцијата на денталните импланти во мандибуларен фронталниот дел и максиларен фронтален и бочен дел од гребените. Материјал и Метод: Неколку пациенти со парцијална и тотална беззабост беа третирани во две фази: аугументација на алвеоларниот гребен или алвеоларна презервација (во согласност со индикациите) и во втората фаза позиционирање на имплантите во фронталните и бочни регии. Пациентите беа проследени во период од две години и истите ќе бидат прикажани. Резултати: Резултатите укажуваат дека BioOss има надополнувачки потенцијал за зголемување на алвеоларните гребени и можат да ги поддржат денталните импланти и функционалното оптеретување. Заклучок: Поставувањето на BioOss за аугументација на алвеоларните гребени и поставување на дентални импланти не само што ќе ја зголемат веројатноста на постоечките клинички протоколи , туку и ќе создаде можност за нови пристапи во овие процедури. Клучни зборови: aугументација, алвеоларен гребен, имплан

Socket Preservation with Implant Placement in the Daily Practice – Case Report

The purpose was to show that significant changes in bone volume and morphology following tooth extraction, can make prosthetic – implant rehabilitation very difficult. In order to prevent ridge atrophy and optimize esthetic in the posterior mandibular area, the local process of socket preservation procedure and exposes, is important as an available treatment. Case report: Male patient, age 32 with a noncontributory medical history, presents to our clinic. The clinical evaluation showed indication for tooth 36 extraction due periodontitis. After tooth (36) was carefully removed with forceps technique, the extraction site was grafted with an osteoconductive bone graft. Implants placement was made occurred 6 months after extraction of the tooth. After 4 months implant placement prosthetic rehabilitation was made. Results: advantages of an augmented alveolar ridge with sufficient bone volume to adjust for uncompromised and esthetic implant placement, renders these procedures more than effective for majority of patients. Conclusion: Loss of teeth due to complicate caries, often result in hard and soft tissue collapse, therefore the preservation of bone volume is of major importance in order to insure the proper implant and esthetic rehabilitation. In order to insure the success of prosthetic – implant therapy, surgical reconstruction of the tissues and the procedure of ridge augmentation are necessary

Repartition of microbial biofilms on metallic structures in dental medicine

Introduction. Microbial biofilms have constituted an extremely serious problem for dental professionals. The presence of microbial biofilms has been evidenced by electron microscopy techniques on the surface of all materials used in dentistry, but the best were found on the surface of dental alloys. Aims. The constitution of microbial strains collection isolated from dental plaque. We studied the development of monospecific biofilms on dental alloys, in order to establish the influence of the physical and chemical structure of the alloys with the dynamics of experimental biofilms. Material and methods. The analysis of bacterial diversity of dental plaque samples was realised with: optic microscope, scanning electronic microscope, determination of bacterial loading, identification of the most important bacterial species and genus after cultivating and isolation in anaerob and aerob media and also automatic identification with VITEK systems. Were tested the patogenity and the virulent status and also the resistance of the cells with no adherence and of the cells included in artificial developed biofilms on dental alloys. Selected materials were: noble alloys (gold-palladium and gold-platinum alloys); seminoble alloys (silver-palladium alloys) and stainless alloys (cobalt-chromium, nikel-chromium alloys). Results. Dental plaque has a great structural complexity (there are, in the same time: spiral bacterium, fungus, some gram positive morphological type). Tested strains have a high capacity of adherence on dental alloys above mentioned, even after 24 hours of incubation. The bacteria are more resistant in adhered state comparing with initial condition. Conclusions. Repartition of the selected monospecifc microbial biofilms on dental alloys is determined by antiseptic potential of the alloys components: the development on stainless alloys of much more thicker biofilms than seminoble and noble alloys. Microbial biofilms appeared preferentially in surface irregularities, with on flat surfaces bacteria formed a continuous layer