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Int Poster J Dent Oral Med 10 (2008), No. 3     15. Sep. 2008

Int Poster J Dent Oral Med 2008, Vol 10 No 03, Poster 422

Therapy by agenesis from lateral incisors by means of reduced diameter implants

Language: English
 

Authors:
Dipl.-Stom. Michael Kirsch, Erfurt

Date/Event/Venue:
30.11.2006 - 02.12.2006
19. Annual congress of the GSI (DGI)
Congress Center Dresden
 

Aim

Patients with congenitally missing lateral incisors more frequently wish by means of implants the gap reduction. However, there are the following problems:

  • reduced bone supply in vestibulooral direction,
    conditional by a missing inductive reasoning for the bone formation of the tooth germ
    and additional physiological resorption
  • intercoronal place supply less than 8 mm
  • reduced soft tissue supply
The aim in question is whether with diameter reduced implants a long-term, optimal success can be reached.
 

Material and Methods

By two healthy patients, a 18-year-old male non-smoker with aplasia of the lateral incisors in the lower jaw and a 17-year-old female smoker (10 cig./day) with aplasia of the lateral incisors in the upper jaw, a intercoronal space of 5 mm was existing . Both patients were pre-treated by orthodontists. It was decided after execution of the clinical and radiological examination and evaluation of the won information to advertise 2.7 mm BEGO-Compress-Implants (15 mm of length). In the first case the improvement in the soft tissue situation was carried out in the front-end by means of connective tissue grafts while in the second case this was carried out during the implantation meeting. In both cases the implants were inserting after the usual surgical protocol. An exception was the use of the nonablative thread moulder for bone condensing and for bone spreading. Vestibulär pitches of screw thread which were covered with autological bone material lay in all Op areas freely. A bone substitute became on this material Biobase (Zimmer Dental; case 1) and bonit matrix (DOT GmbH; case 2) found as a dummy. A cover with membrans (case 1: Biomend, Zimmer Dental; case 2: Cytoplast non resorb, ORALTRONICS GmbH) was carried out. The wound healing was unobtrusive in both cases. After 3 months (case 1) and 6 months (case 2) the implants were loaded with single crowns.
 

Fig. 1: Clinical situation before implant therapy (case 1). Fig. 2: Panoramic radiograph before implant treatment (case 1).
Fig. 3: Clinical situation before implant therapy (case 2). Fig. 4: Panoramic radiograph before implant treatment (case 2).

Results

It did not come to any implant loss in the observation period of 6 years (case 1) and 2 years (case 2). It came from the view of the patient to an optimal result.
 

Conclusions

Implant therapies by patients with congenital missing lateral incisors represent a great challenge today. A long-term therapy with diameter reduced BEGO - Compress - Implants by lacking of bone supply in vestibulo-oral direction and reduced intercoronale space of 5 mm is possible in individual cases. Particularly the nonablative thread moulder enable a gentle bone spreading and bone condensing of the implants bed and the primary stability improves considerably.
 

Fig. 5: Clinical situation 6 years after treatment (case 1). Fig. 6: Panoramic radiograph 6 years after implant therapy (case 1).
Fig. 7: Clinical view after 2 years later (case 2). Fig. 8: Panoramic radiograph 2 years after implant therapy (case 2).

This Poster was submitted by Dipl.-Stom. Michael Kirsch.
 

Correspondence address:
Dipl.-Stom. Michael Kirsch
Liebknechtstr. 14
99085 Erfurt