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Aesthetic gingival management: Preservation of the anatomical structures and the gingival aesthetics by immediate implant-insertion after loss of anterior teeth and premolars—Results of a 5-year prospective study with 348 inserted one-phase implants

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Open Journal of Stomatology 2013年第2期3卷 146-154页

作者： Angelo Troedhan izabela schlichting Andreas Kurrek Center for Facial Esthetics Vienna Vienna Austria Implantology Clinic Ratingen Ratingen Germany

Implant insertion is an alternative to classical treatment with bridges after tooth extraction or traumatic tooth loss in the anterior and premolar region of the upper and lower jaw. Nevertheless both types of prosthetic treatment inhere major gingival aesthetic pitfalls by physiological vertical and horizontal resorption. Aim of the study was to investigate if the immediate insertion of root analogue single-stage implants and prosthetic treatment could prevent gingival recessions and bone resorption thus keeping the natural gingival aesthetics untouched. Between 2003 and 2006, 348 root analogue Q1-Implants (TRINON Karlsruhe GmbH/Germany) were inserted in 342 patients’s premolar and molar regions immediately after tooth extraction or traumatic tooth loss and treated with provisional resin crowns. The observation period with recurring 6-month clinical and radiographic check-ups was a minimum of 5 years. Of 348 inserted implants 4 (1.15%) were lost resulting in an overall success rate of 98.85%. In the first 12 weeks after surgery a mean recession of the buccal gingival margin of 0.2 mm (SD 0.34) could be detected, after final prosthetic treatment an overall mean recession of 0.2 mm (SD 0.13) within the survey period. Immediate implant insertion of root analogue single stage implants and immediate prosthetic treatment with provisional resin crowns after minimal invasive tooth extraction seems to be appropriate to prevent bone resorptions of the buccal alveolar crest and the recessions of the gingiva and papillae and thus suggests to be the preferable treatment to keep the natural gingival and papillary aesthetics untouched preventing further traumatic surgical gingival reconstructions.

关键词： Oral Implantology Single Phase Implants Immediate Implant Insertion Gingival Aesthetics

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Sinus Lift versus Short Implants: Results of a Prospective Radiologic Study and Critical Review of Minimally Invasive Transcrestal Sinus Lift Procedures

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Open Journal of Stomatology 2017年第1期7卷 1-24页

作者： izabela schlichting Dagmar Lacina Bianca Fischak-Treitl Practice for Dentistry and Oral Implantology Vienna Austria Office for General Dentistry and Implantology Mattersburg Austria

Introduction: The current discussion about the use of short implants to avoid bone-augmentation (“sinus lift”) in the lateral maxilla remains a controversial topic and is increasingly at odds with the reality of evolutionary biology. Aim of the study was to determine the percentage of cases from a large routine patient-sample in which short implants might be suitable to avoid sinus lift procedures. Materials and Methods: From January 2012 to June 2015, all patients in three general dental practices in Austria with at least one subantral edentulous area were subjected to routine panoramic X-ray screening. The subantral alveolar ridge heights and the mesial extension of the maxillary sinus towards the canine fossa were measured. Statistics were performed by Excel data analysis (mean value, standard deviation). Results: 2837 patients were screened with 2837 panoramic radiographs presenting 3528 edentulous subantral regions and the subantral bone heights of 5674 maxillary sinuses were surveyed. 57.43% revealed subantral alveolar ridge heights of 4 mm or less;24.43% of all measure-points indicated a maximum alveolar ridge height of 6 mm. In 39.32% of cases, the pneumatisation of the maxillary sinuses with a subantral residual ridge height of 6 mm or less extended as far as the anatomical position of the second premolars, in 20.51% as far as the position of the first premolar and in 10.84% as far as the canine fossa. Discussion: The sinus lift procedure will continue to be one of the basic standard surgical procedures carried out by practice-based dental surgeons who perform implant surgery since in at least two thirds of the cases short implants with lengths of less than 6 mm cannot be applied. Preference should be given to sinus lift-procedures, which can be learned safely with a minimum of time-effort, least risk of failure and lowest possible level of patient morbidity. Transcrestal hydrodynamic ultrasonic sinus lift-procedures with piezotomes seem to fulfill these ba

关键词： Oral Surgery Implantology Sinus Lift Piezotome Surgery Ultrasonic Surgery Short Implants

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Flapless Piezotome-Enhanced Vertical Alveolar Crest-Split and Horizontal Distraction of Alveolar Crests (FPeCSWT) of Less than 2 mm Width: Results of a Prospective Comparative 3-Year Clinical Multicenter-Study with 239 Patients, 261 Crest-Split Sites and 488 Inserted Dental Implants

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Open Journal of Stomatology 2015年第7期5卷 159-178页

作者： Angelo Troedhan Andreas Kurrek Marcel Wainwright izabela schlichting Center for Facial Aesthetics Vienna Vienna Austria Implantology Clinic Oberkassel Dusseldorf Germany Implantology Clinic Kaiserswerth Dusseldorf Germany

Alveolar crest-splitting and horizontal distraction is an established surgical technique to enable implant insertion into the narrow, lateral atrophic alveolar crest. This surgical technique is challenging for the oral surgeon and restricted to crest-widths of 3 - 5 mm: significant procedural bone loss at osteotomy, the need to prepare a full thickness mucoperiostal flap and milling a baseline-osteotomy to weaken the bone for distraction inhere significant risks of accidental fractures. Aim of the study was to investigate if the recently developed novel Flapless Piezotome enhanced Crest-Splitting and Widening Technique (FPeCSWT) could safely narrow down the indication for this procedure to narrow alveolar crests of widths of even less than 2 mm in a three-year survey-period. 239 patients underwent 261 FPeCSWT-surgeries and 488 implants were inserted simultaneously in the upper and the lower jaw and clinical parameters such as intrasurgical complications, patient morbidity, implant loss and vertical bone loss (VBL) in the first three years after surgeries were recorded comparing sites with less than 2 mm width with sites of more than 2 mm. After three years a significant difference (p = 0.24) of VBL could be observed between the group with less than 2 mm crest-width (mean: 0.97 mm, max: 2.0 mm/min: 0.0 mm;SD: 0.41) compared with the group with more than 2 mm crest-width (mean: 0.69 mm, max: 1.5 mm/min: 0.0 mm;SD: 0.36) but was still significant lower when compared with the results of similar studies published with a mucoperiostal-flap approach and baseline bone-cut. The cumulative 3-year-implant-survival-rate was 98.8%, no accidental fracture of the distracted buccal bone-plate occurred. The re-sults of the study suggest that the FPeCSWT narrows safely down the indication for crest-splitting to also crest-widths of only 1 mm. The procedure is highly predictable and significantly reduces the challenge of surgical skills and leads to negligible patient-morbidity. The h

关键词： Dental Implantology Bone-Management Guided Bone Regeneration Piezosurgery Ultrasonic Surgery Crest-Split Ridge-Split Distraction Osteogenesis Biomaterials Dental Implants

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The transcrestal hydrodynamic ultrasonic cavitational sinuslift: Results of a 2-year prospective multicentre study on 404 patients, 446 sinuslift sites and 637 inserted implants

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Open Journal of Stomatology 2013年第9期3卷 471-485页

作者： Angelo Troedhan Andreas Kurrek Marcel Wainwright izabela schlichting Bianca Fischak-Treitl Martin Ladentrog Center for Facial Aesthetics Vienna Vienna Austria Implantology Clinic Kaiserswerth Dusseldorf Germany Implantology Clinic Oberkassel Dusseldorf Germany Office for General Dentistry and Implantology Graz Austria Office for General Dentistry and Implantology Mattersburg Austria

Introduction: In 2006 an ultrasound-surgery-based method to hydrodynamically detach the sinus-membrane utilizing the ultrasonic cavitation effect—the tHUCSL—was developed and a surgical protocol established. The aim of the study was to determine the indication-range and success-rate of this novelty procedure. Materials & Methods: Between 2007 and 2009, 404 patients were treated by 6 oral surgeons of different experience-levels with the tHUCSL in 446 sinussites. 637 implants were inserted and then prosthodontically treated and observed and documented until December 2011. The subantral space was augmented via the 3 mm transcrestal approach with an augmentation volume of 1.9 ccm (+/? 0.988 ccm) and an augmentation height of 10.7 mm (+/? 2.85 mm). Results: Within the survey-period 15 (2.35%) of the 637 inserted implants were lost, mostly before implant loading due to postsurgical infection and nonosseointegration in the augmentation site. 1 implant was lost after implant loading and prosthetic treatment within 1 year after loading. The overall success rate with functional implants in site is 97.65% evenly distributed among the participating surgeons. 86% of the patients were observed with no postsurgical swelling and 87% no postsurgical pain. Discussion: The results suggest the tHUCSL to be a safe minimal-invasive alternative to traditional lateral approach and transcrestal osteotome sinuslift-procedures applicable to all anatomical situations.

关键词： Transcrestal Hydrodynamic Sinuslift Bone Augmentation Implants Ultrasound Surgery Maxillary Sinus

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