engleski

Minimally invasive technique for preservation of stabile periimplant soft tissues after immediate implantation - guidelines and principles for successful implanto-prosthetic rehaliblitation - a clinical study

Objectives: The aim of this clinical study was to investigate clinical success of the socket shield technique and to evalute its outcome on the esthetics of the final prosthetic rehabilitation. Material and methods: This clinical study constited of 30 patients at Department of Oral Surgery with strong indication for tooth extraction in the frontal part of the maxilla. Patients were divided due to their clinical indications:1. Postendodontic horizontal tooth fracture where the fracture line is prosper enough to preserve buccal tooth root and imediate implant placement 2. Postendodontic submarginal fracture when patient rejects ortodonthic tooth extrusion. 3. Crown fracture of vital tooth beyond the marginal bone surface, but patient is not willing to acess ortodontic therapy or conservative treatment. Each group consisted of 10 patients. Partial resection of palatal root was performed in each patient with a view to preserve buccal root as well as buccal bone wall. After resection alveolar bed for implant, located more palatal regarding on buccal root left in alveola, was prepared. Before implant was inserted a buccal root was smeared with Emdogain gel (Straumann, Basel, Switzerland). After all immediate crown was maid following non-functional loading concept. Patients were threated with antibiotic therapy during 7 days after surgery. After 4 - 6 months a permanent implatoprostethic substitute was made, while x-ray analysis was made after 6 months. Results: Patients did not have any kind of complications after surgery. Immediate crowns were replaced with permanent tooth crowns after 4 - 6 months. Two patiens experienced screw loosening after 1 month. Soft tissue contours were preserved in all cases, also buccal bone wall was preserved. In a period of following 6 months there was no any biological or mehanical complications. Conclusion: With buccal bone wall preservation as well as a preservation of gingival tissue using tehnique of immediate implant placement, very good esthetic results were achieved. By deciding which patients are candidates for this surgery indications and guidelines written above need to be followed.

oral surgery ; dental implantology ; alveolar ridge ; socket shield technique

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