Research

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Issue: 01/2017
Dental implant rehabilitation of a patient with Down syndrome – interdisciplinary workflow

Introduction: Implant-supported prosthetic restorations exhibit greater patient satisfaction compared to removable prosthetic restorations. Systemic diseases such as Down syndrome can affect the treatment planning and therapy. Typical oral manifestations of this syndrome include macroglossia, dysplasia of maxilla, malocclusion of the teeth, crossbite, shortened roots and anterior open bite.

Material and methods: This case report describes therapeutic treatments of implant surgery and prosthetic rehabilitation in a patient with Down syndrome using digital treatment concepts.

Results: A complex treatment with dental implants in combination with a prosthetic restoration can be successfully carried out at a Down syndrome patient.

Discussion: It has been shown in this case study, the digital workflow and in particular digital impressions can facilitate treatment procedures in compromised patients.

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Issue: 02/2017 - José Eduardo Maté Sánchez de Val - Ronny Gläser
Long-term analysis of bone stability with a platform-switched and flat-connection implant system – radiological analysis

Background: Dental implants have proven to be a predictable treatment for replacing missing teeth; with an extensive literature base and numerous studies supporting the safety of treatment. They have been introduced modifications protocols and implants to improve osseointegration; including surface topography, implant design, implant anatomy, connection, load time and load type. In all, the survival rates of long-term implant analysis are set at high values above 95%.

Aim: The aimwas to analyze from radiological analysis the stability of bone surrounding implants and complete the follow-up with long-term results.

Materials and methods: Standardized radiographs were taken at the implant placement day and at the moment of the restoration of the prosthesis, recall 1 year and long-term (7 years) by means of a one-position paralleling system. 60 implants (blueSKY, bredent medical GmbH Co. KG, Senden, Germany)have been inserted and after a subgingival healing period of 3 to 6 months have been restored with cemented metal ceramic and Zirconia single crowns. Radiological analysis was performed with image J software Wayne Rasbarnd, USA. Distances between platform to first bone contact were recorded.

Results: No implants were lost during the study period; no abnormal inflammation phenomena were observed that were not due to a peri-implant cicatrization process. The measured distance values between the implant platform and the first contact with the peri-implant bone have been recorded. For the initial moment of implant placement, an average distance of 0.23 ± 0.02 mm was found with a variation at 0.20 ± 0.04 at the time of connection of the prosthesis, and 0.31 ± 0.11 at the 1-year review. After 7 years the bone level has been found at 0.68 ± 0.03 mm from the platform to the first contact.

Conclusions: With the limitations of a clinical study in humans, it can be established that the combination of a platform switch technique with an adequate implant design and adequate attachments allows stabilization of the peri-implant tissues, minimizing the apical migration of the bone during a period of time analyzed in the long term, independent from the kind of connection.

Cited as: Sánchez de Val JEM, Gläser R: Long-term analysis of bone stability with a platform-switched and flat-connection implant system – radiological analysis. Z Zahnärztl Implantol 2017; 33: 143-151

DOI 10.3238/ZZI.2017.0143–0151

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