Читать книгу Practical Procedures in Implant Dentistry - Группа авторов - Страница 4

1 Chapter 3Figure 3.1 Analogue/traditional radiographic template.Figure 3.2 Acrylic radiographic/surgical guide.Figure 3.3 Guided surgery in a full arch implant rehabilitation.Figure 3.4 Full face frontal. This image is shot at the same height as the p...Figure 3.5 Right lateral smile.Figure 3.6 Frontal smile.Figure 3.7 Left lateral smile.Figure 3.8 Retracted frontal shot with teeth apart.Figure 3.9 Retracted frontal shot with teeth in maximum intercuspation.Figure 3.10 Retracted left photograph displaying left side of teeth. The lef...Figure 3.11 Retracted right photograph displaying right side of teeth. The r...Figure 3.12 Occlusal photograph of mandibular teeth using a photographic mir...Figure 3.13 Occlusal photograph of maxillary teeth using a photographic mirr...

2 Chapter 4Figure 4.1 Example of a surgical checklist. Source: Care Implant Dentistry....

3 Chapter 5Figure 5.1 Tripartite effect of tooth loss.Figure 5.2 Resorption patterns of the mandibular edentulous ridge (note the ...Figure 5.3 Progressive healing of extraction socket. BC, blood clot; GT, gra...Figure 5.4 Hard and soft tissue healing of a single tooth extraction. (a) Cl...Figure 5.5 Loss of vertical dimension and facial soft tissue support. (a, b)...

4 Chapter 6Figure 6.1 Osteology of the skull (exploded view).Figure 6.2 Osteology of the skull (frontal view).Figure 6.3 Osteology of the skull (lateral view).Figure 6.4 Innervation and vascular supply of the maxillary and mandibular d...Figure 6.5 Anatomical rendering of head and neck – lateral view.Figure 6.6 Anatomical rendering of head and neck (structures unlabeled). (a)...Figure 6.7 Muscles of mastication and facial expression.

5 Chapter 7Figure 7.1 Three‐dimensional versus two‐dimensional view of incisive foramen...Figure 7.2 Location of the infraorbital foramen. The location of the infraor...Figure 7.3 Changes in the presentation of the maxillary sinus. (a) In the de...Figure 7.4 Implant placement following maxillary sinus augmentation in a sta...Figure 7.5 Position of the greater palatine artery and nerve. The greater pa...

6 Chapter 8Figure 8.1 Mental foramen and neurovascular bundle. Interruption of normal s...Figure 8.2 Comparison of imaging techniques on the same patient. The periapi...Figure 8.3 Imaging of the lingual foramen and proximity to the genial tuberc...Figure 8.4 Tracing of inferior alveolar canal. The capture of CBCT imaging a...Figure 8.5 Contents of the submandibular fossa and closely related structure...

7 Chapter 9Figure 9.1 (a) Teeth 11 and 21 had sustained sporting injury. (b) Both teeth...Figure 9.2 (a) CBCT measurement schematic. Points a–d: buccal bone height, bFigure 9.3 Histological image (20× magnification) showing new bone, residual...Figure 9.4 (a, b) Teeth 11 and 21 indicated for extraction. (c) Minimally tr...Figure 9.5 The No.69 Swann‐Morton® mini‐blade can act as a surgical blade an...Figure 9.6 (a–d) For maxillary and mandibular anterior or single‐rooted teet...

8 Chapter 10Figure 10.1 Titanium rods prior to dental implants being cut from these.Figure 10.2 An individual dental implant cut from the titanium rod.Figure 10.3 The cut implants prior to any surface treatments.Figure 10.4 The implants after sandblasting.Figure 10.5 The implants are then acid etched to remove surface impurities a...Figure 10.6 Finally, the implants are sterilised and packaged.Figure 10.7 Examples of various implant designs. (a) Tapered implant with pa...Figure 10.8 Measuring wettability by the sessile water droplet test.Figure 10.9 Scanning electron microscope (SEM) view of an untreated, machine...Figure 10.10 Classification of implant surface roughness: (a) treated implan...Figure 10.11 Differing thread designs: (a) plateau; (b) reverse buttress; (c...Figure 10.12 (a) Thread geometry, reverse buttress design. (b) Thread pitch,...Figure 10.13 An external hexagonal connection. Note the visible gap between ...Figure 10.14 An internal conical connection. Note the intimate contact betwe...Figure 10.15 An external, ‘flat‐on‐flat’ connection. Abutment and implant ar...Figure 10.16 The internal conical connection moves a potential gap away from...

9 Chapter 11Figure 11.1 Immediate implant placement on day of tooth extraction. Use of a...Figure 11.2 Temporary cylinder in situ opaqued with opaque tints to block me...Figure 11.3 Denture tooth converted into immediate provisional crown.Figure 11.4 Prosthetically guided soft tissue healing with provisional crown...Figure 11.5 Final all‐ceramic crown and abutment in place, recreating natura...Figure 11.6 Assessment of the cone beam computed tomography (CBCT) radiograp...Figure 11.7 Assessment of the CBCT reveals a large root anatomy with minimal...Figure 11.8 The initial osteotomy in the anterior maxilla needs to be initia...

10 Chapter 12Figure 12.1 ‘Nose to chin’ photos of the lips at rest and at high smile are ...Figure 12.2 Periapical radiographs are essential in implant planning as they...Figure 12.3 This image shows a large defect left when an implant became infe...Figure 12.4 This patient presented with a failing first premolar. In plannin...Figure 12.5 This patient presented for implants in the lateral incisor posit...Figure 12.6 Orthodontic site preparation. In this case, an internally resorb...Figure 12.7 The ectopically erupted canine was moved not only to bring it ba...

11 Chapter 13Figure 13.1 Implant loading timeline.Figure 13.2 The Ostell IDX unit utilises resonance frequency analysis to mea...Figure 13.3 Immediate implant placement into socket after tooth extraction....Figure 13.4 Impression of implant at time of placement. Note the protection ...Figure 13.5 Immediate loading with provisional implant crown (PMMA with temp...

12 Chapter 14Figure 14.1 Surgical instrumentation. From left to right: Depth probe, Lagra...Figure 14.2 (a) Anterior (Branemark) retractor, (b) Bishop retractor, (c) Mi...Figure 14.3 Benex^® Extraction System is a specialised device for atraum...Figure 14.4 Micross (Meta) bone scraper.Figure 14.5 Anthogyr Torq Control.Figure 14.6 Surgical cassette housing instruments preventing damage and opti...

13 Chapter 15Figure 15.1 (a) Comparison between full‐thickness and partial‐thickness flap...Figure 15.2 Soft tissue punch.Figure 15.3 (a) Buccal envelope flap. (b) Envelope flap with mid‐crestal inc...Figure 15.4 (a) Two‐sided flap with distal vertical releasing incision at th...Figure 15.5 (a) Papilla‐sparing incision. (b) Modified papilla‐sparing incis...Figure 15.6 (a) Envelope flap designed with palatally/lingually placed crest...

14 Chapter 16Figure 16.1 Suture packaging and descriptions.Figure 16.2 Suture needles.Figure 16.3 Simple interrupted sutures.Figure 16.4 Continuous/uninterrupted sutures.Figure 16.5 (a) Internal horizontal mattress suture continuous. (b) External...Figure 16.6 (a) Internal vertical mattress suture continuous. (b) External v...

15 Chapter 17Figure 17.1 Triad of contemporary implant dentistry.Figure 17.2 Pink Esthetic Score criteria include: mesial papilla (a), distal...Figure 17.3 (a) Implant placement in an upper central incisor area. (b) Note...Figure 17.4 (a) Buccal veneer grafting performed at the time of implant plac...Figure 17.5 (a, b) Robust buccal volume augmentation following combined conn...Figure 17.6 (a) Clinical situation following bone and soft tissue augmentati...Figure 17.7 Close‐up view of the buccal plate of a canine socket following e...Figure 17.8 Schematic illustrating the differences between the peri‐implant ...Figure 17.9. (a) Pre‐operative bone sounding of the buccal plate reveals pro...

16 Chapter 18Figure 18.1 Incorrect placement of implants, with insufficient spacing betwe...Figure 18.2 Placement of an implant should be within the alveolar ridge, ens...Figure 18.3 Placement of an implant too labially will lead to poor aesthetic...

17 Chapter 19Figure 19.1 The peri‐implant phenotype.Figure 19.2 Missing first premolar site with mild to moderate horizontal buc...Figure 19.3 (a–i) Buccal roll flap suturing sequence. (b) Healed first premo...Figure 19.4 Healed lateral incisor site with mild to moderate horizontal buc...Figure 19.5 (a–e) Pouch roll technique incision outline. (b) Healed lateral ...Figure 19.6 Healed first and second molar site with shallow vestibulum and l...Figure 19.7 (a–d) Apically repositioned flap incision and suturing outline. ...Figure 19.8 Healed first premolar, second premolar, and first molar site wit...Figure 19.9 (a–f) Apically repositioned flap incision and suturing outline. ...Figure 19.10 (a, b) Healed first molar site with shallow vestibulum, moderat...Figure 19.11 (a) Partial‐thickness mucosal flap secured apically using singl...Figure 19.12 (a) Free gingival graft incision, graft, and suturing outline. ...Figure 19.13 Surgical blade dimensions.

18 Chapter 20Figure 20.1 Histology: Oral keratinised tissue epithelium consists of four l...Figure 20.2 Schematic drawing showing the distance between the cemento‐ename...Figure 20.3 (a) The desired outline is cut with a blade. (b) Undermining the...Figure 20.4 (a) A deeper, more coronal incision down to osseous is made. (b)...Figure 20.5 (a) Initial presentation showing recession on lateral incisor. (...Figure 20.6 (a) The previous block fixation screw was exposed and removed to...Figure 20.7 (a) The inside of the tissue was de‐epithelialised using a finis...Figure 20.8 (a) Connective tissue graft was harvested from the palate and pr...Figure 20.9 (a) Insertion of the connective tissue in the prepared tunnel bu...Figure 20.10 Three months post‐operative showing gain in soft tissue thickne...Figure 20.11 (a) Buccal pre‐operative view. (b) Occlusal view of the same de...Figure 20.12 (a) Pre‐augmentation bone view. (b) Augmentation with rhBMP‐2‐s...Figure 20.13 (a) Immediately post‐operation 4‐0 PTFE and 6‐0 proline sutures...Figure 20.14 (a) After implant placement and uncovers. Note the frenum and m...Figure 20.15 (a, b) Two strip free gingival grafts harvested from the palate...Figure 20.16 (a) An essex shell was prepared off the wax‐up followed by impl...Figure 20.17 Two months after soft tissue procedure.

19 Chapter 21Figure 21.1 Onlay autogenous bone graft harvested and stabilised on the post...Figure 21.2 (a) Pre‐operative view. (b) Initial situation prior to grafting....Figure 21.3 (a) Bone graft packed and stabilised on the buccal via two screw...Figure 21.4 (a, b) Pre‐operative view and initial situation prior to graftin...Figure 21.5 (a) Outlining the graft borders starting with medial and distal,...Figure 21.6 (a) Initial view of the graft. (b) The graft was split with piez...Figure 21.7 (a) Buccal plate is fixed first followed by palatal plate. Note:...Figure 21.8 (a) We can benefit from excess bone by careful trimming and usin...Figure 21.9 (a) Horizontal and vertical bone regeneration four months after ...Figure 21.10 (a, b) Buccal view of the implant position showing implant plac...

20 Chapter 22Figure 22.1 Open tray impression copings. Notice the square form of the copi...Figure 22.2 Customised impression coping in place, supporting and reproducin...Figure 22.3 Engaging and non‐engaging impression copings. Single restoration...Figure 22.4 Impression jig constructed in the laboratory for intra‐oral pick...Figure 22.5 Parallel technique used to take radiograph of implant and impres...

21 Chapter 23Figure 23.1 (a) With a low smile line <75% of the maxillary incisors in the ...Figure 23.2 (a) Tooth 11 suffering from external resorption. The patient has...Figure 23.3 (a) The use of pink soft tissue replacement and a large soft tis...

22 Chapter 24Figure 24.1 Immediate implant placement and provisionalisation. The maxillar...Figure 24.2 Adding resin (yellow) in this critical contour region to over‐co...Figure 24.3 Patient with missing interdental papillae. Note the interproxima...

23 Chapter 25Figure 25.1 Implant and prefabricated titanium abutment (Esthetic Abutment, ...Figure 25.2 Descriptions of the various implant abutments available.Figure 25.3 Customised titanium abutment with monolithic all ceramic (zircon...Figure 25.4 Multi‐unit abutments (Screw‐Retained Abutments; Straumann) are o...Figure 25.5 All on Four^® Treatment concept (Nobel Biocare). Anterior im...Figure 25.6 Zirconia abutment inserted and final all‐ceramic crown.Figure 25.7 Correctly contoured emergence of abutments are more concave, all...Figure 25.8 Location jig to allow correct placement of the implant abutment....

24 Chapter 26Figure 26.1 Screw‐retained crowns need an access hole on the cingulum area t...Figure 26.2 To achieve screw retention in the anterior region may involve al...Figure 26.3 The hybrid cement/screw restorations involve a restoration being...Figure 26.4 One‐piece screw‐retained restorations with the veneering porcela...Figure 26.5 Use of lateral set‐screw/cross‐pin to allow a bridge to be tempo...Figure 26.6 The use of specialised drivers with a unique head allows for ang...Figure 26.7 The ability to correct the angulation is useful to allow screw r...

25 Chapter 27Figure 27.1 ‘Variobase’ abutment.Figure 27.2 ‘Pre‐milled’ abutment.Figure 27.3 Medentika preface abutment holder.Figure 27.4 Planned case requiring angled screw channel.Figure 27.5 Nobel Biocare ‘ASC’ (angled screw channel).Figure 27.6 Digital design of healing abutment using implant planning data....Figure 27.7 Implant surgery and healing abutment insertion.Figure 27.8 Alignment of healing abutment as scan body ready to design final...Figure 27.9 CAD implant libraryFigure 27.10 Implant coordinates after scan abutment alignment.Figure 27.11 Icam4D scan locators.Figure 27.12 Acquisition of implant positions (Icam4D). Source: Imetric 4D I...Figure 27.13 Design of restoration (3shape Dental System®). Source: 3Shape A...Figure 27.14 Printed try‐in.Figure 27.15 Final restoration ready for insertion three days post‐surgery....Figure 27.16 Pre‐surgery situation.Figure 27.17 Audentes bridges manufactured for surgery.Figure 27.18 Post‐surgery OPG showing bridge insert accuracy.Figure 27.19 Intra‐oral result one week post‐surgery.Figure 27.20 Before and after. One week post‐surgery.

26 Chapter 28Figure 28.1 Poor biomechanical and occlusal planning can lead to rapid failu...Figure 28.2 When examining forces on an object, it is important to be able t...Figure 28.3 Compressive, tensile, and shear forces.Figure 28.4 Correctly planned occlusions are important. Where you place your...Figure 28.5 The resultant vectors when a force is applied to an incline plan...Figure 28.6 Beams transfer loads by resisting bending and are complex struct...Figure 28.7 Class 1, 2, and 3 lever systems.Figure 28.8 The mandible as a class 3 lever system. The occlusal forces are ...Figure 28.9 Cantilevers require rigid and strong anchorage to resist the for...Figure 28.10 (a) Conceptual diagram showing a cantilever with a 2x A‐P sprea...Figure 28.11 Teeth are vertical cantilevers. Crown to implant ratio is impor...

27 Chapter 29Figure 29.1 Implants in upper left central and incisor positions demonstrati...Figure 29.2 Note the gingival embrasure space has been closed with pink porc...Figure 29.3 (a) Fabricating a copy abutment by lining the intaglio of the cr...

28 Chapter 30Figure 30.1 Directing occlusal loads axially rather than allowing lateral lo...Figure 30.2 Steep cuspal inclinations may produce a bending moment allowing ...

29 Chapter 31Figure 31.1 Radiograph of fractured abutment screw within an internal connec...Figure 31.2 Stripped screw head. The top of the screw is carefully removed a...

30 Chapter 32Figure 32.1 Interocclusal space requirements with different restorative opti...Figure 32.2 The transition line or prosthesis tissue junction is visible in ...Figure 32.3 Completely removable mandibular dental prosthesis using two loca...Figure 32.4 Fixed/removable implant‐supported bridgework. (a) Titanium bar. ...Figure 32.5 All on 4® implant‐supported bridgework with angled posterior imp...Figure 32.6 (a) Placement of six implants in the maxilla for full arch impla...

31 Chapter 33Figure 33.1 Comparison of peri‐implant mucositis and healthy peri‐implant ti...Figure 33.2 Excess cement on buccal and lingual of restoration. The clinical...Figure 33.3 Series of radiographs and photographs permitting evaluation of p...

32 Chapter 34Figure 34.1 Digital surface scans acquired from the intra‐oral scan of the l...Figure 34.2 Incorporated resin or silicone‐based markers to increase the num...Figure 34.3 Cone beam computed tomography (CBCT) scan.Figure 34.4 (a–d) Digital planning of implant placement based from a restora...Figure 34.5 (a–c) Digital planning of implant placement based from a restora...Figure 34.6 Digital planning of the surgical guide with the optimal 3D impla...Figure 34.7 The digitally planned surgical guide.Figure 34.8 The surgical guide seated intra‐orally.Figure 34.9 Straumann BLX Guided Surgery kit.Figure 34.10 Intra‐oral scan marker.Figure 34.11 (a–c) Intra‐oral scan markers in situ intra‐orally.Figure 34.12 (a–c) Digital surface scans taken with an intra‐oral scanner wi...Figure 34.13 (a, b) Scan bodies inserted with an intra‐oral digital scanner ...Figure 34.14 (a–c) Digital design and manufacturing of a lower full arch fix...

33 Chapter 35Figure 35.1 Peri‐implant radiolucency noted around failing implant.Figure 35.2 Periodontal and peri‐implant interface. The implant interface co...Figure 35.3 Emergence profile of implant restorations. When the emergence an...Figure 35.4 Titanium curettes designed for use around dental implants to pre...Figure 35.5 Implantoplasty to remove exposed threads and render the surface ...Figure 35.6 Patient with peri‐implantitis treated surgically with full‐thick...Figure 35.7 Regenerative surgical technique in a case with crater‐like intra...Figure 35.8 Final implant‐supported prosthesis demonstrating areas that are ...Figure 35.9 Fixed prosthesis with a large flange impeding access for cleanin...

34 Chapter 36Figure 36.1 Implant fracture. Patient was experiencing unexplained bone loss...Figure 36.2 Fractured abutment screw (gold screw).Figure 36.3 Poor implant positioning and attempted prosthetic recovery with ...Figure 36.4 Minor gingival discolouration in the anterior region adjacent to...Figure 36.5 Continued screw loosening of the abutment and re‐tightening led ...Figure 36.6 Stripped screw head. A fine slot has been cut into the top of th...Figure 36.7 Implant prosthetic misfit due to incorrect abutment insertion.Figure 36.8 Fistula present on the labial gingivae around the maxillary righ...Figure 36.9 Lower 46 implant with prosthesis misfit. The decision was to rep...Figure 36.10 Fractured metal framework and acrylic superstructure with poor ...