498
intraoral scan performed prior extracting the tooth, so the
esthetic outcome is satisfactory. The clinical significance of the
described technique include that the procedure was made in less
appointments, the overall treatment time is reduced and the
opportunity to regenerate the lost labial bone plate is viable with
better preoperative conditions. The use of guided planning was
a key factor in the satisfactory final outcome of the treatment.
PC415
Guided single-implants in the esthetic zone
following socket preservation; 5 year follow-up case
series
A.Y. Gokbuget, N.A. Kocak, S. Pamuk
Istanbul/Turkey
Background: Achieving ideal emergence profile and restoration
contours for single implant-supported prosthesis in the esthetic
zone while preserving soft and hard tissue volume in long-term
is the biggest challenge in implant dentistry. Long-term results
of 5 case using guided-implant surgery following socket preser-
vation after tooth extraction were presented.
Clinical Procedure: A no flap, in non-viable incisors, atrau-
matic extractions were carried out in 5 patients (age 32–
60 years). Preservation and sealing of the sockets were per-
formed with xenograft and free gingival graft from the palatal
side of the patients. Temporary maryland prosthesis were used
by patients during healing. After healing period; flapless implant
placement were performed with teeth supported surgical guide
by the same surgeon. Permanent prosthesis were made with cus-
tom abutments in order to preserve emergence profile. Radio-
graphic controls were done after socket preservation, implant
placement and during 5 year follow-up.
Outcomes: Within the limitations of these case series socket
preservation and guided implant surgery could be considerate as
successful methods in the long-term protection of soft and hard
tissue around esthetic zone implants.
PC416
Hybrid implant placement using papillae-sparing
incisions in the esthetic zone
M. Gozlu1, S. Ekinci2
1 tooth extraction, screw retained e-max ceramic was used for final
Konya/Turkey, 2Istanbul/Turkey
Background: The health of the peri-implant tissues play an
important in the long term outcome of dental implants. In the
esthetic zone it is preferable to avoid elevating papillae because
flap elevation may induce recession and create unesthetic black
triangles.
Clinical Procedure: Material and Methods: A 38-year-old
nonsmoking female patient, with no systemic condition, pre-
sented with missing teeth. The interproximal bone level on the
adjacent tooth is the most critical bone determinant of papilla
support. No observed bone loss in this area. Papillae-sparing
incisions were made. A horizontal releasing incision across the
edentate ridge at the site of tooth. It terminates 1 mm from the
adjacent teeth. Bilateral vertical releasing incisions on the buccal
aspect that extend obliquely, slanting away from the ends of the
horizontal incision. Hybrid dental implant inserted into the
ridge (4.1 mm 9 11.5 mm) (iRES SAGL, Lugano,
E-Poster | Clinical Report Presentation
Switzerland). Bone graft placed over the implant and collagen
barrier membrane positioned over bone graft. Vertical and hori-
zontal incisions were sutured to attain primary closure. The final
restoration was made after 2 months.
Outcomes: Results: Healing was uneventful. The presence of a
complete interproximal papilla around the implant was observed
in the case. The technique with Papillae-sparing incisions
showed esthetically pleasing implant crown with good soft tissue
contours.
Conclusion: This case demonstrates a specific incision design
and technique to achieve predictable esthetic outcome. Papillae-
sparing incisions facilitate accessing the bone to place dental
implants and restore compromised osseous and gingival architec-
ture. It may be necessary to restore teeth adjacent to a compro-
mised implant site to attain optimal esthetics.
PC417
Immediate implant placement in maxillary aesthetic
zone with socket shield technique: a case report
N. Bayraktar, B. Aysesek, S. Ersanli, A. Gultekin, M. Aytekin,
O. Oz
Istanbul/Turkey
Background: Immediate implant placement causes resorption
of surrounding tissues. With the socket shield technique the
root is retained to preserve the periodontal ligament and bundle
bone. In most procedures, particle grafts and membranes are
used to support the buccal plate and soft tissue. It has also been
suggested that resorption of the buccal bundle bone can be
avoided by leaving a buccal root segment in place(socket shield
technique). In this case, minimum facial bone resorption is
expected and volumetric changes are measured by Cone Beam
Computed Tomography (CBCT).
Clinical Procedure: 29 years old male patient was referred to
Istanbul University Dentistry Faculty Oral Implantology
Department due to trauma in anterior maxillary teeth. Teeth
crowns were removed from the horizontally broken teeth.
Implants were placed by preserving the facial bundle bone plate
through the root segments. After implant placement, the socket
was filled with xenograft. Resorbable collagen membrane and
free gingival graft were used to cover the socket during surgery.
Patients teeth were used as temporary teeth in essix plaque as
temporary immediate prosthesis. Gingival contour was recon-
structed by screw retained temporary teeth and 2 months after
restoration.
Outcomes: During postoperative 1 year controls, there was no
change in gingival contour and bone resorption with CBCT.
Pink esthetic score was used to evaluate gingival aesthetic.
Implants healed without adverse events. The comparison of
radiographic images showed physiologic bone remodeling at the
implant shoulders without bone resorption. Volumetric analysis
showed a low degree of contour changes from extraction and
implant placement to the follow-ups before final restoration.
This technique can be used if there is possibility of bone resorp-
tion with immediate implant placement.
© 2018 The Authors.
© 2018 European Federation of Periodontology