 Patients asking for a reduced bulk/size and/or better stabilization of a removable denture These indications include edentulous jaws, the free end situation, and the extremely reduced dentition. The implant treatment in these cases will result in a still removable denture, but with a design that offers improvement in masticatory function, speech, hygiene, and last, but not least, comfort and thus the psychological situation of the patient are distinctively improved.


Q. What are the challenges associated with dealing with oral implant cases? A. The normal challenges are given by the anatomical structures on one side and the functional as well as aesthetic result being strived for on the other side. The ideal implant reconstruction should replace the original tooth in every regard and in many instances


«The ideal implant reconstruction should replace the original tooth in every regard»


should be even better than the situation prior to the treatment. Furthermore, typical anatomical structures have to be protected, as damage to the mandibular nerve would result in permanent numbness of the lower lip on the same side. Other major challenges are related to the aesthetic outcome, when implants plus restoration (crown/bridge) are inserted in the visible zone of patients with a high smile line. Minor changes in contour; like missing ‘papillas’ (triangular shaped gingiva between teeth/crowns) will cause unsightly ‘black triangles’, which might potentially diminish a high level treatment result.


Q. To what extent is facial bone reconstruction required as part of oral implantology? A. In order to avoid any misunderstanding, we have to differentiate between facial and oral bone reconstruction. While the first situation is related to patients suffering from trauma, tumours, or hereditary defects (e.g. cleft palate), the second situation addresses any kind of intraoral performed bone reconstruction. Roughly speaking, during the first three decades of modern implantology (from the Sixties to the late Eighties) implants where mostly inserted when the amount of bone at the recipient side was sufficient. However, during the end of this period, we started to talk about ‘guided bone regeneration’ (GBR), which was performed by using non-resorbable membranes made from GoreTex® which was fixed like a “mini-tent” over the area, where we


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