FEATURE DENTISTRY
needed bone – allowing this tissue to grow until the ‘empty’ (blood filled) space was filled out. During the last two decades we became more and more used to so-called ‘tissue management’, which includes various techniques and materials to augment bone in those sides where the local bone does not allow a implant placement. These augmentation procedures/techniques can be performed together with implant placement or separately in a two-stage procedure, depending on the amount of bone lacking. These sophisticated procedures have become a routine and are kind of mandatory in those cases,
«Augmentation procedures and techniques can be performed together with implant placement»
when special individual aesthetic and/ or functional requirements have to be fulfilled. Thus, the summarizing answer to the question would be, that advanced, state-of-the-art reconstruction techniques allow either to place implants in situations where they could not be placed before and/or can improve the aesthetic and/or functional outcome.
Q. Can you describe 3D simulations in oral implantology? A. The development of hi-tech, 3D x-ray scans (CT- or Digital Volume Tomography/Cone Beam Tomography scans) allow 3D-reconstruction of the existing anatomical situation of each patient in high resolution and at a low dose radiation rate. Based on these advancements in dental imaging, software programmes have been developed allowing ‘backwards planning’ in oral implantology. Opposed to the beginnings of dental implantology, when we inserted implants only in areas, or on patients with sufficient bone, we can nowadays design the final restoration (crowns, bridges, dentures) on the computer, allowing us to decide the exact location and orientation of the implants needed for supporting/
Arab Health Issue 4 2011 33
stabilizing the final reconstruction. Drill guides made from resin and containing metal sleeves for the drills, can be provided by special firms based on our computer planning. These guides assist the dentist in drilling the implant beds in their proper position, orientation, length, and diameter. At the same time, we can analyse and decide, if any augmentation procedures are needed, and/or if vital structures (e.g. the mandibular nerve) is endangered by the implant placement. The latest software allows even the consideration of the impact of the oral rehabilitation on the perioral soft tissues, which is an important aspect with regard to the aesthetic outcome. As we can start out with the final result of our oral rehabilitation using 3D-simulations, this is why it’s called ‘backwards planning’.
Q. What is the lifespan of oral implants and how often does the patient have to return for repeat treatments? A. One simple answer to this question is that implants can last for the remaining lifetime of the patient. However, a more detailed answer would be, that not all of the implants are functioning and/or show an appearance as intended or achieved at the beginning of the treatment. In
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