Maintaining Tissue Architecture in Immediate Implant Placement Following Extraction of Natural Teeth Using Custom Healing Screw
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 5
Abstract
The aim of this study was to compare the conventional healing screw with custom healing screw in terms of maintenance of soft tissue architecture. Twenty-four patients who underwent single tooth extraction and single immediate implant placement were included in the study. Twelve patients were treated with conventional healing screw after immediate implant placement (control group) and 12 were treated with screwretained custom healing screw (test group). After minimally traumatic tooth extraction, a temporary abutment was fabricated utilizing flowable composite, which adapted to the socket architecture, to serve as a customized healing screw. In order to evaluate soft tissue remodeling in all cases, digital impressions were made before tooth extraction, at implant insertion, at 6 months after insertion, and after placement of the final restorations. After 6 months of the Osseo integrated period, the custom healing screw served successfully as a tooth profile for peri-implant tissue. In cases of implants with conventional healing screw, soft tissue remodeling around the implants is observed, in contrast to cases of custom healing abutments. Correct design of a healing abutment is important for maintaining the emergence contour in cases of immediate implant placement. In our study, a considerable difference was observed between the standard healing screw and customized healing screw. The selection between provisional restoration and customized healing abutment is only based on esthetic considerations. Hard and soft tissue modifications occur after tooth extraction and immediate implant placement without provisional restorations. In addition to esthetic results are other reasons that the provisional implant is important in post-extraction crestal socket morphology. Fixed implant-supported provisional crowns are often used to customize the emergence profile and to individualize the surrounding peri-implant soft tissue. A factor for maintaining stable gingival contours is the reproduction of the shape of the root in the cervical third of the extracted tooth with soft tissue conditioning does improve the final esthetic result. It was described more technique way to replace missing teeth with dental implant which is designed to replicate the natural tooth root and crown of the natural tooth. This procedure preserves the gingival mucosa and bone with no damage to adjacent teeth. Other concepts of manufacturing the healing abutment were described to solve a lot of aesthetical and crestal socket morphology of what an immediate implant placement involve. The anatomic harmony abutment ultimately allows for more predictable final restorations by providing the dental laboratory a restorative profile and blueprint for the definitive abutment, thus idealizing the final restoration. A lot of outcomes for the clinicians, patients, dental technician and prosthodontics dentist can be considered. This individualized, anatomical healing abutment copy and preserve the cervical tooth anatomy, is no need for suture after the surgical part (considering this, there will be a better healing for the soft tissue), preserve the soft and hard tissue after the extraction, may improve the restorations and raising the papillae. Thus, the predictability of final restorations is increase by reduce the treatment time, reduce the surgical operations and obtain the satisfaction for the patient. The adequately contoured implant restoration to the corresponding tooth anatomy may be a viable option for preserving the bone and the gingival architecture. Conventional procedure for implant placement involves extraction of offending tooth, waiting 2-4 months for extraction socket to heal, insertion of implant, and again waiting for 3-6 months for integration of implant with surrounding bone; after this procedure, another surgery is necessary to expose the implant and to place a prosthetic abutment. Taking this consideration using anatomic healing screw abutment we eliminate the need for a second stage surgery and may provide a platform to promote periimplant soft tissue healing and minimize remodeling. Aim of this study was to compare the conventional healing screw with custom healing screw to solve problems were the immediate implant placement doesn’t reach the primary stability for immediate loading. In this way was approach an immediate customized healing screw fabrication. This concept can be used in all regions in oral cavity, for fabrication of a customized healing anatomic screw to maintain the crestal socket morphology.
Authors and Affiliations
Sorin Gheorghe Mihali, Paul Cornel Freiman, Emanuel Adrian Bratu
Keywords
Related Articles
- EP ID EP585917
- DOI 10.26717/BJSTR.2018.07.001554
- Views 145
- Downloads 0
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