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Case Report Case Reprt Worldwide Events issn 1868-3207 Vol. 10 • Issue 3/2009 implants international magazine of oral implantology 32009 _case report Bone quality, quantity and metabolism in terms of dental implantation _case reprt Precautions for using zirconia implant abutments _worldwide events 5th Arab German Implantology Meeting DGZI in Damascus Anschnitt DIN A4 23.07.2009 12:12 Uhr Seite 1 Now even more innovative Easy-to-dismantle surgical instruments with LED and generator Easy to dismantle. Easy to assemble. As simple as they are efficient: both the S-11 LED G and the WS-75 LED G can be completely dismantled. And, of course, they can be put back together again. Quick, simple and risk-free: meaning that you too are able to eliminate any risks and work in truly optimum hygienic conditions. Get the new standard for yourself: perfect light, global compatibility, precision, ergonomics – and complete safety. Now at your local dental dealer or at wh.com editorial _ implants I Implantology faces new challenges Dr Friedhelm Heinemann President of DGZI Dear colleagues, in recent years, implantology has been considered to be THE driving force for innovations within dentistry. Companies and investors all over the world were impelled by the apparently infinite growth potential of this market. In the meantime, however, or so it seems, the mood has become much more reserved. Some implant systems have already been withdrawn from the market, and many companies do not act as ag- gressively as they used to. We have to find the answers to the following basic questions. Which are the real growth potentials of implantology, and how can implantology be placed on a changed market in the fu- ture? Contrary to the trend of the increase in gaining independence within our expert field, observable in the past, I believe that it will become more important to go back to the roots of implantology and consider it to be the real interface between parodontology, surgery and prosthetics. The broad digitalization within dentistry by means of 3-D diagnosis combined with modern planning and navigation software, including CAD/CAM manufactured dentures, implies this interface function, also from the technological point of view. Due to the digitalization of dental practices, team spirit is fostered, the flow of information is im- proved, and cooperation between the partners is facilitated. Prosthetic dental planning and the prosthetic guidelines for surgery will be easier to communicate, ultimately contributing to the achievement an op- timal result, and thus efficiently meeting the desire of the patient. In this way, the old requirements and ideas for interdisciplinary cooperation can be realized in a much better manner. With this in mind, I would like to draw your attention to our 39th International Annual Congress which will take place from October 9th to 10th in Munich this year. Thanks to the high class speakers from Germany and abroad, our Annual Congress will again become a special highlight in advanced professional training. I look forward to welcoming you in Munich. Yours, Dr Friedhelm Heinemann President of DGZI implants 3_2009 I03 I content _ implants case report 14 worldwide events 40 Manufacturer news 41 I editorial _ user report 32 Resorption mechanism of an injectable 03 Implantology faces new challenges calcium phosphate bone regeneration cement _Friedhelm Heinemann, Germany – Radiographic and histological monitoring _Sérgio Alexandre Gehrke, Brazil I report I events _ case report 06 Bone quality, quantity and metabolism in _ worldwide events terms of dental implantation 38 DGZI Adria Congress on the Isle of Vis _Jochen Fanghänel, Tomasz Gedrange, Germany _Rolf Vollmer, Rainer Valentin, Germany _ case report _ worldwide events 12 Reconstruction of damaged fresh sockets 40 5th Arab German Implantology Meeting by connective-bone sliver graft from the DGZI in Damascus maxillary tuberosity, to enable immediate dentoalveolar restoration (IDR)— _ worldwide events A clinical case 42 Saudi Arabia—Tradition and modern times! _José Carlos Martins da Rosa, Darcymar Martins 20th Saudi Dental Society and 2nd National da Rosa, Carla Mônica Zardo, Ariádene Cristina Guard “New Dental Era” International Pértile de Oliveira Rosa, Luigi Canullo, Brazil and Conference 2009, organized in cooperation Italy with the German Association of Dental Implantology (DGZI) _ user report _Rolf Vollmer, Germany 18 Clinical outcomes of flapless implant surgery using a handpiece driven _ implant events stereolithographic surgical guide 45 Selected Events 2009/2010 _Volkan Arisan, Z. Cuneyt Karabuda, Turkey I news _ case report 26 Extraction, immediate implant _ social news placement and guided bone regeneration 46 Congratulations and Happy Birthday using a flapless approach to all DGZI-members around the world _Barry K. Bartee, DDS, MD, USA _ manufacturer news _ case report 47 Manufacturer News 28 Precautions for using zirconia implant abutments I about publisher _Moustafa N Aboushelib, Egypt, and Rien van Paridon, Netherlands 50 Imprint implants Cover image courtesy by: Produits Dentaires S.A. 04 I 3_2009 NobelReplaceTM The world’s most used implant system.* Internal tri-channel Color-coded system for connection for accurate accu rate and fast and secure prosthetic component identification restorations and ease of use TiUnite® surface and Groovy™ Color-coding: step-by-step to enhance osseointegration drilling protocol for predictable surgical procedures Implant design that replicates the shape of natural tooth roots 10 YEARS WITH TIUNITE® SURFACE rm New data confi long-term stability. © Nobel Biocare 2009 * Source: Millennium Research Group Versatility, ease-of-use and predict- optimal initial stability. NobelReplace is unique in flexibility and breadth ability have made NobelReplace Tapered is a system that grows to of application. Tapered the most widely used meet the surgical and restorative Nobel Biocare is the world leader implant design in the world.* needs of clinicians and their patients in innovative evi dence-based NobelReplace Tapered is a general – from single-tooth restorations to dental solutions. use, two-piece implant system that more advanced multi-unit solutions. For more information, visit our performs both in soft and hard bone, Whether clinicians are just starting website. one- and two-stage surgical proce- or are experienced implant users, dures, while consistently delivering they will benefit from a system that www.nobelbiocare.com/nobelreplace NobelReplace A4 TiU GB Implants.indd 1 09-07-15 10.47.31 I case _ report Bone quality, quantity and metabolism in terms of dental implantation authors_Jochen Fanghänel*, Tomasz Gedrange*, Germany *Department of Orthodontics, Preventive and Pediatric Dentistry, Centre of Dentistry and Oral Health, Ernst Moritz Arndt University of Greifswald, Germany _Abstract _Introduction Bone is the largest calcium storage, forms part of The orofacial or stomatognathic system with its the supporting tissue and displays distinctive plastic- components forms a functional circle representing a ity and adaptability. Thus, an adequate, differentiated biocybernetic system.11 composition and metabolism are required. The bone A key role is played by bone, particularly the jaw matrix consists of organic and inorganic structures. bones. The structure of the osseous viscerocranium is The cells, osteoblasts, osteoclasts, and osteocytes are targeted to withstand and divert the chewing pres- responsible for bone formation, resorption and me- sure.2,11 This requires a functional composition which tabolism and, thus, for remodeling processes (forma- is maintained even after osseointegration of bone tion and resorption) which permanently occur in bone graft substitutes (Fig. 1). tissue. Periosteum and endosteum form a functional The periods of function and inactivity occurring in unit with bone tissue itself and exercise protective, the jaw bones are more clearly noticeable than in any nutritive and growth functions. other bone of the body. For instance, the mandible and The present paper provides an introduction to reg- the maxilla display different atrophy processes. ular bone structure in the face area which is consid- Continuous remodeling which guarantees adap- ered a precondition of successful implantation. The tation to arising forces requires healthy bone.8 specific properties of the jaw bones have to be ob- served in this context. Bone composition Bone is a specific connective tissue which mainly Fig. 1_Trajectorial structure consists of the extracellular substance/bone matrix, of viscerocranium. cells, blood vessels, and nerves. Weight distribution (in kilograms) in a 70kg weighing man shows that bone and bone marrow rank high, as shown by selected examples in table 1. Table 1_ Weight distribution (in kg) of tissues in a 70 kg weighing man in ranked order. Muscles 30 fat 10 bone 7 bone marrow 3 blood 3 connective tissue 3 skin 2 Bone matrix It consists of organic and inorganic material.9 The inorganic material which determines bone implants 06 I 3_2009 Anschnitt DIN A4 15.04.2009 9:18 Uhr Seite 1 NEW IMPLANTS, NEW ABUTMENTS LIBERTY OF CHOICE NATURALLY FROM CAMLOG Reliable implants, patented Tube-in-TubeTM connection, and from now on as an option: platform switching. Camlog offers more. More information: www.camlog.com a perfect fit © I case _ report Fig. 2_Osseous lamella. Fig. 3_Functional composition of bone and dynamic equilibrium. stiffness, constitutes about half of the matrix. The resorbing osteoclasts is facing the mineralized bone major part (50 per cent) is composed
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