SINGLE DENTAL IMPLANTS
This indication has become one of the routine implant therapies since the successful results of the studies aimed at compensating single tooth deficiencies with implants have been determined in various studies. Single dental implants differ from other implant applications due to the high aesthetic expectations of the patients. As can be seen in the literature, there is no problem in terms of chewing function in cases with single tooth implant.
It is seen that the most important factor in the success of the treatment is the correct localization of the implant at the planning stage and at the surgical stage.
The points to be considered in implant placement are the distance to the adjacent teeth, apico-coronal position, buccal-palatalinal circumference.
Distance to neighboring teeth: In the absence of a single tooth implant placed equal distance to the neighboring roots is foreseen. Too close to the periodontium of the neighboring tooth may cause pathological reactions due to mechanical irritation and circulatory disorder. In the literature, it is recommended that a maximum of 1 mm can be approached to the neighboring root.
In the apico-coronal position, it is accepted that the implant collar may remain at the apical maximum 1.5mm of the enamel-cement boundary of adjacent teeth. In more embedded implants, it was found that the soft tissue contour was positioned asymmetrically in the apical, as the bone supporting the mucosa around the cole was also left in the apical, leading to a prolonged retention of the crown neck.
IMPLANT POSITION EXTRA
In addition to “white aesthetics “, another equally important factor is the “red aesthetic”, which describes the contours of soft tissue. In order to provide red aesthetics, it has been found that the level of bone supported mucosal thickness, papillary and crown margins should be compatible with neighboring teeth, especially in the anterior regions. Flap design is one of the most important factors affecting soft tissue contours. Flap design is a factor that directly affects the nutrition of the tissues around the implant and as a result it determines the soft tissue contours. The flap tension to be obtained after implant application is predicted by taking into account membrane and / or biomaterial applications; the vertical incisions should be decided and the appropriate flap sequence should be chosen. In routine cases, the “aesthetic window” flap type, which includes the incision technique for determining the bucco-palatal localization of the implant with papilla protective flap, has been found to be useful.
Surgical procedures can be performed in most of the implant applications without the need for flap lifting. Surgery without flap is an attempt to preserve the original condition in soft tissue contours without changing the original condition. In cases where flap is removed, blood supply is interrupted for a while as the vascular network and periosteum are damaged. Decrease in blood supply and subsequent improvement in the acidity of the environment during the inflammation leads to a bone resorption that is proportional to the severity of trauma. For this reason, the smallest lembo that provides sufficient visibility in the operation area should be removed.
For the purpose of protecting the papillary, a “papilla-protective” flap that excludes the papillae can be realized.
The disadvantage is that it leaves limited field of view and is not suitable for membrane application. No need for augmentation or membrane application
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