A practice-oriented report of 713 IMPLATM implants By Dr. Dr. med. Henning Aleyt, Head of the Competence Center for Dental Surgery, Zeitz

We would like to present our “long-term” observations with an implant system long established in Germany. We hope that it may make a small contribution as a selection criterion for newcomers to implantology – the practical experience speaks for itself. The IMPLATM implant system is based on a conical screw implant made of titanium which is suitable for all known indications in implantology according to the requirements of routine dentistry. Use in routine treatment is greatly facilitated by the clarity of selection of the individual treatment and system components. The range of prosthetic superstructures in this system combines a hexagonal socket with straight and angled superstructure connectors. These also ensure that the required rotation security is achieved. The angled superstructure components allow an abutment divergence of 15 degrees to be equalized. All superstructures can be easily attached vertically. If needed, a transverse connection is available in the form of horizontal tap holes in the superstructures. Especially for single crowns or compound superstructure constructions, the horizontal screw connection consists of a titanium frame or high-fusing alloy that is integrated in the wax model. A special superstructure connector of plastic allows the individual design of screw-retained superstructures of any castable alloy.

Treatment of a single tooth implant at tooth 46 with a screw-retained crown; view of model from lingual, screw connection with angle screwdriver in the mouth, final finding From 2001 to 2007, we inserted a total of 713 IMPLATM implants in 447 patients. All BRINCKMANN indication groups were included. There were 141 patients with 156 single implants, 131 patients with no teeth at all, in whom 304 implants were inserted. Furthermore, this included 175 patients who received 253 implants for the support of cantilever bridges.

Finding immediately prior to surgery: traumatic loss of tooth 11 with sagittal overbite of 11 mm

Operation site: status post augmentation and fixation of the membrane with special fixation screws The longest implant duration was 6 years, the shortest at the time of the follow-up in September 2007 was 6 months after implanting the superstructure. A total of 20 implants (in 6 patients) were lost after a period of 2-3 years due to bone loss and peri-implantitis. In only 3 cases, restorative methods led to a delay of about one year before loss of the implant. Significantly, in all these cases, no use was made of recalls. The realization that not everything desired is possible, even under modern conditions. Today’s patient is well informed of the possibilities and opportunities of dentistry thanks to constant media coverage. But parallel to this is the realization that not everything wished for is possible, even under modern conditions. Explanation of treatment options and individual wishes but also the risks of this therapy is increasingly important. The dentist is obligated to conduct therapy planning with all available diagnostic means. This helps avoid most therapy mistakes and achieve long-term stable treatment results. In addition to conventional simple measurements and x-ray evaluations, digital methods such as DVT examinations are increasingly used in combination with the corresponding 3D navigation techniques.

3D navigation – screenshot

Transmission of DICOM data to a plaster model using 3D navigation

Endoscopic image, defect bridging with completely absorbable membrane (Durapatch)

Operation site/endoscopic image of defect bridging with completely absorbable membrane (Durapatch)

Original finding with traumatic loss of a front tooth

Impression post in situ – treating a single gap in the front tooth region

Operation site after placement (images above) View after covering the augmentation with a titanium film and fixation using osteosynthesis screws.

Operation site: Frontal view with clearly visible bone deficit in the marginal implant area

Know-how gained from meticulous diagnostic measures must now be transferred to practical application in the selected therapy concept. Supporting augmentative measures of all kinds have become very significant. The predictability and planning of the esthetic-functional success of implant treatment is directly determined by these measures in managing hard and soft tissue. All augmentation procedures and augmentation materials available in modern dentistry form the basis for this. Our long-term observations included both autogenic bone transplants as well as the use of bone replacement material (e.g. Cerasorb, ReBone) as a single substance for defect augmentation in immediate transplants as well as sinus lift procedures in the lateral upper jaw. The IMPLATM implant system can be easily and successfully combined with these augmentation methods. Operation site for x-ray imaging

Complete osseous healing of the former bone withdrawal site

Sagittal section after insertion of a single tooth implant 31 after autogenic bone block augmentation

Sagittal section of 31: well-modeled vestibular osseous bed; resulting in stable soft tissue conditions and good cosmetic results

Precise visualization of augmentation position and its extension as a basis for the subsequent insertion of the implant The regularly inserted implant is adjusted to the periodontally healthy tooth, taking the biological width into consideration as needed. In addition to a position of the implant respective to the prosthesis, a stable implant bed is decisive. This requires an intact peri-implant bone lamella about 0.5 to 2 mm thick, depending on local requirements. In summary It can be said that both general and specific observations on the status of modern implantology can provide experience from the routine practice of dentistry for beginners and for colleagues already practicing implantology. Using and deciding on an implant system should thus also be measured by these parameters. The IMPLATM implant system guarantees solid, comprehensive implants. In conjunction with modern methods of augmentation and new digital diagnostic techniques, this allows concrete predictions of treatment goals. Of course, all currently valid principles must be ensured. This report can make a small contribution to (re)-orientation in implantology. We hope to receive more (even critical) statements from users of this system. Dr. Dr. med. Henning Aleyt Using implantology since 1982 Schütz Dental GmbH Dieselstraße 5-6 61191 Rosbach/Germany www.schuetz-dental.de Phone: +49(0)6003-814-0 Fax: +49(0)6003-814-906 info@schuetz-dental.de