Abstract
Intense forces are naturally downloading on molar roots. Due to inflammation, the post-extraction sockets of the upper molars are often poor of bone on one side. A single implant supporting a prosthetic crown can easily go subject to displacing forces that reabsorbed and recently healed bone can hardly bear. By utilizing a couple of prosthetic roots, i.e.: one screw implant in the side in which bone is richer and one blade implant in the side in which the bony wall has gone subject to reabsorption, it is possible to build a better supported prosthetic crown. The clinical cases performed by the Authors confirm the validity of this implant architecture. Aim of the work is to describe a post-extraction multi-modal implantological technique useful for replacing the roots of upper molars with poor bone support on one side. Materials and Methods: Combination of submerged screw implant and submerged blade implant or emergent screw implant and emergent blade implant welded intraorally. Discussion: The combination of a palatal screw implant and a buccal blade implant, or vice versa, allowed to solve clinical cases and to make reliable prosthetic crowns. Conclusions: The presence of variable residual anatomies in the molar area of the upper jaw recommends the use of morphologically different implant shapes, suitable for the construction of a biomechanically functional prosthetic abutment. Specifically in the presence of bone resorption, the combination of a screw implant and a blade implant allowed us to obtain a reliable abutment. Given the small number of cases performed, further research will confirm the positive results of this technique.
Highlights
The placement of a post-extraction implant to replace a compromised natural root is a therapy widely practiced by specialists, especially with screw implants
The outcome of periodontal pathologies to which the roots have been subjected can lead to asymmetrical resorption of residual bone, leading to the use of a palatal screw implant associated with a vestibular blade implant or vice versa [2]
The possibility of using different implant shapes allows to broaden the horizons of treatment of complex clinical cases, avoiding procedures for modifying the residual bone anatomy, which are unpredictable especially when tissue regeneration or grafting are carried out in anatomical sites that have been subjected to inflammation for a long time
Summary
The presence of variable residual anatomies in the molar area of the upper jaw recommends the use of morphologically different implant shapes, suitable for the construction of a biomechanically functional prosthetic abutment. In the presence of bone resorption, the combination of a screw implant and a blade implant allowed us to obtain a reliable abutment. Given the small number of cases performed, further research will confirm the positive results of this technique. L. Dal Carlo* Dr Luca Dal Carlo Dental Office, Venice, Italy
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