April 22, 2012
Sunday
Brillliant Implant Esthetics – Innovative soft-tissue shaping or prosthetic socket preservation
Platform switching was recently celebrated as the great breakthrough for retaining long-term crestal bone stability. However, a wide implant shoulder with a narrow abutment is not the solution to these complex problems by itself. Another key role retaining crestal bone plays a subcrestal placement and a reliable seal between the interface between abutment and implant. Our in vitro investigations show a leakage of this interface during a cycling loading. Firstly the leakage causes an aggressive and bacteria containing liquid in the internal implant-cavities serving as counterparts of the joint of an abutment. Secondly this fluid is pumped out of the implant-cavities and contaminates the periimplant tissue. Especially the contaminated bone reacts with a resorption. A cone within the implant-abutment connection can serve as a sealing method. Clinical and animal studies proof the lack of peri-implant bone resorption using implants with platform switching combined with a conical seal.
The lack of crestal bone resorption expanded the treatment possibilities as follows:
- ability to use shorter implants
- increased probability to establish and maintain vertical soft tissue height
The important consequence in the daily work is a reduced need of augmentation procedure resulting in a huge increase of patients which accept implant based therapies due to less costs and therapeutically risks. Additionally this tissue care behaviour of the Ankylos® implant system facilitates the manufacture of the suprastructure - at the dental chair as well as in the dental lab. Especially an aesthetic result borne on a platform switched implant requires a creative implementation on the part of the dental technician, taking the surrounding soft tissues (emergence profile) and the face into due account.
