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<title xml:lang="en">Successful Rehabilitation of Partial Edentulous Maxilla and Mandible with New Type of Implants: Molecular Precision Implants</title>
<author>
<name sortKey="Danza, Matteo" sort="Danza, Matteo" uniqKey="Danza M" first="Matteo" last="Danza">Matteo Danza</name>
<affiliation>
<nlm:aff id="I1">University of Chieti-Pescara, Via Carducci 83, 65122 Pescara, Italy</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lauritano, Dorina" sort="Lauritano, Dorina" uniqKey="Lauritano D" first="Dorina" last="Lauritano">Dorina Lauritano</name>
<affiliation>
<nlm:aff id="I2">Translational Medicine and Surgery Department, Neuroscience Centre of Milan (NeuroMI), University of Milano-Bicocca, Via Cadore 48, 20052 Monza, Italy</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Carinci, Francesco" sort="Carinci, Francesco" uniqKey="Carinci F" first="Francesco" last="Carinci">Francesco Carinci</name>
<affiliation>
<nlm:aff id="I3">Chair of Maxillofacial Surgery, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PMC</idno>
<idno type="pmid">25525437</idno>
<idno type="pmc">4265518</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265518</idno>
<idno type="RBID">PMC:4265518</idno>
<idno type="doi">10.1155/2014/307364</idno>
<date when="2014">2014</date>
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<title xml:lang="en" level="a" type="main">Successful Rehabilitation of Partial Edentulous Maxilla and Mandible with New Type of Implants: Molecular Precision Implants</title>
<author>
<name sortKey="Danza, Matteo" sort="Danza, Matteo" uniqKey="Danza M" first="Matteo" last="Danza">Matteo Danza</name>
<affiliation>
<nlm:aff id="I1">University of Chieti-Pescara, Via Carducci 83, 65122 Pescara, Italy</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lauritano, Dorina" sort="Lauritano, Dorina" uniqKey="Lauritano D" first="Dorina" last="Lauritano">Dorina Lauritano</name>
<affiliation>
<nlm:aff id="I2">Translational Medicine and Surgery Department, Neuroscience Centre of Milan (NeuroMI), University of Milano-Bicocca, Via Cadore 48, 20052 Monza, Italy</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Carinci, Francesco" sort="Carinci, Francesco" uniqKey="Carinci F" first="Francesco" last="Carinci">Francesco Carinci</name>
<affiliation>
<nlm:aff id="I3">Chair of Maxillofacial Surgery, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Case Reports in Medicine</title>
<idno type="ISSN">1687-9627</idno>
<idno type="eISSN">1687-9635</idno>
<imprint>
<date when="2014">2014</date>
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<div type="abstract" xml:lang="en">
<p>The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. Atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. The immediate load of implants is a universally practiced procedure; nevertheless a successful procedure requires expertise in both the clinical and the reconstructive stages using a solid implant system. Excellent primary stability and high bone-implant contact are only minimal requirements for any type of implant procedure. In this paper we present a case report using a new type of implants. The new type of implants, due to its sophisticated control system of production, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.</p>
</div>
</front>
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</div1>
</back>
</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Case Rep Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Case Rep Med</journal-id>
<journal-id journal-id-type="publisher-id">CRIM</journal-id>
<journal-title-group>
<journal-title>Case Reports in Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">1687-9627</issn>
<issn pub-type="epub">1687-9635</issn>
<publisher>
<publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25525437</article-id>
<article-id pub-id-type="pmc">4265518</article-id>
<article-id pub-id-type="doi">10.1155/2014/307364</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Successful Rehabilitation of Partial Edentulous Maxilla and Mandible with New Type of Implants: Molecular Precision Implants</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Danza</surname>
<given-names>Matteo</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-3550-1812</contrib-id>
<name>
<surname>Lauritano</surname>
<given-names>Dorina</given-names>
</name>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Carinci</surname>
<given-names>Francesco</given-names>
</name>
<xref ref-type="aff" rid="I3">
<sup>3</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1">
<sup>1</sup>
University of Chieti-Pescara, Via Carducci 83, 65122 Pescara, Italy</aff>
<aff id="I2">
<sup>2</sup>
Translational Medicine and Surgery Department, Neuroscience Centre of Milan (NeuroMI), University of Milano-Bicocca, Via Cadore 48, 20052 Monza, Italy</aff>
<aff id="I3">
<sup>3</sup>
Chair of Maxillofacial Surgery, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy</aff>
<author-notes>
<corresp id="cor1">*Dorina Lauritano:
<email>dorina.lauritano@unimib.it</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Indraneel Bhattacharyya</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>19</day>
<month>11</month>
<year>2014</year>
</pub-date>
<volume>2014</volume>
<elocation-id>307364</elocation-id>
<history>
<date date-type="received">
<day>17</day>
<month>7</month>
<year>2014</year>
</date>
<date date-type="rev-recd">
<day>11</day>
<month>10</month>
<year>2014</year>
</date>
<date date-type="accepted">
<day>3</day>
<month>11</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2014 Matteo Danza et al.</copyright-statement>
<copyright-year>2014</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. Atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. The immediate load of implants is a universally practiced procedure; nevertheless a successful procedure requires expertise in both the clinical and the reconstructive stages using a solid implant system. Excellent primary stability and high bone-implant contact are only minimal requirements for any type of implant procedure. In this paper we present a case report using a new type of implants. The new type of implants, due to its sophisticated control system of production, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.</p>
</abstract>
</article-meta>
</front>
<body>
<sec id="sec1">
<title>1. Introduction</title>
<p>The popularity of postextraction immediate loading implants has increased considerably between patients and dentists in the last years. The advantages of immediate loading postextraction implants surgery are evident. In fact extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month [
<xref rid="B1" ref-type="bibr">1</xref>
]. The loss of alveolar ridge reduces the chance of implant rehabilitation, so implants insertion in postextractive surgery represents a solution to the loss of bone [
<xref rid="B2" ref-type="bibr">2</xref>
<xref rid="B4" ref-type="bibr">4</xref>
]. Bone loss is an important problem limiting implants placement for conspicuous resorption after extraction of teeth. The thinning of the ridges, the changes in gingival contour, and the loss of interdental papilla with the appearance of unsightly black spaces are the characteristics observed in these cases. The atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment [
<xref rid="B5" ref-type="bibr">5</xref>
,
<xref rid="B6" ref-type="bibr">6</xref>
]. The maintenance of the ridges bones during the extraction, the primary stability of the implant, a careful control of the soft tissues, and proper manufacturing of the provisional prosthesis are important factors for long-term clinical success [
<xref rid="B7" ref-type="bibr">7</xref>
<xref rid="B9" ref-type="bibr">9</xref>
]. A proper control of biofilm with good oral hygiene during the healing period is considered a key factor in the positive outcome for the postextraction implants [
<xref rid="B10" ref-type="bibr">10</xref>
]. Over the past decade changes in dental implant design and surface configuration and an improved understanding of the biological and biomechanical aspects have improved clinical outcome of implant treatments. The ultimate goal of an improved protocol is to reduce the number of surgeries and decrease timeframe between surgery and prosthesis. These new protocols will result in increased acceptance of implant therapy. Because implant macrogeometry/microgeometry play a crucial role during the healing phase, it is important when documenting immediate loading cases to identify clearly type of implant and rehabilitation used [
<xref rid="B11" ref-type="bibr">11</xref>
,
<xref rid="B12" ref-type="bibr">12</xref>
].</p>
</sec>
<sec id="sec2">
<title>2. Molecular Precision Implant (MPI) Characteristics</title>
<p>MPI (molecular precision implants, Ditron Dental, Israel), due to its sophisticated control system of the surfaces, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.</p>
<p>The characteristics of these new implants are as follows:</p>
<p>MolecuLock TM:
<list list-type="roman-lower">
<list-item>
<p>seal between implant and abutment,</p>
</list-item>
<list-item>
<p>biomechanical design and 1 micron level production to reduce microgaps and micromovement risks;</p>
</list-item>
</list>
</p>
<p>surface treatment:
<list list-type="roman-lower">
<list-item>
<p>Al
<sub>2</sub>
O
<sub>3</sub>
surface blasting and double acid etching,</p>
</list-item>
<list-item>
<p>high purity cleaning procedures;</p>
</list-item>
</list>
</p>
<p>implant body:
<list list-type="roman-lower">
<list-item>
<p>high initial stability even in compromised bone situations,</p>
</list-item>
<list-item>
<p>expanding tapered implant body, with double-thread self-tapping design, condensing bone gradually, to enhance primary stability,</p>
</list-item>
<list-item>
<p>insertion rate of the molecular precision implants of 2.2 mm per revolution;</p>
</list-item>
</list>
</p>
<p>restorative platform:
<list list-type="roman-lower">
<list-item>
<p>a beveled collar shifting the implant-abutment junction inward, in order to achieve platform-switching configuration,</p>
</list-item>
<list-item>
<p>platform switching generating a perfect environment for the soft tissue growth and helping prevent bone resorption;</p>
</list-item>
</list>
</p>
<p>assisted osteointegration:
<list list-type="roman-lower">
<list-item>
<p>unique spherical helix chamber forming a localized infrastructure that serves as a scaffold for promoting wound healing and bone formation from existing osteoblasts;</p>
</list-item>
</list>
</p>
<p>apex design:
<list list-type="roman-lower">
<list-item>
<p>apex with self-tapping drilling blades that enables smaller osteotomy,</p>
</list-item>
<list-item>
<p>the self-tapping function supporting a precise adaptation of the implant thread to the bone, thus providing optimal primary stability,</p>
</list-item>
<list-item>
<p>improved ease of insertion and allowing mild direction refinement during the initial stages of insertion.</p>
</list-item>
</list>
</p>
</sec>
<sec id="sec3">
<title>3. Case Report</title>
<p>A young patient aged 43 presented with pain symptoms arising during mastication at the level of the left maxillary and mandibular semiarches. X-rays showed granulomas with vertical bone reabsorption, rhizolysis, and extensive exposure of molar furcation (
<xref ref-type="fig" rid="fig1">Figure 1</xref>
).</p>
<p>In the mandible, an extensive apical osseous reabsorption caused by endodontic cone beyond the apex was present at level 3.5 (Figures
<xref ref-type="fig" rid="fig2">2(a)</xref>
and
<xref ref-type="fig" rid="fig2">2(b)</xref>
). Fracture of the prosthetic crown of 3.4 and gum recession in the distal teeth (Figures
<xref ref-type="fig" rid="fig3">3(a)</xref>
and
<xref ref-type="fig" rid="fig3">3(b)</xref>
) were present also. The treatment plan will provide removal of the upper as well as the lower bridge, extraction of the two upper and lower molars, and postextractive immediate loading implant insertion.</p>
<p>Atraumatic extraction of the two mandibular premolars was performed and a new site for implant in 3.6 site was formed (Figures
<xref ref-type="fig" rid="fig4">4(a)</xref>
and
<xref ref-type="fig" rid="fig4">4(b)</xref>
).</p>
<p>MPI (Ditron Dental, Israel) were placed in different sites: 4.2 × 16 in 3.4, 5 × 16 in 3.5, and 4.2 × 11.5 in 3.6 (Figures
<xref ref-type="fig" rid="fig5">5(a)</xref>
,
<xref ref-type="fig" rid="fig5">5(b)</xref>
, and
<xref ref-type="fig" rid="fig6">6</xref>
). All implants showed high primary stability and were loaded with provisional abutments supporting a provisional prosthetic. The X-ray showed an optimum crestal and mesial distal position of the implants, as well as their excellent position to the surrounding bone (Figures
<xref ref-type="fig" rid="fig7">7</xref>
<xref ref-type="fig" rid="fig11">11</xref>
).</p>
<p>Subsequently maxilla was treated. The fixed prosthesis was removed (
<xref ref-type="fig" rid="fig12">Figure 12(a)</xref>
) and the two molars were extracted with mini-invasive technique (Figures
<xref ref-type="fig" rid="fig12">12(b)</xref>
,
<xref ref-type="fig" rid="fig13">13(a)</xref>
, and
<xref ref-type="fig" rid="fig13">13(b)</xref>
).</p>
<p>3 MPI were inserted in correspondence to 2.5, 2.6, and 2.7 sites. The MPI measure was, respectively, 3.75 × 15, 4.2 × 13, and 6 × 10. The primary stability was excellent and the implants were immediately loaded using provisional Pek abutments (Figures
<xref ref-type="fig" rid="fig14">14</xref>
,
<xref ref-type="fig" rid="fig15">15(a)</xref>
,
<xref ref-type="fig" rid="fig15">15(b)</xref>
, and
<xref ref-type="fig" rid="fig16">16</xref>
).</p>
<p>Therefore, after two months from the insertion of the maxillary implants, definitive titanium abutments were placed (
<xref ref-type="fig" rid="fig17">Figure 17</xref>
).</p>
<p>X-rays showed good implants/abutments contact and final prosthesis was performed in mandibula (
<xref ref-type="fig" rid="fig18">Figure 18</xref>
) and in maxilla (Figures
<xref ref-type="fig" rid="fig19">19(a)</xref>
and
<xref ref-type="fig" rid="fig19">19(b)</xref>
).</p>
</sec>
<sec id="sec4">
<title>4. Discussion</title>
<p>The solution of the complex implantology problems requires an accurate diagnosis. In case of postextractive immediate loading implantology the following points are requested:
<list list-type="roman-lower">
<list-item>
<p>high primary stability,</p>
</list-item>
<list-item>
<p>high bone-implant contact,</p>
</list-item>
<list-item>
<p>reliable surface treatment.</p>
</list-item>
</list>
</p>
<p>MPI are manufactured with an extremely accurate productive process. From casting to packing, each phase is monitored to guarantee perfect manufacturing of the implant, perfect and ultra-precise prosthetic contact (MolecuLokTM), innovative surface treatment to provide a macro-micro surface geometry that improves the osteointegration process (molecular precision surface).</p>
</sec>
<sec id="sec5">
<title>5. Conclusion</title>
<p>MPI (molecular precision implants) (Ditron Dental, Israel) represent the ultimate state of the art in implantology and their characteristics facilitate the placement of implants with immediate loading after extractions.</p>
</sec>
</body>
<back>
<sec sec-type="conflict">
<title>Conflict of Interests</title>
<p>The authors declare that there is no conflict of interests regarding the publication of this paper.</p>
</sec>
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<floats-group>
<fig id="fig1" orientation="portrait" position="float">
<label>Figure 1</label>
<caption>
<p>Extensive exposure of molar furcation.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float">
<label>Figure 2</label>
<caption>
<p>Extensive apical osseous reabsorption.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float">
<label>Figure 3</label>
<caption>
<p>Lateral cross bite, blocking behavior, and fracture of the prosthetic crown of 3.4 and signs of suffering with gum recession in the distal teeth.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.003"></graphic>
</fig>
<fig id="fig4" orientation="portrait" position="float">
<label>Figure 4</label>
<caption>
<p>Postextractive implant site.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.004"></graphic>
</fig>
<fig id="fig5" orientation="portrait" position="float">
<label>Figure 5</label>
<caption>
<p>MPI 4.2 × 11.5 in 3.6 and MPI 5 × 16 in 3.5 site.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.005"></graphic>
</fig>
<fig id="fig6" orientation="portrait" position="float">
<label>Figure 6</label>
<caption>
<p>MPI 4.2 × 16 in 3.4 site.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.006"></graphic>
</fig>
<fig id="fig7" orientation="portrait" position="float">
<label>Figure 7</label>
<caption>
<p>Implants placed in premolars and molar site.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.007"></graphic>
</fig>
<fig id="fig8" orientation="portrait" position="float">
<label>Figure 8</label>
<caption>
<p>Implants with abutment.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.008"></graphic>
</fig>
<fig id="fig9" orientation="portrait" position="float">
<label>Figure 9</label>
<caption>
<p>Provisional prosthesis.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.009"></graphic>
</fig>
<fig id="fig10" orientation="portrait" position="float">
<label>Figure 10</label>
<caption>
<p>X-ray showing an optimum crestal and mesial distal position of the implants.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.010"></graphic>
</fig>
<fig id="fig11" orientation="portrait" position="float">
<label>Figure 11</label>
<caption>
<p>Provisional prosthesis.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.011"></graphic>
</fig>
<fig id="fig12" orientation="portrait" position="float">
<label>Figure 12</label>
<caption>
<p>Removal of preexisting prosthesis.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.012"></graphic>
</fig>
<fig id="fig13" orientation="portrait" position="float">
<label>Figure 13</label>
<caption>
<p>The two molars were extracted and implants positioned.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.013"></graphic>
</fig>
<fig id="fig14" orientation="portrait" position="float">
<label>Figure 14</label>
<caption>
<p>Implants inserted in 2.5, 2.6, and 2.7 sites.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.014"></graphic>
</fig>
<fig id="fig15" orientation="portrait" position="float">
<label>Figure 15</label>
<caption>
<p>Gingival sutures and provisional prosthesis.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.015"></graphic>
</fig>
<fig id="fig16" orientation="portrait" position="float">
<label>Figure 16</label>
<caption>
<p>Close contact between implants and the surrounding bone.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.016"></graphic>
</fig>
<fig id="fig17" orientation="portrait" position="float">
<label>Figure 17</label>
<caption>
<p>Definitive titanium abutments.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.017"></graphic>
</fig>
<fig id="fig18" orientation="portrait" position="float">
<label>Figure 18</label>
<caption>
<p>X-rays showing good implants/abutments contact and final prosthesis.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.018"></graphic>
</fig>
<fig id="fig19" orientation="portrait" position="float">
<label>Figure 19</label>
<caption>
<p>The X-ray control after final prosthesis.</p>
</caption>
<graphic xlink:href="CRIM2014-307364.019"></graphic>
</fig>
</floats-group>
</pmc>
</record>

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