Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol
Identifieur interne : 002988 ( Pmc/Curation ); précédent : 002987; suivant : 002989Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol
Auteurs : Evdokia Chasioti [États-Unis] ; Mohammed Sayed [États-Unis] ; Howard Drew [États-Unis]Source :
- Case Reports in Dentistry [ 2090-6447 ] ; 2015.
Abstract
The case report will present some novel techniques for using a “staged” protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture. Proper assessment of the CBCT allowed the surgeon to do an osteotome internal sinus lift in an optimum location. The depth of the bone needed for the osteotome sinus floor elevation was planned. The staged appliance allowed these sinus-augmented sites to heal for an extended period of time compared to implants, which were uncovered and loaded at an earlier time frame. The staged protocol and CBCT analysis enabled the immediate implants to be placed in proper alignment to the adjacent fixture. After teeth were extracted, the osseointegrated implants were converted to abutments for the transitional appliance. Finally, the staged protocol allowed for soft tissue enhancement in the implant and pontic areas prior to final insertion of the prosthesis.
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DOI: 10.1155/2015/439706
PubMed: 25632356
PubMed Central: 4302971
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol</title><author><name sortKey="Chasioti, Evdokia" sort="Chasioti, Evdokia" uniqKey="Chasioti E" first="Evdokia" last="Chasioti">Evdokia Chasioti</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101</wicri:regionArea></affiliation></author><author><name sortKey="Sayed, Mohammed" sort="Sayed, Mohammed" uniqKey="Sayed M" first="Mohammed" last="Sayed">Mohammed Sayed</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Restorative Dentistry, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Restorative Dentistry, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101</wicri:regionArea></affiliation></author><author><name sortKey="Drew, Howard" sort="Drew, Howard" uniqKey="Drew H" first="Howard" last="Drew">Howard Drew</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25632356</idno><idno type="pmc">4302971</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302971</idno><idno type="RBID">PMC:4302971</idno><idno type="doi">10.1155/2015/439706</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">002988</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002988</idno><idno type="wicri:Area/Pmc/Curation">002988</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002988</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol</title><author><name sortKey="Chasioti, Evdokia" sort="Chasioti, Evdokia" uniqKey="Chasioti E" first="Evdokia" last="Chasioti">Evdokia Chasioti</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101</wicri:regionArea></affiliation></author><author><name sortKey="Sayed, Mohammed" sort="Sayed, Mohammed" uniqKey="Sayed M" first="Mohammed" last="Sayed">Mohammed Sayed</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Restorative Dentistry, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Restorative Dentistry, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101</wicri:regionArea></affiliation></author><author><name sortKey="Drew, Howard" sort="Drew, Howard" uniqKey="Drew H" first="Howard" last="Drew">Howard Drew</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101</wicri:regionArea></affiliation></author></analytic><series><title level="j">Case Reports in Dentistry</title><idno type="ISSN">2090-6447</idno><idno type="eISSN">2090-6455</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The case report will present some novel techniques for using a “staged” protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture. Proper assessment of the CBCT allowed the surgeon to do an osteotome internal sinus lift in an optimum location. The depth of the bone needed for the osteotome sinus floor elevation was planned. The staged appliance allowed these sinus-augmented sites to heal for an extended period of time compared to implants, which were uncovered and loaded at an earlier time frame. The staged protocol and CBCT analysis enabled the immediate implants to be placed in proper alignment to the adjacent fixture. After teeth were extracted, the osseointegrated implants were converted to abutments for the transitional appliance. Finally, the staged protocol allowed for soft tissue enhancement in the implant and pontic areas prior to final insertion of the prosthesis.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="El Askary, A S" uniqKey="El Askary A">A. S. El Askary</name></author><author><name sortKey="Meffert, R M" uniqKey="Meffert R">R. M. Meffert</name></author><author><name sortKey="Griffin, T" uniqKey="Griffin T">T. Griffin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="El Askary, A S" uniqKey="El Askary A">A. S. El Askary</name></author><author><name sortKey="Meffert, R M" uniqKey="Meffert R">R. M. Meffert</name></author><author><name sortKey="Griffin, T" uniqKey="Griffin T">T. Griffin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gahleitner, A" uniqKey="Gahleitner A">A. Gahleitner</name></author><author><name sortKey="Watzek, G" uniqKey="Watzek G">G. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Case Rep Dent</journal-id><journal-id journal-id-type="iso-abbrev">Case Rep Dent</journal-id><journal-id journal-id-type="publisher-id">CRID</journal-id><journal-title-group><journal-title>Case Reports in Dentistry</journal-title></journal-title-group><issn pub-type="ppub">2090-6447</issn><issn pub-type="epub">2090-6455</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25632356</article-id><article-id pub-id-type="pmc">4302971</article-id><article-id pub-id-type="doi">10.1155/2015/439706</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-7265-1342</contrib-id><name><surname>Chasioti</surname><given-names>Evdokia</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/0000-0001-8667-8987</contrib-id><name><surname>Sayed</surname><given-names>Mohammed</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>Drew</surname><given-names>Howard</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Periodontics, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</aff><aff id="I2"><sup>2</sup>Department of Restorative Dentistry, Rutgers School of Dental Medicine, Rutgers University, 110 Bergen Street, Newark, NJ 07101, USA</aff><author-notes><corresp id="cor1">*Mohammed Sayed: <email>dr.moh2008@yahoo.com</email></corresp><fn fn-type="other"><p>Academic Editor: Abbas Azari</p></fn></author-notes><pub-date pub-type="ppub"><year>2015</year></pub-date><pub-date pub-type="epub"><day>6</day><month>1</month><year>2015</year></pub-date><volume>2015</volume><elocation-id>439706</elocation-id><history><date date-type="received"><day>29</day><month>5</month><year>2014</year></date><date date-type="rev-recd"><day>12</day><month>9</month><year>2014</year></date><date date-type="accepted"><day>13</day><month>11</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2015 Evdokia Chasioti et al.</copyright-statement><copyright-year>2015</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 case report will present some novel techniques for using a “staged” protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture. Proper assessment of the CBCT allowed the surgeon to do an osteotome internal sinus lift in an optimum location. The depth of the bone needed for the osteotome sinus floor elevation was planned. The staged appliance allowed these sinus-augmented sites to heal for an extended period of time compared to implants, which were uncovered and loaded at an earlier time frame. The staged protocol and CBCT analysis enabled the immediate implants to be placed in proper alignment to the adjacent fixture. After teeth were extracted, the osseointegrated implants were converted to abutments for the transitional appliance. Finally, the staged protocol allowed for soft tissue enhancement in the implant and pontic areas prior to final insertion of the prosthesis.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Pre-treatment periapical radiographs.</p></caption><graphic xlink:href="CRID2015-439706.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Pre-treatment smile photograph.</p></caption><graphic xlink:href="CRID2015-439706.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Schematic showing the steps of staged approach treatment plan.</p></caption><graphic xlink:href="CRID2015-439706.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>(a) Tenting screw technology for implant # 5 site development. (b) Significant bone increase in vertical and horizontal dimensions, confirmed by the CBCT sagittal slice.</p></caption><graphic xlink:href="CRID2015-439706.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Steps of phase I treatment. (a) First set of provisional prostheses delivered after planned teeth extraction. (b) Intraoral picture 1 month after planned teeth extraction. (c) Intraoral picture depicting delivery of enhanced provisional prostheses.</p></caption><graphic xlink:href="CRID2015-439706.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Internal sinus lift and implant osteotomy prepared through the surgical guide for site # 14.</p></caption><graphic xlink:href="CRID2015-439706.006"></graphic></fig><fig id="fig7" orientation="portrait" position="float"><label>Figure 7</label><caption><p>Panoramic radiograph shows the placement of six implants per arch. Note metal-reinforced fixed provisional prostheses retained by retained teeth.</p></caption><graphic xlink:href="CRID2015-439706.007"></graphic></fig><fig id="fig8" orientation="portrait" position="float"><label>Figure 8</label><caption><p>Soft tissue enhancement around lower molar implants, during stage 2 implant uncovery.</p></caption><graphic xlink:href="CRID2015-439706.008"></graphic></fig><fig id="fig9" orientation="portrait" position="float"><label>Figure 9</label><caption><p>Intraoral photograph shows screw-retained implant provisional prostheses. Pink acrylic was added to enhance esthetics, which will be used as “blue-print” for the definitive prostheses.</p></caption><graphic xlink:href="CRID2015-439706.009"></graphic></fig><fig id="fig10" orientation="portrait" position="float"><label>Figure 10</label><caption><p>Flapless immediate one-stage implant placement at # 6 and # 11 extraction sockets.</p></caption><graphic xlink:href="CRID2015-439706.010"></graphic></fig><fig id="fig11" orientation="portrait" position="float"><label>Figure 11</label><caption><p>Photographs show patient's smile. (a) Pre-treatment. (b) During treatment.</p></caption><graphic xlink:href="CRID2015-439706.011"></graphic></fig><fig id="fig12" orientation="portrait" position="float"><label>Figure 12</label><caption><p>Frontal views for patient's smile. (a) Pre-treatment. (b) During treatment.</p></caption><graphic xlink:href="CRID2015-439706.012"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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