Der Fallbericht beschreibt die oralen Symptome und den Verlauf einer bis dato nicht diagnostizierten systemischen Morbus-Crohn-Erkrankung bei einem Jugendlichen vor und während der Therapie.

Der Fallbericht beschreibt die oralen Symptome und den Verlauf einer bis dato nicht diagnostizierten systemischen Morbus-Crohn-Erkrankung bei einem Jugendlichen vor und während der Therapie. Keywords: Mundschleimhautveränderung, Magen-Darm-Erkrankung, Biopsie, Morbus Crohn

Radikuläre Zysten sind die häufigsten Zysten des Kieferknochens. Bedingt durch ihr langsames und expandierendes Wachstum können sie unbemerkt eine beachtliche Größe erreichen und werden nicht selten als Zufallsbefunde entdeckt, ehe sich die ersten klinischen Symptome zeigen. Der Fallbericht beschreibt das diagnostische und therapeutische Vorgehen bei der Behandlung einer großlumigen radikulären Zyste im Unterkiefer eines 63-jährigen männlichen Patienten. Keywords: Radikuläre Zyste, Zystostomie, Zystektomie, Enukleation, Knochenaugmentation

Immediate implant placement and immediate loading of single-tooth implants are reliable treatment options with high implant survival rates and good long-term results. Because of the anatomy of the roots immediate implant placement is usually performed in incisors, canines and premolars. If performed in molars the authors usually suggest to place the implant in the septa between the roots. In the majority of cases the vertical height in between the roots is insufficient for implant placement. In those cases a sinus-lift procedure after the healing of the socket is inevitable. The aim of the described workflow is to avoid a second invasive surgical intervention to place an implant together with sinus grafting procedures by immediate implant placement in the palatinal root. Keywords: Immediate implant placement, immediate reconstruction, sinus grafting, dental implant

Introduction: A twenty seven years old male patient arrived in our clinic (dental emergency) in 2009 with a root fracture in cervical part with dislocation of the tooth 21 after an injury . A CBCT (Cone Beam Computed Tomography) was performed to identify the bone formation at this region. The patient was informed on different treatment options. As example orthodontic extrusion, Maryland bridge, surgical crown lengthening and immediate implantation. He chose an immediate implant insertion. Schulte und d'Hoedt described in 1974 immediate implantation with Tubingen Implants in the upper jaw. Later 1977 Ledermann published about immediate loading of implant in lower jaw. Treatment: Four days after the accident the immediate implant insertion took place. After the extraction with the Benex^® extraction system, implant was inserted. The implant was inserted in the right dimensional position, because that is necessary for the aesthetic outcome . The torque of the implants was about 35 Ncm, so an immediate non-occlusal loading was performed. Discussion: The functional and aesthetic treatment was made 4 month later. In this patient a thick gingival biotype, thicker than 1,5 mm ensured the stability of the tissue. This leads to a good forecast of the late aesthetic outcome. Seven years after the surgery a stable soft tissue without any inflammation and recession was present. The peri-implant gingiva was rose and healthy with a textured surface like that seen on the surface of an Orange Peel which is called as Stippled. Conclusion: There are a lot of factors which can influence the success of implantation in the aesthetic zone. High risks for aesthetic failure are patients with gummy smile and patients with thin gingiva type. Our patient had thick gingiva type and low smile line. Chen and Buser showed that immediate or early implantation with simultaneous bone augmentation is more successful than late implantation. The three-dimensional (3D) position of the osseointegrated dental implants provides favorable esthetical results and preserves the surrounding soft and hard tissues architecture. Keywords: immediate, implantation, fracture, root

Die implantologische Rehabilitation eines Patienten nach einer Einzelzahnextraktion in der ästhetischen Zone stellt häufig eine klinische Herausforderung dar. Der Beitrag geht auf die Besonderheiten der Sofortimplantation zur Behandlung von Extraktionsalveolen und die zur Verfügung stehenden restaurativen Möglichkeiten ein. Außerdem werden verschiedene Risikofaktoren diskutiert, welche die Prognostizierbarkeit des Ergebnisses beeinträchtigen können. Keywords: Zahnextraktion, Einzelzahnimplantat, Sofortimplantation, provisorische Versorgung

Purpose: The purpose of this study was to analyze and evaluate the clinical success of distal cantilevers of fixed full-arch prostheses for the rehabilitation of edentulous arches in conjunction with immediate loading. Materials and Methods: Twenty-seven patients (15 men and 12 women) with a mean age of 59 years received 203 implants (Ankylos, Dentsply), either in edentulous jaws or after extraction and immediate implant placement. All implants were splinted together with provisional restorations and loaded immediately after surgery. After an average of 60 days, the definitive prostheses were fabricated and cemented provisionally. Thirty-one prostheses were delivered. A total of 92 units on distal cantilevers were incorporated into the prostheses. Implant stability was recorded (via percussion testing) after prostheses were removed and crestal bone levels were measured with radiographs. Results: Average crestal bone loss was 0.33 mm. After a follow-up of 5 years, only one prosthesis broke (at the connection between the main part of the denture and the distal extension). A total of five implants were lost because of overloading or peri-implantitis (during early healing). The success rate of implants was 94.5%, the survival rate was 97.5%, and the survival rate of the prostheses was 96.7% after a loading period of 79.30 ± 35.31 months. Conclusions: Based on the long-term clinical data, distal cantilevers on a full-arch prosthesis can be a successful treatment modality and can be employed in patient treatment planning when posterior support is indicated. Keywords: cantilever, complications, crestal bone loss, implant-retained prostheses

Purpose: Few studies have compared the effects of immediate loading on implant prognoses in smokers and nonsmokers. The aim of this prospective study was to evaluate the long-term success of immediately loaded platform-switched implants placed in smokers and nonsmokers with edentulous jaws. Materials and Methods: Platform-switched implants were placed using the same treatment protocol in the healed edentulous jaws of two groups of patients: group A patients had smoked at least 20 cigarettes a day for more than 10 years, and group B consisted of nonsmokers. All implants were loaded immediately with provisional fixed prostheses, and definitive cement-retained restorations were delivered 4 to 6 weeks later without removing the abutments. In a standardized follow-up protocol, the implants were evaluated clinically and radiographically at the start of loading, 4 to 6 weeks later, and annually thereafter. Results: Sixty-six implants (36 in the maxilla and 30 in the mandible) were placed in eight smokers. Twelve nonsmokers received 97 implants (55 in the maxilla and 42 in the mandible). During an average loading period of 62.53 (± 44.13) months for the smokers and 98.20 (± 19.53) months for the nonsmokers, three implants failed. Two failed in group A (one because of overloading and one because of peri-implanitis) and one failed in group B (overloading), resulting in implant survival rates of 97% and 99%, respectively. No significant differences were found between groups regarding plaque, bleeding, probing pocket depths, or crestal bone loss, either mesially or distally, resulting in success rates of 92.42% for group A and 98.00% for group B. Conclusions: Long-term clinical outcomes for immediately loaded platform-shifted implants placed in heavy smokers appear to be comparable to those for nonsmokers if the abutments are placed on the day of surgery and never removed.

Die Dislokation von Implantaten in benachbarte Strukturen ist eine mögliche Komplikation bei einer dentalen Implantation. Der vorliegende Bericht beschreibt anhand eines klinischen Falls den Verlauf und das chirurgische Management einer intraoperativen Implantatdislokation in die Spongiosaräume der Mandibula bei einer 52-jährigen, allgemein gesunden Patientin. Dabei wird auf anatomische Strukturvariationen des Alveolarknochens hingewiesen, die die Wichtigkeit des Beherrschens eines adäquaten chirurgischen Protokolls hervorheben. Insbesondere wird in diesem Zusammenhang die Rolle der Implantatprimärstabilität als entscheidend erachtet. Keywords: Dentale Implantation, Komplikation, Dislokation, Mandibula

Für den implantologischen Langzeiterfolg ist die Auswahl eines mechanisch stabilen und klinisch bewährten Implantatsystems besonders wichtig. Der vorliegende Bericht beschreibt zwei klinische Fälle, die seit 1988 bzw. 1993 mit Ankylos®-Implantaten erfolgreich versorgt sind. Dabei zeigen sich stabile periimplantäre Weichgewebe- und Knochenverhältnisse in der letzten Verlaufskontrolle nach über 20 Jahren funktioneller Belastung. In diesem Zusammenhang wird auf das seit seiner Entwicklung im Jahre 1985 im Wesentlichen unveränderte spezielle Design des Ankylos®- Implantatsystems hingewiesen: Das progressive Außengewinde und die präzise Innenkonusverbindung mit Selbsthemmung. Keywords: Dentale Implantate, progressives Gewindedesign, Innenkonusverbindung mit Selbsthemmung