Cirugía guiada y reconstrucción tisular luego de un fracaso: la importancia del diagnóstico y la planificación. Reporte de caso clínico / Guided surgery and tissue reconstruction after failure: the importance of diagnosis and planning. Report of a clinical case

La realización de un nuevo tratamiento luego de un fracaso con implantes dentarios representa un gran desafío para el profesional especialistas en implan-tología, así como para el paciente que debe someter-se a un nuevo procedimiento para rehabilitarse. En estos casos, el diagnóstico y la planificación exhaus-tiva previa nos permiten optimizar el tiempo y los re-cursos, arribando al resultado esperado de forma eficiente. En este reporte de caso se presenta la re-habilitación de una paciente que acude a la consulta con un fracaso implantario previo y con alta deman-da estética. Se diseñó una guía quirúrgica de preci-sión para la colocación de un implante Straumann®Bone Level Tapered 3,3 NC ­ Narrow CrossFit® ø 3,3 mm 8 mm junto a la regeneración ósea guiada para compensar la deficiencia de los tejidos circundantes. La rehabilitación protésica consistió en una corona cemento atornillada en disilicato de litio. En el control al año pudo valorarse la estabilidad de la rehabilita-ción protésica, así como de los tejidos circundantes y el contorno estético junto al perfil de emergencia mimético logrado al final del tratamiento (AU)

Carrying out a new treatment after a failure with dental implants represents a great challenge for the implantology specialist professional, as well as for the patient who must undergo a new procedure to rehabilitate. In these cases, the diagnosis and prior exhaustive planning allow us to optimize time and resources, arriving at the expected result efficiently. This case report presents the rehabilitation of a patient who comes to the clinic with a previous implant failure and with high aesthetic demand. A precision surgical guide was designed for the placement of a Straumann® Bone Level Tapered 3.3 NC ­ Narrow CrossFit® ø 3.3 mm 8 mm implant together with guided bone regeneration to compensate for the deficiency of the surrounding tissues. The prosthetic rehabilitation consisted of a screw-retained cement crown in lithium disilicate. In the one-year control, the stability of the prosthetic rehabilitation, as well as the surrounding tissues and the aesthetic contour, together with the mimetic emergence profile achieved at the end of the treatment, could be assessed (AU)

Clinical analysis of peri-implantitis caused by cement remnant / 实用医学杂志

Objective To analyse the influencing factor,clinical appearance and solution of peri-implanti-tis,especially caused by cement remnant. Methods In this retrospective study 23 typical cases of peri-implantitis were collected in our implantology center from Jan.2016 to Dec.2016.The general data such as age,sex,systemic diseases,habits of smoking and alcohol,history of periodontitis,surgery process,materials and way of restoration were recorded in details.This study enrolled individuals from a private practice who had cement-retained implant res-torations,scheduled for regular implant maintenance or coming for consultation on a complication. Results All screw-retention(100%)and 50% cement retention peri-implantitis cases suffered from local and systemic diseases, 30% screw-retention and 20% cement retention healthy cases suffered from local and systemic diseases,which showed a significant differences(P<0.05),but there was no significant difference between screw and cement reten-tion in peri-implantitis group.85.7% of screw-retention and 50% of cement retention cases had a poor oral hygiene (PLI=2or3).Despite the other possible factors(such as diabetes,periodontitis and heavy smoker),8 cement-re-tained implants suffered from peri-implantitis.5 cases showed the cement remnant on the x-ray photo. Conclusion There are many pathogenic factors leading to peri-implantitis that may be single or combined.Cement remnant direct-ly leads to peri-implantitis.Clearance of excess cement together with scaling and laser treatment,or even combined with guided bone regeneration surgery are effective for treatment of peri-implantitis.