Why should you sacrifice peaks? Take advantage of them!

The clinical experience has shown that in immediate post-extraction procedures it is possible to preserve the bone peaks of the alveoli because the convergent neck facilitates the maintenance of thick and healthy tissues.

In Dr. Loi’s case presented next up, the truncated hyperbolic cone morphology has allowed to preserve all the circumferential bone and to leave space for the clot, while the UTM (Ultrathin Threaded Microsurface) treatment of the neck has allowed an optimal stabilization and organization of the fibres, thus  accelerating the healing process.

All these aspects have contributed to the natural regeneration of the circumferential bone despite the initial deficit, showing that surgical and morphological peculiarities of the Prama implant play a primary role reaching the excellent biological and aesthetic results which Prama users have become accustomed.

FROM CLOT TO NEW CIRCUMFERENTIAL BONE

Loi I.

Numeri Uno 26: 14-15, 2017
Implant or Technique
Clinical practice has demonstrated in the 3 years of commercial life of the Prama implant great success both in terms of survival and aesthetic success, but it is still difficult today to define how much this can be attributed to the surgical and morphological features of the implant or to the prosthetic technique.
We have chosen therefore to document the following case of immediate post-extraction where, both radiographically and clinically, the great bone compensation obtained around the neck of the Prama implants is evident without the use of filling materials. The hyperbolic cone-shaped transmucosal morphology has helped to bring the implant/abutment gap out of the tissues and leave space for the clot in the absence of bacteria, while the microlining of the neck allows an ideal stabilization and organization of the fibers, accelerating the healing process. All of these factors contributed to the natural regeneration of circumferential bone despite the initial deficit, even before the benefits of the B.O.P.T. technique could present themselves.
CASE REPORT
The patient, aged 84, came to observation with a fracture of element 23, which held a bridge reaching as far as elements 26 and 27. On radiological observation, an area containing radiopaque particulates in the soft tissues surrounding the stump pin was evident: after interviewing the patient, it became clear that this was the cement dispersion, which was integrated in a fragmentary manner so as to make it invisible to clinical observation and difficult to remove. The fracture may have occurred within the previous 6 months, during which the patient reports having had inflammatory phenomena treated with generic antibiotics until the formation of the large abscess for which she consulted us. During the aforementioned period, the bridge was not mobile because it was stabilized on elements 26 and 27.
At the patient's request, the bridge was cut between 25 and 26 to save part of the prosthesis and insert 3 Prama implants with 3.80 diameter, whose neck design allows for a vertical positioning range that compensates for defects or excess bone, with all the resulting problems. The defect caused by the abscess at the canine had a diameter of about 1 cm.