Journal of Oral Implantology August 2013 - (Page 467)

CLINICAL Functional Load in Oblique Bicortical Implants: Parasinusal Implants and Palatine Implants Aurelio Tomasi Morgano, MD* The history of intraosseous implantology, as a whole, begins with the introduction of the Formiggini screw. Single-piece implants were subsequently derived from titanium bars. The intrinsic function of the emerging stump was immediate loading. The great stability of the implant in the bone thus demanded was eventually achieved by means of the self-tapping screw and bicortical support. Oblique implants were subsequently adopted to make the best use of the bone available and to avoid zones at risk, such as the maxillary sinus and the inferior alveolar nerve. Angled stumps on osseointegrated 2-stage implants were also described in the literature. There has since been a switch from sunken to single-stage implants in view of the usefulness of immediate loading. Recent articles have illustrated the use of inclined, nonbicortical implants; these are still placed in the spongy bone. Key Words: oblique implants, parasinusal implants, palatine implants INTRODUCTION T he history of intraosseous implantology, as a whole, begins with the introduction of the Formiggini screw. Single-piece implants were subsequently derived from titanium bars. The intrinsic function of the emerging stump was immediate loading. The great stability of the implant in the bone thus demanded was eventually achieved by means of the self-tapping screw and bicortical support.1 Oblique implants were subsequently adopted to make the best use of the bone available and to avoid zones at risk, such as the maxillary sinus and the inferior alveolar nerve. Angled stumps on osseointegrated 2-stage implants were also described in the literature.2,3 There has since been a switch from sunken to single-stage implants in view of the usefulness of immediate loading.4 Recent articles have illustrated the use of inclined, nonbicortical implants5,6; these are still placed in the spongy bone. Centro di Odontoiatria, Torino, Italy. * Corresponding author, e-mail: tomasimorgao@alice.it DOI: 10.1563/AAID-JOI-D-09-00121.1 MATERIALS AND METHODS Conical titanium screws with a standard length of 30 mm and diameters ranging from 3.5 to 5.5 mm are used. Their bodies have 3 to 5 threads. Each thread has a triangular notch that removes small bone fragments and creates a precision housing. The shaft of the screw is a little more than 2 mm in diameter and can thus be bent without damaging the screw by means of a tool that exerts a countermovement to prevent injury to the bone. Few surgical instruments are required (Figure 1), and they must be used with delicacy and precision. Overheating of the bone during perforation must be prevented by irrigation with a jet of water. Technique Drilling of the mucoperiosteum with a lanceolate cutter is followed by the use of 1- to 1.5-mm helical cutters. The screw is inserted with a circular or pipette spanner, and a dynamometric ratchet is used to assess the torque of the immediate loading. The basal cortical bone is reached. After the stability of the screw is checked, it is bent parallel to the other pilasters and shortened to the length of the stump. If the screw is not stable, it is removed Journal of Oral Implantology 467

Table of Contents for the Digital Edition of Journal of Oral Implantology August 2013

Literary Responsibility—Everyone Has a Role to Play
Rehabilitation of Surgically Relocated Integrated Dental Implants With and Without Bone Morphogenesis Protein-2
Erratum
Marginal Fit of Implant-Supported All-Ceramic Zirconia Frameworks
Influence of the Implant Diameter With Different Sizes of Hexagon: Analysis by 3-Dimensional Finite Element Method
Autologous Dental Pulp Stem Cells in Regeneration of Defect Created in Canine Periodontal Tissue
Histologic and Biomechanical Evaluation of 2 Resorbable-Blasting Media Implant Surfaces at Early Implantation Times
Efficacy of Guided Bone Regeneration Using Composite Bone Graft and Resorbable Collagen Membrane in Seibert’s Class I Ridge Defects: Radiological Evaluation
Minimal Iliac Bone Harvesting in Sinus Lift Surgery
Functional Load in Oblique Bicortical Implants: Parasinusal Implants and Palatine Implants
Ultrasonic Oscillations for Conservative Retrieval of a Rare Fracture of Implant Healing Abutment
Craniofacial Implant-Retained Auricular Prosthesis: A Case Report
Gingival Conditioning in an Implant-Supported Prosthesis: A Clinical Report
An Early Loaded Implant-Supported Mandibular Complete Arch Fixed Prosthesis in a Young Completely Edentulous Patient: A Case Report
Computer Guided Surgery for Implant Placement and Dental Rehabilitation in a Patient Undergoing Sub-Total Mandibulectomy and Microvascular Free Flap Reconstruction
Guided Bone Regeneration for Socket Preservation in Molar Extraction Sites: Histomorphometric and 3D Computerized Tomography Analysis
Osseointegration of Dental Implants and Osteonecrosis of the Jaw in Patients Treated With Bisphosphonate Therapy: A Systematic Review
Review of Current Literature

Journal of Oral Implantology August 2013