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 Table of Contents  
CASE REPORT
Year : 2013  |  Volume : 4  |  Issue : 4  |  Page : 563-565  

One-piece implant in reduced edentulous space closure: A report of two cases


1 Department of Oral and Maxillofacial Surgery, Rungta Dental College, Bhilai, C.H, India
2 Department of Peroidontics, The Oxford Dental College, Bengaluru, Karnataka, India

Date of Web Publication17-Dec-2013

Correspondence Address:
Sunil Dutt Christopher
No. 53/5V, Kempanna Reddy Layout, Hulimavu, B.G. Road, Bengaluru - 560 076, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-237X.123093

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   Abstract 

Dental Implants have gained popularity over the years and are increasingly becoming the choice of treatment. Different clinical situations are often encountered where modifications have to be considered in order to achieve successful rehabilitation. One of the challenges faced includes non-availability of sufficient space for conventional implants. Here, we present 2 case reports of patients with over two year follow up using one piece implant.

Keywords: Anodontia, implants, one-piece implant, smaller diameter implants


How to cite this article:
Christopher SD, Savitha A N. One-piece implant in reduced edentulous space closure: A report of two cases. Contemp Clin Dent 2013;4:563-5

How to cite this URL:
Christopher SD, Savitha A N. One-piece implant in reduced edentulous space closure: A report of two cases. Contemp Clin Dent [serial online] 2013 [cited 2019 Nov 15];4:563-5. Available from: http://www.contempclindent.org/text.asp?2013/4/4/563/123093


   Introduction Top


The edentulous space between the teeth especially the upper laterals, lower anteriors and upper and lower premolars still remains a challenge to the practicing dentist. The space can further be decreased by drifting of adjacent teeth, changing the dimensions of the space available. The conventional methods to achieve closure are light cure build ups, laminates, bridge or removable partial denturess, which can affect the tooth, gingival health and contour as well as cause damage to the adjacent teeth. [1],[2],[3],[4] In this vicious paradigm an implant emerges as a better solution in avoiding the associated problems.The placement of conventional dental implants requires certain principles. The area of concern however is restoring of edentulous spaces between the teeth by a thinner implant to satisfy both esthetic and functional requirements. [5]

One-piece implants are currently experiencing an era of renaissance in implant dentistry for a variety of reasons, the most important of which are minimally invasive surgical techniques, maximum tissue preservation, a simpler treatment sequence and lower cost. In terms of implant prosthodontics, technical complexity is minimized by reducing the number of components required, which also means that less treatment time is required. In conjunction with state-of-the-art computer-aided design/computer-aided manufacturing technologies, numerous innovative treatment options are now available, encompassing the entire range of modern prosthodontics. [6]


   Case Report Top


We report a case of two patients aged 36-year-old male and 20-year-old female were treated for edentulous space closure. Patients were selected systemically healthy, non-smokers with no contraindication for surgery. Following the clinical evaluation, the procedure and complication of implant therapy were explained and consent taken for the proposed treatment. The spacing between the teeth was carefully evaluated both clinically and on the cast and was found to be about 5.5 mm in one and 5 mm in the other patient; mesio-distally with a 4 mm width (bucco-palatally) at the crestal region in both. Partial closure of spacing in the male patient was noted due to drifting of adjacent teeth. Radiographs were assessed for the type of bone and for the presence of any pathology. The condition of adjacent and upper teeth was assessed and found within bounds [Figure 1],[Figure 2],[Figure 3],[Figure 4],[Figure 5] and [Figure 6].
Figure 1: Pre-operative photograph showing the spacing in premolars (patient 1)

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Figure 2: One-piece implant in space in the region of 1st premolar (patient 1)

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Figure 3: At 2 years post-operative photograph following prosthetic rehabilitation (patient 1)

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Figure 4: Post-operative radiograph after 2 years showing the one-piece implant place (patient 1)

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Figure 5: Space due to congenitally missing upper left lateral incisor closed (patient 2)

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Figure 6: At 2 years post-operative radiograph of upper left lateral incisor closed using one-piece implant (patient 2)

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Treatment procedure

Armamentarium include surgical implant kit containing drills (2 mm and 2.2 mm only), round bur, wrench, insertion tool and physio-dispenser.

Following standard aseptic preparation, implant site was anesthetized by infiltration of Lignocaine with adrenaline. Flaps on the buccal aspect using crestal incisions were raised. The appropriate position of the implant on the crest was marked using a round bur. A 2 mm Pilot drill was used to make the penetration until the desired length. Then a 2.2 mm drill was used to the depth of 13 mms and the single piece implant (TRX OP 2.8 mm × 13 mm, Life Care Devices Pvt. Ltd.) inserted using the wrench.

Treatment outcomes

A total of two patients treated for edentulous space between the teeth using one-piece implant showed complete success. There were very minimal post-operative complaints mainly in the 1 st week after placement. Surrounding tissues including adjacent teeth were found to be in good condition on follow-up for 2 years. On completion of treatment, the patient's esthetics and functions improved.


   Discussion Top


This paper reports a case of a 2 years follow-up of two patients in whom edentulous space closore due to missing first and second premolars was achieved using one-piece implant. Good clinical results were achieved with no sign of bone resorption or infection or implant rejection due to any other cause.

Clinicians come across situations where spacing between teeth caused due to various reasons require treatment. Conventional treatment modalities such as light cure build ups, laminates and RPDs have their own limitations.

Ever since implants have gained popularity, its use in different situations and structural re-modifications has been an ongoing process. One such invention is the one-piece implant and its usage in situations mentioned above. [7]

The advantages of one-piece implants are many; esthetic and functional rehabilitation, shorter procedure time, minimum armamentarium, least damage to the surrounding tissues and better usage in space closure where conventional implants [8] are not feasible and reduced cost. [9] Since a small drill is used, the damage to the surrounding tissues is minimal and immediate esthetic rehabilitation is possible. The one-piece implants have shown to possess better advantages to the conventional dental treatment protocols for filling of minimal space measured between 5 mm and 6 mm. [10]

Management of edentulous spaces in patients with missing teeth demands careful planning and often a multidisciplinary approach. The success of implant depends on the presence of sufficient tissue dimensions and on primary stability being achieved safely. [11] In situations where esthetic and functional requirements are demanding and challenging as in congenitally missing anterior teeth of smaller diameter, edentulous space following orthodontic treatment or additional space that remains following conventional implant replacements, the dentist needs to plan for an alternative treatment procedure that best suits the situation. In such instances, one-piece implants can provide satisfactory results.

The patient's acceptance of the treatment plan and restorative solution were certainly promoted by the use of one-piece implants with careful treatment planning and a minimal invasive insertion technique. The favorable implant survival rate and stable bone level together with esthetic and soft-tissue outcomes indicate that this one-piece implant is a viable treatment option.

The conventional space management options include; no treatment, orthodontic space closure and replacement of the missing tooth with denture, bridge or composite restorations. This article considers the possible options for closure of space of 5-6 mm with the use of implant. New methods and techniques should be added for advantages and further research is advised in this field.

 
   References Top

1.Garg AK, Finley J, Dorado LS. Single-tooth implant-supported restorations in the anterior maxilla. Pract Periodontics Aesthet Dent 1997; 9:903-10.  Back to cited text no. 1
    
2.Kim S, Oh KC, Han DH, Heo SJ, Ryu IC, Kwon JH, et al. Influence of transmucosal designs of three one-piece implant systems on early tissue responses: A histometric study in beagle dogs. Int J Oral Maxillofac Implants 2010; 25:309-14.  Back to cited text no. 2
    
3.Pirker W, Kocher A. Immediate, non-submerged, root-analogue zirconia implant in single tooth replacement. Int J Oral Maxillofac Surg 2008; 37:293-5.  Back to cited text no. 3
    
4.Theoharidou A, Petridis HP, Tzannas K, Garefis P. Abutment screw loosening in single-implant restorations: A systematic review. Int J Oral Maxillofac Implants 2008; 23:681-90.  Back to cited text no. 4
    
5.Vigolo P, Givani A. Platform-switched restorations on wide-diameter implants: A 5-year clinical prospective study. Int J Oral Maxillofac Implants 2009; 24:103-9.  Back to cited text no. 5
    
6.Hannes Thurm-Meyer, Thomas Horn, Sebastian Brahman. Renaissance of one-piece implants. Quelle BDIZ EDI Journal 2/2008.  Back to cited text no. 6
    
7.den Hartog L, Raghoebar GM, Stellingsma K, Meijer HJ. Immediate loading and customized restoration of a single implant in the maxillary esthetic zone: A clinical report. J Prosthet Dent 2009; 102:211-5.  Back to cited text no. 7
    
8.Fugazzotto PA. Shorter implants in clinical practice: Rationale and treatment results. Int J Oral Maxillofac Implants 2008; 23:487-96.  Back to cited text no. 8
    
9.Amr Zahran. Clinical evaluation of OsteoCare™ Midi one-piece implants for immediate loading Implant dentistry today September 2008;2:26-31.  Back to cited text no. 9
    
10.Siepenkothen T. Clinical performance and radiographic evaluation of a novel single piece implant in a private practice. Int J Oral Maxillofac Implants 2007;97 Suppl:S69-78.  Back to cited text no. 10
    
11.Donati M, La Scala V, Billi M, Di Dino B, Torrisi P, Berglundh T. Immediate functional loading of implants in single tooth replacement: A prospective clinical multicenter study. Clin Oral Implants Res 2008; 19:740-8.  Back to cited text no. 11
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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