Augmentation Techniques – the Basis of Aesthetic

Summary Patients’ aesthetic demands have become the main criterion by which to judge the achievements of modern dental implantology. Consequently, implant positioning is dictated by restorative considerations rather than by the traditional criteria of bone quanti- ty and morphology. Techniques of guided bone regeneration have significantly expanded the spec- trum of indications, and restorative treatment steps are today facilitated by advanced implant hardware. Two distinct strategies are used to address bone defects in the aesthetic zone: single-step procedures and staged approaches. Single-step procedure means that bone augmentation and implant place- ment are performed in a single session. This approach should remain confined to two-wall bone defects (classes I and II). Single-wall defects should be addressed in a staged procedure. Approaching the problem step by step will offer maximum control of the hard and soft tissue structures involved. The first step is to augment the bone using block grafts. The second step is to place the implants and perform soft-tissue adjustments if necessary. The restorative phase is initiated by delivering temporary restora- tions that will shape the emergence profile. Careful patient selection is recommended in all sit- uations, and patients with large defects should be duly informed about existing limitations. (References available from the author.) EDI Case Studies 11 Fig. B7 CAMLOG implant (diameter 5 mm) in place. Adequate size of the buccal lamella follow- ing augmenta- tion. Fig. B9 Implant sur- rounded by healthy peri- implant soft tissue of adequate thickness. Fig. B8 Restorative phase after placement of a tempo- rary restora- tion for gingival shaping. Fig. B10 Modified zirco- nia abutment in place. Fig. B11 All-ceramic restoration. The excess soft tissue on the facial surface is going to be removed after 2 years at the earliest. Claudio Cacaci, Dr. med. dent. 1986–1991 Medical school in Munich, Germany 1991–1993 Clinic and Polyclinic for Dental and Maxillofacial Surgery in Munich, Germany 1994–1996 Polyclinic for Dental Surgery and Implantology, Frankfurt, Germany 1995 Authorized specialist in oral surgery 1996 Assistant Medical Director at the Polyclinic for Dental Surgery and Implantology, Frankfurt, Germany 1997 Private practice together with Dr. Jan Hajto in Munich, Germany VITA: