Zero Bone Loss: Knochenerhaltende Behandlungskonzepte. Tomas Linkevičius

Abb. 2-23 Zwei Implantate mit Platform-Switching und konischer Verbindung zeigen unterschiedliche Ergebnisse. (a) Deutliche Knochenresorption. (b) Implantat mit Platform-Switching auf Knochenniveau. (c) Ausgezeichnete Knochenstabilität.

      Zusammenfassung

      Der polierte Implantathals wird nicht osseointegriert und erzeugt einen Knochenverlust, wenn er unterhalb des Knochenniveaus platziert wird.

      Ein Mikrospalt ist verheerend für den Knochen, da es zum Austreten von Bakterien und zu Mikrobewegungen des Abutments im Implantat kommt.

      Durch Platform-Switching wird der Mikrospalt in horizontaler Ebene nach innen verschoben, sodass die bakterielle Leckage vom Knochen entfernt wird.

      Eine konische Verbindung stabilisiert den Implantat-Abutment-Übergang, schließt aber für sich genommen einen Knochenverlust nicht aus.

      Literatur

1.Canullo L, Fedele GR, Iannello G, Jepsen S. Platform switching and marginal bone-level alterations: The results of a randomized-controlled trial. Clin Oral Implants Res 2010;21:115–121.

2.Alomrani AN, Hermann JS, Jones AA, Buser D, Schoolfield J, Cochran DL. The effect of a machined collar on coronal hard tissue around titanium implants: A radiographic study in the canine mandible. Int J Oral Maxillofac Implants 2005;20:677–686.

3.Hämmerle CH, Brägger U, Bürgin W, Lang NP. The effect of subcrestal placement of the polished surface of ITI implants on marginal soft and hard tissues. Clin Oral Implants Res 1996;7:111–119.

4.Shin YK, Han CH, Heo SJ, Kim S, Chun HJ. Radiographic evaluation of marginal bone level around implants with different neck designs after 1 year. Int J Oral Maxillofac Implants 2006;21:789–794.

5.Hänggi MP, Hänggi DC, Schoolfield JD, Meyer J, Cochran DL, Hermann JS. Crestal bone changes around titanium implants. Part I: A retrospective radiographic evaluation in humans comparing two non-submerged implant designs with different machined collar lengths. J Periodontol 2005;76:791–802.

6.Peñarrocha-Diago MA, Flichy-Fernández AJ, Alonso-González R, Peñarrocha-Oltra D, Balaguer-Martínez J, Peñarrocha-Diago M. Influence of implant neck design and implant-abutment connection type on peri-implant health. Radiological study. Clin Oral Implants Res 2013; 24:1192–1200.

7.Wiskott HW, Belser UC. Lack of integration of smooth titanium surfaces: A working hypothesis based on strains generated in the surrounding bone. Clin Oral Implants Res 1999;10:429–444.

      8.Adell R, Lekholm U, Rockler B, et al. Marginal tissue reactions at osseointegrated titanium fixtures (I). A 3-year longitudinal prospective study. Int J Oral Maxillofac Surg 1986;15:39–52.

      9.Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387–416.

10.Jung YC, Han CH, Lee KW. A 1-year radiographic evaluation of marginal bone around dental implants. Int J Oral Maxillofac Implants 1996;11:811–818.

      11.Abrahamsson I, Berglundh T, Linder E, Lang NP, Lindhe J. Early bone formation adjacent to rough and turned endosseous implant surfaces. An experimental study in the dog. Clin Oral Implants Res 2004;15:381–392.

12.Derks J, Håkansson J, Wennström JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: Early and late implant loss. J Dent Res 2015;94(3 suppl):44S–51S.

13.Kano SC, Binon PP, Curtis DA. A classification system to measure the implant-abutment microgap. Int J Oral Maxillofac Implants 2007;22:879–885.

14.Dibart S, Warbington M, Su MF, Skobe Z. In vitro evaluation of the implant-abutment bacterial seal: The locking taper system. Int J Oral Maxillofac Implants 2005;20:732–737.

      15.Gross M, Abramovich I, Weiss EI. Microleakage at the abutment-implant interface of osseointegrated implants: A comparative study. Int J Oral Maxillofac Implants 1999;14:94–100.

      16.Quirynen M, Bollen CM, Eyssen H, van Steenberghe D. Microbial penetration along the implant components of the Brånemark system. An in vitro study. Clin Oral Implants Res 1994;5:239–244.

17.Zipprich H, Miatke S, Hmaidouch R, Lauer HC. A new experimental design for bacterial microleakage investigation at the implant-abutment interface: An in vitro study. Int J Oral Maxillofac Implants 2016;31:37–44.

18.Hermann JS, Schoolfield JD, Schenk RK, Buser D, Cochran DL. Influence of the size of the microgap on crestal bone changes around titanium implants. A histometric evaluation of unloaded non-submerged implants in the canine mandible. J Periodontol 2001;72:1372–1383.

19.King GN, Hermann JS, Schoolfield JD, Buser D, Cochran DL. Influence of the size of the microgap on crestal bone levels in non-submerged dental implants: A radiographic study in the canine mandible. J Periodontol 2002;73:1111–1117.

20.Hermann F, Lerner H, Palti A. Factors influencing the preservation of the periimplant marginal bone. Implant Dent 2007;16:165–175.

21.Ericsson I, Persson LG, Berglundh T, Marinello CP, Lindhe J, Klinge B. Different types of inflammatory reactions in peri-implant soft tissues. J Clin Periodontol 1995;22:255–261.

      22.Ericsson I, Nilner K, Klinge B, Glantz PO. Radiographical and histological characteristics of submerged and non-submerged titanium implants. An experimental study in the labrador dog. Clin Oral Implants Res 1996;7:20–26.

      23.Hermann JS, Buser D, Schenk RK, Schoolfield JD, Cochran DL. Biologic width around one- and two-piece titanium implants. Clin Oral Implants Res 2001;12:559–571.

      24.Hermann JS, Cochran DL, Nummikoski PV, Buser D. Crestal bone changes around titanium implants. A radiographic evaluation of unloaded nonsubmerged and submerged implants in the canine mandible. J Periodontol 1997;68:1117–1130.

25.Broggini N, McManus LM, Hermann JS, et al. Persistent acute inflammation at the implant-abutment interface. J Dent Res 2003;82:232–237.

26.Broggini N, McManus LM, Hermann JS, et al. Peri-implant inflammation defined by the implant-abutment interface. J Dent Res 2006;85:473–478.

27.Piattelli A, Vrespa G, Petrone G, Iezzi G, Annibali S, Scarano A. Role of the microgap between implant and abutment: A retrospective histologic evaluation in monkeys. J Periodontol 2003;74:346–352.

28.Linkevičius