Focus on implants - Nobel Biocare

7 March 2008 <strong>Focus</strong> on implants 99
Figure 17: Prepared sinus,
left side
Figures 15, 16 & 17.
Once the membrane had
been elevated, osteotomies
were prepared for the
simultaneous placement of
two implants (SPI implant,
Alpha Bio, Israel, modified
and marketed as NobelActive
by NobelBiocare), Figures
18 & 19.
With the osteotomies
prepared, the sinuses were
both packed with large
particulate Bio-Oss (Geistlich
Biomaterials, Wolhusen,
Switzerland), Figures 20 &
21. The two implants were
then placed by hand with
excellent primary stability
and closed over with cover
screws, Figures 22- 25.
The lateral windows were
covered with a bovine
peri-cardium membrane
(Tutogen Medical GmbH,
Germany) and the flaps
sutured with tension free
closure, Figures 26-29.
The post-operative periapical
radiographs, Figures
30 & 31, show a good
position and volume of tissue
around the implants for later
restoration once integrated.
Although experienced
surgeons will not have any
problems handling these
frequently encountered
problems, even less experienced,
but properly trained
surgeons should be able to
perform these and other
surgical procedures with a
greater degree of safety. 19
The advantage of Piezo
surgery is that it creates a
virtually blood free operating
area increasing visibility and
minimal heat is generated by
the inserts, minimising
necrosis due to cellular
damage. One slight drawback
may be that it is slower than
conventional approaches, but
the advantages far outweigh
this slight inconvenience.
References
Figure 18: Implant osteotomy, right side Figure 19: Implant
osteotomy, left side
Figure 21: Graft placement, left side Figure 22: Alpha bio SPI implant placement, Figure 23: Alpha bio SPI implant
placement, left side
Figure 25: Stable implant and graft in situ,
left side
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Figure 20: Graft placement, right side
Figure 24: Stable implant and graft in situ, right
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Dr Nikhil Sisodia BDS qualified from
Bristol University in 1995. Following
a year as a Senior House Officer in
Restorative Dentistry and several years
in general practice in London, he
found his passions were in the
cosmetic and advanced restorative
field, which led him to undertake
further courses in the UK and abroad.
He is an active member of the
American Academy of Cosmetic
Dentistry, Association of Dental
Implantology, a Fellow of the International Congress of Oral
Implantology and is currently Country Chairman (UK) for the
European Society of Cosmetic Dentistry. Nik is also an active
member of the British Academy of Cosmetic Dentistry and
serves on the Board of Directors as Chairman of the Congress
Committee. Dr Konstantin Varga DMD, Master of Oral
Medicine in Implantology, practises in private practice in
Torquay, Devon..