Implants in the Esthetic Zone: A step-by-step treatment strategy

Implants in the Esthetic Zone: A step-by-step treatment strategy

Ueli Grunder

This book presents an unconventional implant treatment strategy for the esthetic restoration of anterior teeth that has proven effective over years of clinical experience.
Written by a highly respected and innovative surgeon, this book presents an unconventional implant treatment strategy for the esthetic restoration of anterior teeth that has proven effective over years of clinical experience.
In addition to reviewing biologic principles, treatment planning, indications, esthetic analysis, and prosthetic options, the author focuses on factors such as gentle tooth extraction, precise implant positioning, criteria for one- and two-stage implant placement, and most importantly, a wide range of soft tissue management techniques in his approach.
This book also presents techniques to improve the esthetic outcome of any dental implant therapy, regardless of treatment strategy. With more than 4,000 clinical images and illustrations of all procedures and techniques discussed, this tour de force by a leader in implant dentistry raises the reader’s awareness of the high demands of implant dentistry and how clinicians can achieve optimal results.

Contents

1. Introduction

• Why this book?
• Citing of references
• Instruments used
• Materials used

2. Esthetics

• General
• Long-term results
• Summary/References

3. Possible failures

• Excessively long clinical crown
• Scarring
• Absence of papillae
• Buccal tissue volume deficiency
• Restorative materials that cause soft tissue discoloration
• Summary/References

4. Biological principles

• Introduction
• Papilla between an implant and a natural tooth
• Papilla between two adjacent implants
• Buccal area
• Effect of the implant-abutment interface
• Limits of planning
• Summary/References

5. Treatment planning principles

• General
• Dental history
• Clinical examination
• Radiographic examination
• Special aspects of clinical and radiographic evaluation
• Summary/References

6. Prosthetic planning/alternatives to dental implants

• General
• Replacing a single missing tooth
• Replacing two missing teeth
• Restoring a large edentulous space
• Summary/References

7. Prosthetic options to compensate for tissue deficits

• General
• Compensating for vertical defects
• Compensating for lack of papillae
• Compensating for horizontal defects
• Compensating for lack of lip support
• Summary/References

8. Initial analysis

• General
• Lip line
• Shape of the jaw
• Tooth shape
• Tooth position
• Adjacent teeth
• Soft tissue
• Available bone
• Width of the edentulous space
• Function
• Occlusion
• Treatment planning based on the pretreatment evaluation
• Application example
• Summary/Reference

9. Extraction

• General
• Papilla collapse at the adjacent tooth after extraction
• Papilla preservation at the adjacent tooth
• Buccal soft tissue support
• Preservation of papilla between two teeth to be extracted
• Ridge preservation procedures
• No ridge preservation measures before implant placement
• Summary/References

10. Implant position

• General
• Bucco-oral positioning
• Axial inclination
• Mesiodistal positioning
• Apicocoronal depth
• Ideal implant positioning
• Influence of implant position on prosthetic options
• Number of implants
• Application example
• Consequences of implant malpositioning
• Surgical template
• Summary/References

11. Immediate implants

• Initial mistakes
• Learning effects
• Procedures to compensate for tissue los
• Temporization
• Summary/References

12. Implant placement with simultaneous guided bone regeneration (GBR)

• Biological rationale
• Esthetic rationale
• Long-term results
• Surgical procedure
• Failure
• Summary/References

13. Two-stage implant procedures

• Ridge augmentation before implant placement – General
• Augmentation with membrane and xenograft
• Augmentation with an autogenous bone block
• Augmentation with an autogenous bone block and membrane
• Augmentation with autogenous bone cone, xenograft, and membrane
• Summary/References

14. Soft tissue grafting

• General
• Surgical procedure
• Limits of possibility
• Typical errors
• Inlay graft technique
• Summary/References

15. Stage-two implant surgery

• With papilla-sparing incision
• With flap reflection
• With scalloped incision
• Limited punch technique
• Summary/References

16. Stage-two surgery with simultaneous soft tissue grafting

• With a horizontal incision
• With flap mobilization
• Roll flap technique
• Envelope technique (tunnel technique)
• Inlay graft
• Summary/References

17. Temporary restoration

• Requirements
• The ideal temporary restoration
• Summary

18. Prosthetics

• General
• Cemented versus screw-retained
• Soft tissue management with the implant suprastructure
• Final impression of the two-part suprastructure
• Two-piece crown
• One-piece crown
• One-piece bridge
• Retainer for natural teeth
• Summary/References

19. Summary: Six case examples step by step

• Immediate implant placement
• Single-tooth implant with GBR
• Two implants with GBR
• Two-stage implant procedure for single tooth replacement
• Two implants, two-stage procedure
• Complex case

Dr Ueli Grunder

Graduated in 1982 from the Dental Institute of the University of Zürich and received his doctorate degree (Dr med dent) in 1984. After working for two years in private practice, he completed a three-year Postgraduate Masters Degree program in Crown and Bridge, Partial Dentures and Materials Science under the tutelage of Professor P. Schärer at the University of Zürich, where he has taught dental implantology since 1987. Dr Grunder was accredited as a Reconstructive Dentistry Specialist (SSRD specialist status) in 1993, and has held a WBA Postgraduate Education Diploma in Oral Implantology from the Swiss Dental Association since 2011. He runs a private practice in Zollikon-Zürich, Switzerland, with Dr Gaberthüel from 1989 to 2014, and with Drs Schneider and Jung since 2014. Dr Grunder’s main fields of activity include Esthetic Periodontology, Fixed Crown and Bridge Prosthetics, and Implantology. His international lectures and various publications focus on surgical and prosthetic aspects of dental implantology. Dr Grunder is Past-President of the Swiss Society of Oral Implantology (SGI) and the European Academy of Esthetic Dentistry (EAED). He also works as a reviewer for several dental journals.