Meeting patient desires while optimising clinical results
Featured Products Promotional FeaturesPosted by: Dental Design 2nd November 2022
Dr Amit Patel is a Specialist Periodontist with extensive experience in dental implantology. He recently used the new Neodent® Zi Zirconia Implant System and here shares his case.
As dentists, our goal is to get patients out of pain and provide them with beautiful and functional solutions that will last them as long as possible. However, our work is just as much about meeting patient expectations and working with them to find solutions that fulfil their personal preferences and desires – whether that is providing fixed or removable restorations, identifying treatment options that fit into their lifestyle, or using products from preferred materials.
The case presented here was a female, 56-year-old patient who presented to the practice looking for a solution for her failing UR3. She was keen to explore non-metal options having done some research online about the potential benefits and availability of certain products. This particular request is becoming more and more common among patients that I see – a growing number of people are increasingly aware about what is being put into their body and there is a clear demand for metal-free dentistry.
In this situation, a comprehensive assessment was conducted, confirming that the patient was fit and healthy with a clear medical history. The intraoral examination revealed no abnormalities, no active disease and generally good oral hygiene. The patient had a few existing restorations, but the main issue was the fractured roots of the UR3, which had a failing post crown in place.
All possible treatment options were discussed with the patient in detail. The prognosis of the UR3 was poor, so extraction was indicated. Restoration could then be achieved either with a removable bridge or an implant-retained crown. All benefits, risks and limitations of the different options were described in detail, but the patient remained most interested in the fixed option, where it could be achieved with a metal-free solution. A ceramic implant and crown were suggested and the patient gave informed consent to proceed.
The existing UR3 was extracted as atraumatically as possible and left to heal for 6-8 weeks. The patient then returned for surgical treatment, which was planned using a CBCT scan to ensure minimal complications.
The implant placement technique selected was typical of a simple implant procedure and followed the manufacturer’s instructions. A 4.3 x 11m Neodent® Zi Ceramic Implant System was chosen to fulfil the patient’s desire for a metal-free restoration. A flap was raised and the implant placed at the predetermined bone level position and chosen angle, torqued to 60 Ncm. Guided bone regeneration (GBR) was performed to replace the missing buccal bone following extraction of the fractured roots, using a synthetic grafting material, as per the patient’s preferences. The flap was closed and sutured without tension. All the appropriate post-operative instructions were given to the patient, with special emphasis on maintaining oral hygiene around the surgical site.
During the 3-month surgical review, healing had been good and the site looked healthy, with good soft and hard tissue attachment. An Implant Stability Quotient (ISQ) was taken to measure and confirm the stability of the implant and the strength of the integration.
The implant was uncovered and open tray impressions were taken and sent to the laboratory to fabricate the restoration. This was a screw-retained, zirconia crown loaded onto a zirconia abutment, maintaining the patient’s wishes to stay metal-free.
The patient loved her smile and was very happy with the outcome of treatment. Given her positive experience with the ceramic implant and restoration, she is considering a similar implant treatment to replace her now also failing UL4.
The new Neodent® Zi Ceramic Implant was an excellent choice for this case, not only because it catered to the patient’s desire for a no metal, but also thanks to its unique design and manufacture process. Unlike other zirconia products often made in a machine, the Zi Ceramic Implant is constructed using an injection moulding technique, which reduces the risk of microscopic fractures in the material for superior strength and reliability. It also facilitated beautiful tissue healing, with the zirconia abutment encouraging gingival attachment for no probing depth and optimised aesthetics. Plus, there are various diameters available to suit different cases.
This case demonstrates the importance of having a diverse armamentarium behind you that allows you to meet the needs and desires of your patients. It’s their mouth and their treatment, so we must find solutions we trust to deliver good clinical results that operate within our patient’s preferences. When my patients request metal-free options, I will only place Neodent® implants because of their simplicity.
Figure 1a – Post extraction and 6-8 weeks healing
Figure 1b – Post extraction and 6-8 weeks healing
Figure 2 – Implant placement
Figure 3 – Implant in situ
Figure 4 – Grafting material packed around implant
Figure 5 – Soft tissue closed without tension
Figure 6 – Radiograph immediately post placement
Figure 7 – 1 week post-op
Figure 8 – 3 months post op
Figure 9 – 2 months post op radiograph
Figure 10 – post treatment
Figure 11 – post treatment UR3
Figure 12 – post treatment UL4
For more information, please visit https: www.neodent-uk.co/zi-implant
Author bio:
Dr Amit Patel is a specialist in periodontics. He graduated in dentistry from the University of Liverpool in 1997 and obtained his Membership of the Faculty of Dental Surgeons at the Royal College of Surgeons in Edinburgh in 2000. Dr Patel also underwent a 4-year training programme in periodontics and implantology at Guy’s, Kings and St Thomas’ Dental Institute, achieving his Masters in periodontology and clinical dentistry. Passionate about providing specialist dentistry to the highest degree, Dr Patel also trains other dental professionals. As Associate Specialist in periodontics and Honorary Clinical Lecturer at the University of Birmingham Dental School, he teaches at undergraduate and postgraduate level. He also lectures both nationally and internationally.
