Introduction
The internal submerged tapered dental implant system, named Luna S® was developed under these market's reflections. Luna S® has many specific positive bony preservational characteristics, such as tapered body which show higher torque value than that of cylinder type, and high initial stability from the effects to compress the surrounding bone at the time of implant placement, and sharp threads with self cutting edges minimizing bone resistance by penetration power, and well-designed 1st thread thread decreasing bone necrosis. Internal hex structures with frictional tapered connections between implant and abutment, there are miminal rotation with strong stability. We tried to apply this implant in the various immediate implant placement during last year.
CASE REPORTS
- Article Review -
Based on evidence and clinical experience, the following five factors determine the best clinical and aesthetic outcome for implants placed right after tooth extraction in the aesthetic zone.
1. Socket type
Type I socket : ideal socket for immediate implant placement as long as there is no inflammation of soft tissue and all localized infection in the socket is thoroughly curetted and removed.
(a) Type I Socket : Facial bone plate is intact and there is no facial soft tissue recession. This is an ideal socket for immediate placement
(b) Type II socket : Facial bone plate is missing, but there is no facial soft tissue recession. This is not a good socket for immediate implant placement in the aesthetic zone
(c) Type III socket : Not a good socket for immediate implant placement
2. Soft tissue biotype
Recommend protocol based on biotype :
A. Thick Biotype : Immediate placement and provisional (if primary stability >35 Ncm).
B. Thin Biotype : Immediate placement but delayed provisional 3-4 months later.
3. Implant position : Ideal
Minimally invasive flapless procedure, placing a slightly narrower implant that is >2 mm from the buccal plate and is 1 mm subcrestal is recommended.
Greater soft tissue fill on the facial aspect and between the adjacent teeth and the implant.
4. Dual Zone Grafting: Previously, clinicians’ only grafted
If the “jumping gap” between the implant and bone was >1.5-mm. Today it is recognized that adding a bone graft regardless of the distance between the implant and bone, has tremendous esthetic benefits in maintaining soft tissue height.
Grafting in conjunction with immediate implant : preventing horizontal bone loss, but also in maintaining crestal bone, hence leading to better soft tissue volume around implants.
5. Immediate or Delayed Provisional Restoration :
The biotype modification procedure is the key for better long-term results.
- Case Review -
Case 1
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Conclusion
The criteria for implant success reported at mobility, pain, radiolucency and peri-implant bone loss. Guiding and maintaining extra bone and soft tissue volume around implants is the key to achieving and maintaining good soft tissue aesthetics. And chronic periapical infection is a risk factor but not an absolute contraindication for immediate implant placement. And All implants are tested prior to prosthesis placement for integration success by counter-torque testing at 25 and 32 Ncm. And there was no discernible crestal bone loss. During the short one year period, Luna S® had good results, with all implants were achieved successful osseointegrations and were prosthetically loaded.
수상 소감
2013년부터 포스터를 제출해 왔고 SID에도 참여하고 있는데 이번에 처음으로 수상하게 돼 영광스럽다.
이번 임상포스터는 immediate 임플란트, 발치 후 즉시 식립하는 임플란트를 시행한 케이스다.
신흥 임플란트 제품 중 Luna S 제품을 이용해서 케이스와 함께 논문 리뷰 형식으로 포스터를 발표했다. Luna S 임플란트는 기존의 tapered된 형태가 아닌 tapered-straight 곡선을 가진 임플란트로, 발치 후 즉시식립 시에 강한 초기고정력을 갖게 해주어 initial stability를 얻을 수 있다. 발치창과 임플란트 픽스처 부위 사이의 갭을 충분히 커버할 수 있는 임플란트라고 생각한다.
