logo 17 • CAMLOG Partner Magazine • March 2018 24 Dr. Jörg-Martin Ruppin, Penzberg PROSTHETIC RESTORATIONS WITH ISY IMPLANTS ONE SYSTEM, MANY OPTIONS Implant dentistry has been firmly established in dentistry for over twenty years. In the pioneering days of implant dentistry, efforts focused mainly on reliable osseointegration. Due to advances both in implant surfaces and shapes as well as surgical techniques, success rates of 95–99% are achieved today accompanied by excellent long-term stability [1,2]. Fig. 1: The well-formed alveolar ridge is fully adequate for restoration with a full denture. Fig. 3: Checking the first drill holes with directional indicators. Fig. 2: Stabilization of the prosthesis in the mandible was only possible by using implants. Although the patients’ needs for implant restoration are by no means satisfied, the literature shows a certain stagnation in the number of implant restorations performed. A recent, nationwide online survey in Germany [3] confirmed that the number of teeth extracted exceeds the number of implants inserted by a factor greater than 10. There is therefore an obvious imbalance between patient needs on the one hand and performed implant restorations on the other. This is due to a number of reasons, ranging from the subjective reservations of patients about implants, to the partly demanding necessary surgical interventions, to financial aspects [2]. From the patient’s perspective, a modern implant system should therefore primarily be economical without sacrificing quality, long-term stability, and safety of use. From a user’s perspective, aspects such as “workflow”, “efficiency” and “simplicity” are also crucial, since time efficiency has a major impact on the economic efficiency of treatments in everyday practice. An implant system should therefore satisfy the following requirements: - Safe application and long-term stability - High quality and precision - Cost-effective - A workflow that is as easy and effective as possible. As mentioned initially, the term “costeffectiveness” exceeds by far the simple matter of price. Major aspects are time efficiency and workflow simplicity: only when a system is time efficient in its application to the patient and the number and duration of treatment sessions can be reduced, does a system offer economic added value beyond the mere material price of the individual components, which can be decisive for a cost-effective treatment method. Using two patient cases as examples, the workflow and prosthetic options of the iSy System are described. First case: the Locator® restoration The first patient case presents the restoration of an edentulous mandible with four interforaminal implants. At the time of restoration, the patient was just under 70 years old. The general medical history was normal apart from hypertension and nicotine dependence. The maxilla was also edentulous but could be treated sufficiently with a full denture as the alveolar ridges were still well formed (Figs. 1 and 2). However, the patient complained of insufficient retention of the prosthesis in the mandible. The bone available in the mandible was well suited for restoration with implants, only the width of the crestal portion of the alveolar process was strongly atrophied (Cawood class IV) [4]. After consultation with the patient on the treatment options, the iSy System was chosen. Implant insertion At the time of implantation, the extraction of the residual denture in the mandible was approximately six weeks prior, in CASE STUDY
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