logo 18 • CAMLOG Partner Magazine • July 2018 COVER STORY 7 are better suited to minimize bone loss and recessions in cases of dehiscence. This resumé from the research was a great opportunity for the two subsequent speakers – Professor Vladimir Kokovic and Dr. Frank Maier – who have both already dealt intensively with the CERALOG® Implant System. In the past, Vladimir Kokovic has conducted intensive clinical research into the primary stability of CERALOG® Implants, also in order to explore the possibility of immediate loading protocols. In one of his studies he observed initial ISQ values of just over 60, a drop in Week 3 to values around 54 and an increase in Week 16 to areas around 64. He sees the possibility of immediate loading protocols in the mandibular posterior region with CERALOG®. Singletooth reconstructions are the system's domain and the advantages are best realized in the anterior region – due to the material and its dual surface texture of 1.6 µm endosseous and 0.5 µm in the neck region for the transition zone. Vladimir Kokovic firmly believes in the future of ceramic implants and explained this by the high user-friendliness and positioning precision of the two-piece hexalobe implant. This is also preferred to the one-piece monobloc implant by Frank Maier. He considers the biological aspects of implant materials to be important (zirconium dioxide, unlike titanium, does not release ions), but at the same time considers it appropriate to remove the stigma of alternative medicine and place ceramic implants on a broader scientific basis. For example, he does not consider ceramic drills to be a good choice, because they have poor thermal conductivity and therefore present a greater risk of heat necrosis. Frank Maier comes from the Tübingen School and sees an indication for zirconium dioxide implants both in combination with PEKK abutments and with zirconium dioxide abutments for single teeth and smaller bridges up to a maximum of five pontics. In one female patient, he inserted a four-pontic bridge on three implants, which were restored once with PEKK abutments and once with zirconium dioxide abutments for comparison purposes. The clinician and the patient assessed both restorations as being equivalent, but the patient ultimately opted for the zirconium dioxide abutments for biological reasons. Restorative concepts Due to demographic developments, the focus in the practice is increasingly on older patients. This requires concepts that take advanced age into account or, better still, "the aging process" – and therefore do not at some point pose unsolvable problems for patients with decreasing visual and manual abilities. The speakers in this session, Dr. Luca Cordaro, Dr. Claudio Cacaci and Dr. Rémy Tanimura, agreed that it was therefore important to strategically consider which restorative concept to recommend to older people. Whereby the individual situation of the patient is the top priority. Dr. Luca Cordaro advocated several smaller bridges for total restorations, incorporating the residual dentition whenever possible. Dr. Claudio Cacaci and co-authors already presented the Munich concept "One dental prosthesis for two life phases" about ten years ago. This is characterized by a fixed cemented restoration that can be converted into a removable telescopic restoration. The functional elements for this are 2° milled zirconium dioxide abutments on CAMLOG® Implants and electroplated abutments. Even at the time, this concept was very convincing, as well as being new. Based on 13 to 14 year old patient cases, Dr. Claudio Cacaci can today prove that this worked exactly as envisioned and could accompany people through the different stages of age. According to Claudio Cacaci, regular follow-up checks and professional dental hygiene are an indispensable part of this concept.
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