SW I S S M
Report on experience by Dr. Axel Hentschel, MKG, Magdeburg
Protective devices for Z-Look3 implants – Experiences with Flexiplast dentures
The implants from Z-Systems offer excellent primary stability intraoperatively. Even with indications near the limits, e.g. extreme vestibular bone loss in the upper anterior region after trauma, the implant could be inserted with primary stability. The implant must then be protected optimally against loads/movements to be able to heal safely. I as dental surgeon initially reduced the implant only occlusally and then returned the patient for immediate temporary denture treatment to the referring colleagues. Unfortunately I have not had such good experience with this course of treatment. Despite explaining to referring colleagues the importance of implant protection during the healing period, protective devices of very different design were used, frequently also with unsuitable means. The consequences were loosening and loss of implants. This meant reimplantation for me. In agreement with my referring colleagues, patients now leave my practice only if sufficient temporary dentures have been provided and the patient has been educated comprehensively about his behaviour and care of the temporary denture. I have tried out a number of protective devices, from temporary crowns with spacers and deep drawn Miniplast splints to be worn for 24 hours up to reworking already existing patient dentures. I have almost stopped using Miniplast splints, patients complain about problems when biting, tightly sitting splints and difficult care. I am increasingly using Flexiplast dentures which despite rather clumsy clasps guarantee good seating and safe bite fixation and are accepted well by my patients. To produce the Flexiplast dentures, anatomical impressions are sent preoperatively to the laboratory (best of all cast straight away with model casting plaster for dispatch). One should plan a good 2 – 3 weeks for dispatch, production and return. After consultation with the dental technicians, I have a drilling template produced at the same time in the prosthetically optimum position and the suitable interim denture made of Flexiplast for the implant position thus determined. The interim denture is measured like a model cast denture, without occlusion disturbances and anchored firmly to the residual teeth by plastic clasps. The position of the implant in the jaw is already largely determined by the drilling template so that the Flexiplast denture only has to be adapted slightly to the implant abutments and the implants can be protected unproblematically by the temporary protective device. The implant insertion locations are left free all round and can be ground out further if there are any early contacts with the implant abutment. The distance from the implant abutment to the Flexiplast denture can be checked optimally by means of Fit Checker®, for instance. I frequently let my patients wear the interim restorations for several days before surgery to become accustomed to them. They become accustomed to them quickly and can help in locating early contacts during postoperative insertion. I consider these Flexiplast dentures to be a safe protective concept to guarantee healing of the Z-Systems implants with protection against contact. When they are treated in this way I can return patients to referring colleagues with a better feeling.
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Z-Systems comments
In the case of implantation without using a drilling template, the Flexiplast denture can also be produced postoperatively. The implants must be protected by a deep-drawn Miniplast splint until the Flexiplast denture is inserted. Caution :: In the case of partial support of the Flexiplast denture on the mucosa, subsidence of swelling of the gingiva postoperatively in the implantation area must be considered and the Flexiplast denture must be checked carefully and if necessary relined to guarantee at all times sufficient distance between implant abutment and protective device. Should your laboratory not possess the necessary equipment for producing a Flexiplast denture, Z-Systems can name you a suitable laboratory.
Konstanz, January 2008 Z-Systems AG Lohnerhofstraße 2 :: 78467 Konstanz :: Germany Phone +49 (0)7531 2824-0 :: Fax +49 (0)7531 2824-24 support@z-systems.de :: www.z-systems.de
10/08 140.125