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Video Details
下顎臼歯部を複数インプラントで即時再構築

Description:
この外科的ビデオでは、以前グラフトした下顎臼歯部に即時暫間補綴するため、複数の隣接したインプラントの埋入をする治療を取り扱う。CBCTや3Dイメージを見直しながら診断の説明をする。可能な骨の分析、下顎神経の位置について考察する。インプラント埋入や補綴、外科的ガイドを活用した的確な治療の立証についても話される。石灰化した骨にアログラフトとPRGFを使用したボーングラフティングが効果的な外科的プロトコールの一環として歯肉組織のマネジメントと共に明確にされる。インプラント埋入時、ファイナルアバットメントの装着を活用した暫間補綴を円滑にする際に「ワンアバットメント・ワンタイム」テクニックが役に立つ。補綴治療では、アバットメントへのアクリル処理の使用、バキュームの形をしたマトリックスを使用した手術の際のイミディエートリライン、3つ組のリラインマテリアルが取り上げられる。術後2カ月のソフトティッシュ治癒の写真、スナップキャップや流動性レジンを活用して採られた最終的な印象も含まれる。

Date Added:
6/5/2013

Author(s):

Maurice Salama, DMD Maurice Salama, DMD
Dr. Maurice A. Salama completed his undergraduate studies at the State University of New York at Binghamton in 1985, where he received his BS in Biology. Dr. Salama r...
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Online Videos / Surgery / Implant / Immediate Reconstruction of the Posterior Mandible with Multiple Implants




Questions & Comments
Rene Rebeil - (6/9/2013 6:04 PM)

Exellent presentation as well as the spanish translation

henry salama - (6/8/2013 12:08 PM)

For most clinicians, hand tightening the abutment fully at the time of placement will probably deliver in the range of 15-20 Ncm and that is enough to seat the abutment completely. The so called "pre-torque" that we perform when we do final torquing to 30-35 Ncm creates an effect on the SCREW not on the abutment position. Therefore, no adverse positional change or affect should be seen on the final restoration. Hand tightening at placement ensures easy removal & replacement of the primary abutment in case it is deemed as not optimal for a final restoration. I hope that helps.

Paul Boulos - (6/8/2013 7:17 AM)

Dr Salama.thanks for the nice presentation. my question is if you torque the abutments before cementation this might affect the seating of the crowns especially if they are joint. meaning that the abutment might sink a bit into the fixture and its all varied on the three fixtures.any comment. thank again for the beautiful work.

henry salama - (6/7/2013 2:47 PM)

At implant placement, restorative abutments are only hand tightened. Final torque is not utilized until the abutments are deemed acceptable and only prior to final cementation. There are many ways to utilize the "one abutment/one time" technique. One, utilize pre-machine contoured abutments that have dedicated snap on components, or, choose and shape an abutment as needed and impress it prior to placement to fabricate a refractory die. That die is utilized by the lab to fabricate a resin transfer coping that can be used for taking the final impression.

e chan - (6/7/2013 11:48 AM)

Are the final abutments torque in at 30Ncm in 2 months on the day of final restoration cementation? So the final crown restorations are finished after 2 months healing? At surgical stage, you just put the final abutments on and do the temporization without torquing abutments, right? If one abutment one time and never removed, then do you just use snap caps and take impression and no need to remove the final abutments to give to the lab to adjust the final abutments, and leaving all final abutments in mouth after you put them on on the day of surgery.

rally garcia - (6/7/2013 3:37 AM)

awesome !!

Maurice Salama - (4/11/2013 3:22 AM)

Thanks Bassam. We are considering revisiting past cases and showing the follow up and reposting them. Would that be of interest? Dr. Salama

Bassam Algheryafi - (4/10/2013 7:58 PM)

Very inspirational presentation Dr.Salama; is there anyway you can put together all links related to this case or any case in future thus we can watch it from the start to finish? thanks for your dedication to this forum.

Maurice Salama - (3/27/2013 5:22 PM)

Loc; Thanks for the nice comments, please see my previous post below. Arrestin or Acromycin can be utilized for the antibiotic paste. Thanks Dr. Salama

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