Caroliene Meijndert

102 Chapter 6 Materials and Methods Study design This report describes a prospective case series with a follow-up of one year. Recruitment of patients , implant treatment and follow-up took place at the Department of Oral and Maxillofacial Surgery of the University Medical Centre Groningen, the Netherlands. Patients Patients were eligible if they met the inclusion criteria; >18year of age, adequate oral hygiene, non-smoking, no medical and general contraindications for the surgical procedure (ASA score ≥III, Smeets et al. 1998), no periodontal pathology in the remaining dentition, indicated by bleeding on probing combined with pockets ≥4mm. An intra-oral radiograph and a cone beam computer tomography (CBCT) were made to determine whether it was likely to expect that the implant would gain sufficient initial stability immediately after tooth removal. Recommendations of Buser et al. (2017) were followed concerning immediate implant placement, being: a fully intact facial bone wall at the extraction site with a thick wall phenotype (> 1 mm), a thick gingival phenotype, no acute infection at the extraction, and sufficient volume of bone apical and palatal of the extraction site to allow implant insertion in a correct 3D position with sufficient primary stability. Three patients were included; two presented with a irreparable resorption defect in the root of the right central incisor and one patient was referred for replacement of a fractured left central incisor. One case is presented to illustrate. See figure 1 . After detailed explanation of benefits and risks of possible treatment options, the patients chose an implant supported restoration to replace the failing central incisor. Written informed consents were obtained from the patients before enrolment. All patients were treated following the same immediate placement and restoration protocol as described below. After inclusion After inclusion an alginate impression was made and send to the dental lab where a plaster model was fabricated. An open impression tray was printed based on a scanned version of the plaster cast and a surgical drilling template was manually produced according to the ideal position of the future crown. The preferred implant position was planned so that the restoration could be screw retained.