Replacement of a missing posterior tooth in the
mandible
(iSy® by CAMLOG)
Implants are generally regarded as being a high-end therapy involving relatively high costs. In the quest for economical
treatment strategies with first class quality, the iSy® Implant by CAMLOG has proven to be an excellent offering. The
philosophy of the system is to simplify treatment and thus reduce costs. iSy® by CAMLOG consists of only a few
components. The simplified surgical protocol and the lean processes save considerable time and costs in daily dental
practice. Implant insertion is reduced to three drilling sequences and is concluded with a single patient form drill
included with each implant set. A pre-mounted implant base is used as insertion post and also as base for the gingiva
former and the multifunctional cap.
Case presentation
The iSy Implant was designed for standardized implant treatment and provides a straightforward approach to the
solution. When used in the right indication, as in the following case study, this implant provides an economically
appealing option. The case study presents the prosthetic restoration with an implant after loss of a posterior tooth in the
mandible.
Authors: Dr. Manfred Wolf, Dr. Daniel Rein
Indication: replacement of a missing
posterior tooth in the mandible
April 2, 2015
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Fig. 1
Fig. 4
Fig. 2
Fig. 2
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Fig. 3
Fig. 1: initial situation: the first molar in the left mandible is missing. The gap is to be filled prosthetically with an implant. The patient wished
for the most simple treatment possible.
Fig. 2: the panorama-x-ray prior to therapy shows sufficient bone height for the insertion of an 11 mm iSy Implant.
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Fig. 4
Fig. 2
Fig.
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Fig. 3: minimally invasive exposure of the alveolar ridge. The bone is
exposed with a marginal lingual relief cut of the planned implant
position.
Fig. 34
Fig.
Fig. 4: the mucosa and periosteum are mobilized and flapped. To
keep the alveolar ridge exposed during surgical intervention, the
mucosal flaps in the buccal region can be retained with small sutures.
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Fig.325
Fig.
Fig. 5: the iSy Surgical and prosthetic set includes the surgical instruments necessary for preparation of the implant bed and can be sterilized
inclusive of contents.
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Fig. 2
Fig.
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Fig. 6: the implant position is marked after mobilizing and fixing the
mucoperiostal flap. The cortical bone is slightly center-punched with
the round bur which simplifies placing of the pilot drill.
Fig. 2
Fig.
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Fig. 7: pilot drilling defines the depth and axis of the implant site. The
iSy® Pilot drill is fitted with depth markings. The lower edge of the
markings corresponds to the implant length (9, 11 or 13mm).
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Fig.328
Fig.
Fig.
Fig. 8: the iSy Direction and depth indicators are inserted into the drill holes for orientation purposes and depth and alignment checked. Then
the preparation of the implant bed can be completed with the iSy® Single patient form drill and the tap.
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Fig. 99
Fig.
Fig.910
Fig.
Fig. 9: the iSy Implant can be removed directly from the holder using the implant insertion tool. To this purpose, the insertion tool is inserted
into the implant base until it audibly snaps into place under slight pressure.
Fig. 10: Insertion of an iSy Implant (5.0 x 11 mm). The implant is placed in the implant bed using the insertion tool, inserted manually and
given its final position with the iSy® Torque wrench (epicrestally).
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Fig. 10
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Fig.
Fig. 11
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Fig.
Fig. 11: the inserted implant. The implant base acts as basis for the gingiva former and the temporary restoration respectively.
Fig. 12: after cleaning of the implant base, the before shortened multifunctional cap is mounted. The cap now acts as base for the chairside
fabricated temporary restoration. Alternatively, a gingiva former can be mounted on the implant.
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Fig.10
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Fig.
Fig.11
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Fig.
Fig. 13: the temporary crown has been prepared such that it is hollow Fig. 14: finishing the temporary crown with a silicone polisher. Then
inside and fits on the multifunctional cap. The crown is lined with resin the crown is polished in the usual manner.
and the cavity filled completely.
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Fig.
Fig.12
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Fig.
Fig.13
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Fig. 15: the temporary crown (on multifunctional cap) is mounted on the implant base by applying slight pressure.
Fig. 16: to ensure uninterrupted healing, the crown is placed without contact to the antagonist dentition taking into account the occlusion. The
temporary implant-supported crown does not function through intercuspation nor the forward or sideward movements.
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Fig.12
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Fig.
Fig.
Fig.13
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Fig. 17: the inserted temporary restoration. Neither the crown nor the implant are loaded under static or dynamic occlusion.
Fig. 18: panorama x-ray after insertion and restoration of the implant with a temporary crown. The patient's wish for a cost-effective prosthetic
implant restoration was fulfilled with the iSy® by CAMLOG in an efficient manner. A metal-ceramic crown on an iSy Abutment is planned as
final restoration.
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