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14 CASE STUDY FUNCTIONAL TREATMENT METHODS STANDARDIZED IMPLANT PROSTHETICS BASED ON THE ISY CONCEPT Dr. Steffen Kistler, Landsberg/Lech (Germany) and MDT Ricarda Eiterer, Marktoberdorf (Germany) Trends in dental implant therapy are not heading towards standardized, functional, and cost-effective treatment methods in the esthetic area. With the advances that have been made in recent years in implant therapy, both dentists and patients are increasingly demanding options for a functional and esthetic prosthe- tic restoration. Because of improved oral health, the number of single-tooth restorations has increased across all age groups. The trend is moving from the preparation of healthy tooth substance for bridge restorations to single-tooth implants. A good dental restoration is very important to our patients. They are increasin- gly opting for fixed implant therapy. The extensive experience we have gained and the resulting successes provide us with many opportunities to make implementing standardized procedures significantly easier and quicker. New implant concepts or short or thinner implant versions allow implantation for specific indications without elaborate surgical procedures such as bone augmentation. In the following article we describe a straightforward and gentle treatment concept in the lower posterior region using the iSy Implant System from CAMLOG. Part of the therapeutic concept of our practice is to keep the number of surgical procedures during implant treatment as low as possible. This concept is both gentler and requires less time, which also makes the treatment more cost-effective for every- body involved. Transmucosal healing of implants in the non-esthetic zone in accordance with the necessary criteria is state of the art in our practice [1,2]. The stable peri-implant soft-tissue cuff acts as a barrier to the underlying structures during open healing and reduces the risk of microbial contamination, which the implant healing would be affected by immediately after the surgical procedure. Transmucosal attachment is an essential prerequisite for a successful implant resto- ration. The iSy Implant Concept helps us to achieve this. Adherence to the concept means that the implant base remains in the mouth until the attachment of the final prosthetic restoration. The healing cap and the multifunction cap – for scanning or impression taking – are attached to the implant base. This avoids frequent changes of the abutment and the adhesion of the collagen fiber network is only minimally disrupted when the restoration is attached [3]. Findings and planning A 59-year-old patient presented because of a root fracture of the first molar in the fourth quadrant. The general medical and dental findings were otherwise nor- mal. Following extraction of tooth 46 and the previous loss of the second molar 47, the chewing function had to be restored. The patient wanted a fixed restoration on implants. He declined the alternati- ve of removable dentures because he had already had implants inserted at another site and is very pleased with them. The option of a shortened dental arch was not considered due to the issue of elongation of the adjacent teeth. About one year after the extraction of 46, we evaluated the bone height and width at the surgical site using a DVT image. We had our dental technician prepare a gui- de template to ensure correct prosthetic positioning of the implant. Two iSy Im- plants were planned, one in regio 46 with 11 millimeters in length and 3.8 millimeters in diameter and one in regio 47 (9 millime- ters in length, 4.4 millimeters in diameter). The inner configuration of the implant has Fig. 1: The radiograph shows the reossification of the alveoli and an appropriately high jaw bone. Fig. 2: The surgical site in regio 46, 47 reveals adequate kerati- nized gingiva. Fig. 3: A crestal incision line and a mesial releasing incision are used to expose the jaw bone.