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This article presents a case report of transmucosal implant with a convergent collar (PRAMA) inserted in the anterior maxillary esthetic area. The purpose of this study is to evaluate soft and hard tissue after 12 months. One implant was placed in the esthetic area. The implant was immediately loaded with a screwed provisional prosthesis. After 3 months the definitive screwed prosthesis was inserted. The patient was reassessed 12 months post-implant placement, and during the examination, the soft-tissue texture, color, and amount of keratinized tissue was checked. No statistically significant horizontal dimensional changes of the alveolar ridge were observed between each time-point. Mean soft tissue levels significantly improved between base-line and 12 months. The reduced buccal width of the transmucosal component gives more space to the gingival thickness and promotes stability and give a better seal. The use of transmucosal implant creates a shift of the inflammatory cell infiltrate away from the crestal bone level., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

There are many techniques to regenerate a sufficient bone thickness, in both vertical and horizontal direction, when bone is reabsorbed after extractions or after a long period of edentulism. The present study wants to evaluate from a clinical point of view results obtained using the GBR technique with a e-PTFE titanium reinforced membrane in posterior jaw (4.5-4.7). A 57-years-old male patient presented the failure of two implants in zone 4.6-4.7; after the latter's removal and a healing period of 6 months, the wide bone defects have been filled with heterologous bovine bone mixed with autologous bone and covered with e-PTFE titanium reinforced membrane fixed to the alveolar ridge. After 6 months the site was opened to remove the fixing screws and to place two new dental implants in zone 4.5-4.7; after the osseointegration period of 6 months, the implants were uncovered and two healing-screw were positioned. A significant increase in alveolar bone both vertical and horizontal was observed, such as to allow excellent aesthetic and functional result, testifying the success of the procedure. [ABSTRACT FROM AUTHOR]

Purpose. The edentulous severely atrophic maxilla, as consequence of alveolar bone resorption and pneumatisation of the maxillary sinus, represents a serious limitation to the implant rehabilitation. Implants insertion via palatal approach (PA), in combination with relatively minimally invasive techniques aimed at increasing bone volume without the use of autologous bone harvesting is a valid alternative among the options for the rehabilitation of the upper jaw. Clinical case. In a 70-year-old female, with a severe maxillary atrophy, 6 spiral taper implants were placed with the PA, combined with the bilateral transcrestal elevation of both the sinus floors and nasal cavities; a further GBR, with resorbable pericardium membrane covering a termoplastic allograft associated to a xenograft, was performed. The second stage was performed after 6 months. Implant prosthetic functionalization was carried out in 4 months by placing the removable prosthesis in direct contact with the healing cup screws. After that period the case was finalized with a hybrid prosthesis. Clinical and radiographic follow-ups were carried out at 6 months and at one year after prosthetic finalization, during which no pathological signs were recorded. Conclusions. The PA implant insertion described by the Authors, combined with bone augmentation procedures, performed in the same stage, may represent a valid and reliable solution to rehabilitate maxillary edentulous patients. [ABSTRACT FROM AUTHOR]