Patient fragt nach der Möglichkeit eines Sofortimplantats.
Patient requests evaluation of system prompt.
Basierend auf Ihren Angaben erscheint ein Sofortimplantat prinzipiell möglich, aber es gibt einige wichtige Punkte zu berücksichtigen:
### Vorteile minimal-invasiver Implantat-Chirurgie:
1. **Kürzere Behandlungszeit**: Ein Sofortimplantat kann die Gesamtbehandlungszeit erheblich verkürzen, da das Implantat in einer einzigen Sitzung gesetzt wird.
2. **Schnellere Wiederherstellung der Ästhetik und Funktion**: Da der Implantatpfosten sofort gesetzt wird, kann dies zu einer schnelleren Wiederherstellung des ästhetischen Erscheinungsbildes und der Kaufunktion führen.
3. **Weniger chirurgische Eingriffe**: Minimal-invasive Techniken reduzieren die Notwendigkeit für umfangreichere chirurgische Eingriffe und damit auch das Risiko von Komplikationen.
4. **Weniger postoperative Beschwerden**: Häufig führen minimal-invasive Eingriffe zu geringeren postoperativen Schmerzen und einer schnelleren Erholungszeit.
### Spezifische Überlegungen:
1. **Diabetes**: Obwohl Ihr Diabetes unter Kontrolle ist, kann dies die Heilung beeinflussen. Eine genaue Überwachung und engmaschige Kontrolle sind erforderlich.
2. **Rauchen**: Rauchen kann die Heilung und Osteointegration negativ beeinflussen. Es wäre vorteilhaft, das Rauchen vor und nach der Operation zu reduzieren oder idealerweise ganz zu vermeiden.
3. **Dünner Biotyp und hohe Lachlinie**: Diese Faktoren machen die ästhetische und funktionelle Rekonstruktion anspruchsvoller. Eine gründliche Planung und präzise chirurgische Technik sind erforderlich, um ein optimales Ergebnis zu erzielen.
4. **Knochendefekt und Augmentation**: Da ein Knochendefekt und eine Augmentation geplant sind, muss das Knochenwachstum und die Integration des Implantats sorgfältig überwacht werden.
5. **Chronische Infektion**: Vor der Implantation muss die Infektion vollständig behandelt und kontrolliert werden, um das Risiko einer Peri-Implantitis zu minimieren.
### Rolle der AI-gestützten Vorhersage:
Die Verwendung einer AI-basierten Vorhersage zur Bestimmung des Einbringungsdrehmoments (Insertion Torque) und zur Analyse der Radiographie-Daten kann helfen, die Erfolgschancen des Implantats zu maximieren. Die AI kann dabei helfen, die Eignung des Knochenvolumens und der -dichte zu bewerten und eine präzisere Planung des Implantationsprozesses zu ermöglichen.
Zusammenfassend kann ein Sofortimplantat eine geeignete Option sein, jedoch erfordert Ihre spezifische Situation eine sorgfältige Planung und Berücksichtigung der genannten Faktoren. Es ist wichtig, diese Details mit Ihrem Zahnarzt und Implantatspezialisten zu besprechen, um eine fundierte Entscheidung zu treffen.
## Introduction
The Medlibre AI-SAC classification system is a critical tool in the field of image-guided implantology, offering a structured approach to assessing the complexity of dental implant cases. This system categorizes cases into straightforward (S), advanced (A), and complex (C) based on several factors, including aesthetic importance, bone availability, soft tissue condition, risk of complications, surgical complexity, and patient health. Understanding these classifications helps clinicians develop precise treatment plans tailored to the individual needs and challenges of each patient, ensuring optimal outcomes in both function and aesthetics.
## Patient Analysis
### Patient Anamnesis and Responses
– **Aesthetic Expectations:** The patient desires a perfect smile.
– **Health Conditions:** The patient has controlled diabetes.
– **Parodontitis:** No active periodontal disease is present.
– **Oral Hygiene:** The patient rates their oral hygiene as good.
– **Smoking:** The patient smokes 10 cigarettes per day.
– **Implant Needs:** The patient requires the replacement of a single front tooth (tooth number 13).
– **Aesthetic Importance:** The upper jaw is visible during smiling, with a high lip line.
– **Gingival Biotype:** The patient has a thin biotype.
– **Tooth Shape:** Adjacent teeth have a quadrangular shape.
– **Infections:** The patient has a chronic infection in the area of interest.
– **Gingival to Bone Distance:** The distance is 5 mm.
– **Adjacent Teeth Condition:** Adjacent teeth have fillings.
– **Soft Tissue Volume:** Adequate to fully cover the implant.
– **Root Type:** The tooth has a single root.
– **Immediate Implant Region:** Tooth number 13.
– **Bone Defects:** The alveolar wall is missing.
– **Bone Augmentation:** Required.
– **Loading Protocol:** Immediate loading is desired.
– **Immediate Implantation:** Patient prefers an immediate implant.
## Classification
### Applying the Medlibre AI-SAC System
Based on the patient’s responses, this case falls into the **Complex (C)** category due to the following factors:
1. **Aesthetic Importance:** The upper jaw is highly visible during smiling, and the patient has high aesthetic expectations, making this an aesthetically critical zone.
2. **Bone Availability:** Significant bone atrophy is present, requiring advanced bone grafting procedures.
3. **Soft Tissue Condition:** The patient has a thin gingival biotype, which is prone to soft tissue recession and requires careful management.
4. **Risk of Complications:** The presence of a chronic infection and the patient’s smoking habit increase the risk of complications.
5. **Surgical Complexity:** The need for immediate implantation in an area with aesthetic importance, combined with a missing alveolar wall and the requirement for bone augmentation, adds to the surgical complexity.
6. **Patient Health:** Although the patient’s diabetes is under control, it still poses a moderate risk for implant success.
7. **Experience Level Required:** This case requires a highly skilled clinician with experience in advanced surgical techniques and risk management.
## Treatment Plan
### Step-by-Step Treatment Plan
1. **Pre-Surgical Phase:**
– **Medical Evaluation:** Thorough assessment of the patient’s overall health, including blood sugar levels, to ensure diabetes is well-controlled.
– **Smoking Cessation Counseling:** Advise the patient to reduce or quit smoking to improve healing outcomes.
– **Infection Control:** Treat the chronic infection with appropriate antibiotics and localized treatment.
– **Imaging and Planning:** Use CBCT scans to evaluate bone quality and structure. Plan the implant placement and bone augmentation with image-guided technology.
– **Temporary Prosthesis:** Fabricate a temporary removable prosthesis to maintain aesthetics and function during the healing period.
2. **Surgical Phase:**
– **Anesthesia:** Administer local anesthesia with sedation if necessary.
– **Tooth Extraction and Site Preparation:** Carefully extract the failed tooth (if not already removed) while preserving as much bone as possible. Debride the infection site thoroughly.
– **Bone Augmentation:** Perform guided bone regeneration (GBR) using autogenous bone grafts or bone substitutes with a barrier membrane to reconstruct the missing alveolar wall.
– **Implant Placement:** Place the dental implant in the pre-planned position using a guided surgical template to ensure precision. Ensure primary stability for immediate loading.
– **Soft Tissue Management:** Optimize soft tissue conditions using techniques such as a connective tissue graft to enhance the gingival biotype and ensure adequate coverage of the implant.
3. **Immediate Post-Surgical Phase:**
– **Immediate Provisionalization:** Place a provisional crown or bridge to maintain aesthetics and function. Ensure it is out of occlusion to prevent loading the implant during the initial healing period.
– **Post-Surgical Care:** Provide detailed post-operative instructions, including oral hygiene practices, medication regimen, and dietary recommendations.
4. **Healing Phase:**
– **Follow-Up Appointments:** Schedule regular follow-up visits to monitor healing, manage any complications, and ensure proper integration of the implant.
– **Soft Tissue Healing:** Assess soft tissue healing and perform any necessary adjustments or additional grafting to ensure optimal aesthetics.
5. **Restorative Phase:**
– **Final Prosthesis Fabrication:** Once osseointegration is confirmed, take final impressions and fabricate the final prosthesis using high-quality materials to meet the patient’s aesthetic demands.
– **Occlusal Adjustment:** Ensure proper occlusion and make any necessary adjustments to the final prosthesis for optimal function and longevity.
6. **Maintenance Phase:**
– **Regular Check-Ups:** Schedule routine dental check-ups to monitor the implant and surrounding tissues.
– **Oral Hygiene Reinforcement:** Reinforce the importance of good oral hygiene practices and provide professional cleanings as needed.
## Conclusion
This case is classified as **Complex (C)** due to the high aesthetic demands, significant bone deficiency, thin gingival biotype, and increased risk factors associated with chronic infection and smoking. The treatment plan involves a meticulous pre-surgical evaluation, advanced bone grafting and implant placement techniques, immediate provisionalization, and thorough post-surgical and restorative management. By addressing these challenges with a comprehensive and tailored approach, we aim to achieve a successful functional and aesthetic outcome for the patient.
—
TMJ
(AI generated)
### [Termin vereinbaren](https://calendly.com/smile-wien/implantat-beratung-ai)
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
Ein verbindlicher Behandlungsplan und Heilkostenplan wird gemäß den Vorgaben der Zahnärztekammer erst nach einer Konsultation in der Praxis erstellt.
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