Dentists have entered a new era in implant dentistry. The major excitement and buzz in the field of implant dentistry in recent years involves the introduction of three-dimensional (3-D) “virtual” evaluations of patients using computed tomography (CT) scan technology or in-office cone beam scanners.

Implant restoration in the esthetic zone requires precise coordination between all members of the dental team. This coordinated approach to treatment is exemplified in the cases provided in this article, which required the expertise of an implant surgeon, an orthodontist, a restorative dentist, and a laboratory technician.

Recent advances in technique have led to the simplification of the restoration of the resorbed posterior maxilla with dental implant-supported prostheses. An indirect, minimally invasive, low-risk sinus elevation procedure can be performed using hand-held, end-cutting osteotomes, and a surgical mallet to elevate the sinus floor in an area localized to the apex of the implant osteotomy.

Denture use remains a controversial factor contributing to residual ridge resorption. For the hopeless dentition or the already edentulous jaws, the insertion of an implant-supported prosthesis can reduce bone loss and may even promote bone growth.

The key to  contemporary restorative dentistry is the fabrication of healthy, maintainable, esthetic, and functional prostheses. The true success of any restoration is reliant on the creation of an “illusion of reality," regardless of the restorative modality used (eg, porcelain laminate veneers, crowns, and/or implant-supported prostheses). Developments and advances to the restorative armamentarium have significantly improved the clinician’s ability to deliver predictable and reliable treatments.

Inside Dentistry February 2006 70 "Implant placement requires a 3-dimensional mindset…” Emergency Intraoral Repairs with Narrow-bodied Implants Michael Kleinman, DDS Private Practice in Cosmetic, Restorative, and Implant Dentistry, New York, New York

By educating the general dentist about implants, he or she can develop the skills to diagnose, treatment plan, and, when appropriate, refer the patient for treatment, or perform the treatment themselves. General practitioners must understand the current state of implant therapy as well as the choices currently available.

Optimal implant results in the esthetic zone can be predictably achieved using customized, patient-specific abutments. Encode™, a computer-aided design and computer-aided manufacturing (CAD/CAM) implant-restorative system developed by 3i (Palm Beach Gardens, FL), uses a unique healing abutment with codes embedded in the occlusal surface.

Over the last decade, the number of cosmetic dental procedures performed in the general dental practice has increased steadily each year. Likewise, the use of dental implants as a tooth replacement option has become a more routine treatment alternative for patients missing teeth or requiring tooth removal.

In this article, the treatment of a 32 ­year-old woman with a partially resected and reconstructed anterior mandible (re­sulting from an aggressive, central giant-cell granuloma) and restored with the SPI® system will be presented.