Clinical casebook
The LASAK BioniQ implant system, highlighted in this clinical casebook, prioritizes both simplicity and effectiveness. It meets the rigorous demands for long-term functionality and esthetics in dental implantology. This contemporary system provides versatile instrumentation, accommodating both freehand and guided surgical techniques.
Delayed implantation and immediate loading in a teenager in the esthetic zone
Doc. MUDr. Martin Starosta, Ph.D.
Anamnesis
An 18-year-old female patient sought treatment for a persistent fistula on tooth 21. The issue stemmed from a bicycle accident five years before, which had injured her upper lip and subluxated the affected tooth. Initially, the soft tissue was sutured, and the tooth repositioned, with follow-up care provided by her dentist. A year after the accident, the patient noticed discoloration of the tooth, prompting a series of endodontic treatments. Due to the tooth‘s increased mobility, it was stabilized using a composite splint connecting it to the adjacent teeth.
Immediate implantation and minimally invasive shaft-seal technique
MUDr. Vaclav Veselsky
Anamnesis
A 66-year-old patient sought treatment at our practice following an acute fracture of his intact upper right first premolar (tooth 14). The patient, in good general health, was not on any long-term medication and was a non-smoker. After careful assessment, we proposed an immediate implant placement using a minimally invasive Socket-Seal technique combined with the “poncho“ technique. The procedure began with a gentle extraction of the fractured tooth, taking care to preserve the integrity of the alveolar bone. We then placed a 10 mm long BioniQ Tapered implant with a 4 mm diameter in the space previously occupied by the right root. To support optimal healing and integration, we used LASAK‘s OssaBase-HA for augmentation around the implant site.
BioniQ guided surgery in case of low bone volume
MUDr. Pavel Hyspler
Anamnesis
A 52-year-old female patient sought treatment for complications with an implant at the site of tooth 36. The implant, placed approximately six years earlier at another practice, had begun to show signs of loosening. An OPG revealed significant bone loss around the implant, indicative of peri-implantitis. Given the extent of the damage, we decided to remove the failing implant and excochleate the defect. After a three-month healing period, we performed a CBCT scan to plan a new implant-supported restoration. After careful consideration of all available options, we determined that a tilted implant would be the most suitable approach. This implant was strategically inserted to bypass the mandibular canal, ensuring optimal positioning while preserving vital structures.
Implantation with BioniQ pilot guided drilling in combination with dynamic navigation
MUDr. Jiri Hrkal
Anamnesis
A 65-year-old female patient, in good health and a non-smoker, sought treatment at our practice. Her case required the removal of an unsatisfactory fixed restoration supported by teeth 17, 15, and 14, as well as the extraction of tooth 14. Teeth 17 and 15 had previously undergone endodontic treatment. After a thorough assessment, we developed a comprehensive treatment plan. This included placing a 14 mm long BioniQ Straight implant with a 3.5 mm diameter in the region of tooth 14. We also planned a fixed metal-ceramic bridge spanning teeth 17-15 and a metal-ceramic implant-supported bonded dental crown. Given the complexity of the case we decided on a combined approach using guided pilot drilling and dynamic navigation.
The right dental implant prosthetics for long-term success with BioniQ Plus implants
Dr. Volker Bonatz, M.Sc., M.Sc.
Anamnesis
A 70-year-old female patient presented with a significantly damaged tooth 26. This tooth was part of a bridge construction that had been in place for over three decades. Upon examination, we found the tooth to be extensively destroyed subcoronally. Our treatment plan involved the careful removal of the compromised tooth 26, including its roots, without the need for osteotomy. Following the extraction, we proposed placing BioniQ Plus implants in the areas of teeth 25 and 27.
Computer-assisted surgical procedures with LASAK BioniQ implants
MUDr. Jiri Hrkal
Anamnesis
A 76-year-old patient, in good health and a non-smoker, sought treatment at our practice for an unilaterally shortened dental arch in his right mandible. His primary request was for a fixed, implant-supported denture to restore functionality and aesthetics. After a comprehensive evaluation, including a CBCT scan and dental impressions, we developed a treatment plan tailored to the patient‘s needs. Our approach involved placing three BioniQ implants in the regions of teeth 45, 46, and 47. These implants would serve as the foundation for a fixed, screw-retained metal-ceramic dental bridge designed to provide a durable and natural- looking solution.
Implants and prosthetics for the ageing patient
Dr. Volker Bonatz, M.Sc., M.Sc.
Anamnesis
A 70-year-old patient sought treatment for discomfort in the right mandible, specifically in an area where a bridge had been in place for approximately 30 years. We found that the mesial bridge abutment at tooth 45 was subcoronally destroyed. Additionally, tooth 47 exhibited tenderness when pressure was applied to the bite block. Given the patient‘s age and the condition of the jawbone, we aimed to avoid augmentation. Instead, our treatment plan involved placing particularly narrow implants in the atrophied areas. Due to the absence of an antagonist tooth, it was determined that replacing tooth 47 with a third implant was unnecessary.
Implant prosthetics for atrophied maxilla and mandible using 2.9mm BioniQ implants
Dr. Volker Bonatz, M.Sc., M.Sc.
Anamnesis
The patient presented to Dr. Volker Bonatz with residual lower anterior teeth and a 35-year-old full-arch maxillary bridge, which had already deteriorated. The patient reported reduced masticatory function accompanied by pain. Following the extraction of the remaining teeth, a total of ten BioniQ implants with a diameter of 2.9 mm were placed. A basic pilot guided drilling was selected. Due to significant atrophy, the treatment goal was to achieve a removable prosthetic solution for both the maxilla and mandible. Wearable provisional prostheses were used for approximately three months before the final restorations were delivered.
Complete denture reconstruction with BioniQ and BioniQ Plus implants
Doc. MUDr. Martin Starosta, Ph.D.
Anamnesis
A 58-year-old female smoker presented with a complex dental situation. Her maxilla was edentulous but with a preserved alveolus, and had been treated with an overdenture for the past four years. In the mandible, she had a non-functional fixed bridge supported by teeth 45, 43, 33, and 35, along with a separate molar at position 46. At the patient‘s request, we prioritized treatment of the mandible. Only after the successful completion and a one-year follow-up of the mandibular treatment did we proceed with the maxilla. For the upper jaw, we implemented a fixed restoration supported by six implants.
Functional for 21 years: bone defect treatment without the use of bone substitutes using 2.9 mm diameter
MUDr. Jaroslav Tvrdik
Anamnesis
The patient presented in May 2002 with pain in tooth 36. The tooth was extracted and the inflammation healed. Due to the width of the gap and the volume of the alveolar bone, two IMPLADENT implants with a diameter of 2.9 mm were implanted in June 2003. After the healing phase, a metal crown coated with Adoro material was fitted. The patient visited the dental office for regular recalls over the next 21 years after treatment. The restoration required one revision during this period. At the last recall in March 2024, i.e. 21 years after insertion, the implants remained stable. Based on a comparison of X-rays, no bone resorption was detected around the implants over the years.
Functional for 23 years: 3.7 mm diameter implant after a front tooth injury
MUDr. Jaroslav Tvrdik
Anamnesis
The patient presented 14 days after the extraction of tooth 11 due to an injury and requested an implant-supported restoration. In March 2001, pathological changes were detected in the area of the planned implantation. A sequestrectomy was performed and the gap was treated with a removable temporary prosthesis. The implant treatment was scheduled for October 2001. The IMPLADENT implant with a diameter of 3.7 mm and a length of 12 mm was inserted in November 2001. After the implant healed, a metal-ceramic crown was fitted in June 2002. The patient came for regular recalls. No subjective or objective changes were observed. Despite significant bruxism, the original dental restoration is still functional and esthetic after 23 years.