Surgical Manual of Implant Dentistry: Step-By-Step Procedures, Daniel Buser, Jun-Young Cho, Alvin B. K. Yeo, 123 pp., illustrated. Chicago: Quintessence Publishing; 2007. Reviewed by Richard A. Kraut, DDS.
This book is a step-by-step guide for the surgical placement of the Straumann Dental Implants. Because each implant system is unique, this book will be useful primarily to those who use the Straumann system. The book is divided into 7 chapters covering surgical techniques for esthetic and nonesthetic sites, as well as for cases involving guided bone regeneration and sinus floor elevation. It does not include treatment planning but does conclude with a series of beautifully illustrated cases.
The first chapter, Basic Surgical Principles, is an excellent resource for those dentists who are preparing to do their first surgical placement. It begins with instructions for antibiotic prophylaxis, and for preparation of the face and oral cavity. Detailed step-by-step diagrams illustrating the required drilling sequence are anatomically correct and illustrate the surgical technique in a complete, coherent and easy to follow manner. The second half of the chapter illustrates the need to vary implant width based on residual alveolar ridge width, the space between the remaining teeth, and the preferred space between adjacent implants. The book stresses the need to avoid the mandibular canal. However, the authors do not provide a recommended zone of safety. Such guidelines would help dentists who are just beginning to place implants. Flap development is included in the third and subsequent chapters.
The second chapter, Indications for Each Implant Type, discusses criteria for selecting the type of implant that is best for various clinical indications. The authors recommend a different shoulder or platform when placing maxillary central incisors and cuspids to enhance the esthetic result of the restoration.
The third chapter, Surgical Procedures in Standard Nonesthetic Sites, details procedures in the posterior mandible and posterior maxilla. The section on flap development is truly outstanding. It offers a clear explanation and detailed diagrams showing how to reflect the mucoperiosteum for full visualization of the area. Readers should pay close attention to the authors' suggestion about using traction sutures to keep flaps open for surgical access and guides. The book provides detailed guidance on flap closure to provide keratinized mucosa around the implants. They suggest modifying the incision with a Palacci incision or incorporating a mucosal graft as part of the closure procedure. The diagrams and legends are easy to follow and should be invaluable to those who are just integrating the surgical phase of implantology into their practice. Prospective surgeons will need to consult other resources for help in learning suggested techniques for suturing.
The fourth chapter, Surgical Procedures in Standard Esthetic Sites, offers guidance on flap design, drilling sequences, and implant positioning. The authors recommend a space of at least 1.5 mm from an adjacent tooth to an implant. They recommend a platform depth of 1-mm apical to the cemento enamel junction of adjacent teeth. The implant should also be placed 1-mm palatal to the labial surface of the adjacent teeth. The chapter also includes instructions for the use of connective tissue grafts to achieve gingival contour that will harmonize with adjacent areas.
The fifth chapter, Surgical Procedures for Implant Placement with Simultaneous Sinus Floor Elevation, provides instructions for managing localized bone defects in the esthetic zone. As in previous chapters, superb illustrations help the reader understand the steps necessary to achieve the desired result in this demanding area.
The sixth chapter, Surgical Procedures for Implant Placement with Simultaneous Sinus Floor Elevation, provides instructions on the use of sinus elevation to compensate for insufficient alveolar bone height. The authors recommend a staged approach if the area has less than 5 mm of natural bone. They then discuss a facial bony window technique, which can result in 8–15 mm of additional bone height. They also discuss the use of an osteotome technique, which can increase bone height by 4–7 mm. Both techniques are amply illustrated. Unfortunately, no mention is made in how to treat perforated sinus membranes.
The last chapter consists of 14 illustrated cases. The work is clearly illustrated and of enviable quality. Theses cases bring to life the previous diagrams and should stimulate the readers to strive for the superb results shown.
This is an outstanding manual and should be a welcome addition to the library of those who are preparing to do the surgical phase of implant dentistry.
Richard A. Kraut, DDS
Montefiore Medical Center
Albert Einstein College of Medicine
Bronx, New York