In Situ Tooth Replica Custom Implant: Rationale, Material, and Technique
This study introduced a new concept of an in situ, custom-made, tooth replica dental implant. It was obtained by injecting a self-set, nonresorbable polymer type bone graft substitute into the tooth socket after extraction. Based on its cited properties, new composite bone cement Cortoss was suggested. The properties were reviewed and evaluated. The technique of application was described with a simulation model presented that appeared simple. Apparently, immediate duplication of tooth anatomy was achieved; thus, the concept might have the potentials of spontaneous adaptation and stabilization, preservation of alveolar bone, increasing implant-bone surface area, better load distribution, and bone stimulation. Modifications were also described to manage cases of resorbed alveolar bone as well as long-standing extracted teeth. Investigations were still required to assess the performance of the material and if modifications would be needed.Abstract
Armamentarium required for manipulation and delivering Cortoss into socket. (A) Dual cartridge containing the material. (B) Mixing gun. (C) Mixing tips. (D) Plastic syringes. (E) IV catheters with stopper (arrow). (F) Flexible metal wire.
Illustrative model. (a) A natural lower first molar attached into place in a stone model. (b) Embedded in rubber; bucco-occlusal view. (c) Lingual view. (d) Extraction socket.
Surgical template. (a) Outer surface showing access opening. (b) Inner surface. (c) Template in place; buccal view. (d) Occlusal view.
Figure 4 . Catheter with stopper (arrow) and wire (dashed arrow) for assessment of extension. Figure 5. Catheter adjusted. Figure 6. Radiograph of Figure 5. Figure 7. Catheter attached to Luer-lock syringe, loaded with Cortoss and ready for injection. Figure 8. The syringe is gradually drawn outward as indicated by the stopper (arrow).
Coronal portion of resulting implant; buccal view (top left) with its radiograph (bottom left) and occlusal view (right).
The analogous implant after removal from the socket (left) and its corresponding extracted natural tooth (right). (a) Buccal aspect. (b) Lingual aspect. (c) Mesial aspect. (d) Distal aspect.
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