Ultracain ds forte

Before surgery, all patients were advised to rinse with 0.2% chlorhexidine for 1 min. Local anesthesia was performed by the infiltration of articaine containing 1:100,000 adrenaline (Ultracain D-S forte, Sanofi, Vienna, Austria) at the implant site. Midcrestal and intrasulcular incisions were conducted to enable raising a minimal full-thickness flap and exposing the alveolar ridge. Implant bed preparation was performed using spiral drills of increasing diameter under copious irrigation. All bone-level tapered implants (SLActive^®, Institut Straumann AG, Basel, Switzerland) were placed according to the standard protocol of the manufacturer. Two-thirds of the implants (n = 21) had a regular platform, while one-third (n = 9) had a narrow platform. Implants revealing an insertion torque of <35 Ncm were destined for a two-stage procedure with uncovering after 3 months. Implants demonstrating a higher insertion torque were provided with a healing abutment. Sutures (Neosorb Rapid, medipac^®, Kilkis, Greece) were removed after 7–10 days. Postoperative pain was controlled by administering 400 mg ibuprofen every 6 h. After a healing period of at least 3 months, all patients were scheduled for digital and conventional impression taking.

Patients were rehabilitated with bone level tapered implants (Institute Straumann AG, Basel, Switzerland) following the standard surgical protocol of the manufacturer under local anesthesia (Ultracain D-S forte, Sanofi, Vienna, Austria). Suture removal was scheduled after 7–10 days. Postoperative analgesia was controlled by ibuprofen 400 mg every 6 h. After a healing period of ≥3 months, impression-taking was performed to fabricate screw-retained zirconia crowns.

All four patients were operated by the same surgeon which performed by using 4% articaine and 1:100000 epinephrine as local anesthetic agent (Ultracain DS forte, Sanofi-Aventis, Germany). We designed a horizontal crestal incision in the area of upper maxilla in which zygomatic implants were going to be placed and a full-thickness mucoperiosteal flap was raised to the infraorbitary foramen in order to visualize hard tissue. Implant drilling sequence was performed, and implants were placed following the previous digital planification. Finally, the healing abutment was placed and after repositioning of the flaps, the wound was closed with 4–0 nylon sutures (Supramid, Serag-Wiessner, Germany). Cuadro de los pacientes con las posiciones de los implantes.

As in the similar studies carried out before, local anesthetic solution containing 1:100,000 epinephrine (Ultracain DS Forte; Sanofi-Aventis) and 4% articaine was used for the inferior alveolar nerve block.^{6 (link),15 (link)} After anesthesia, a standard access cavity was prepared in the mandibular teeth and the root canal orifices were found using #10 manual K-files (VDW). The teeth were isolated by using a rubber dam. The working length was set to 1 mm shorter than the apical foramen by using #10 K-file and an apex locator (J. Morita Co., Tustin, CA) and then confirmed with periapical radiography. The working length was repeatedly checked throughout the treatment procedure. One of the three file systems was used for shaping and cleaning the root canals in a single visit. Each file was used only in a single tooth.

All necessary dental treatments were applied before the sinus lifting procedure. The sinus lifting operation was carried out under local anesthesia (Ultracain DS Forte, Sanofi Aventis, Istanbul, Turkey) in a staged surgical approach. The maxillary sinus was grafted utilizing a lateral window technique, as described by Kent and Block [20 (link)]. Chlorhexidine digluconate solution 0.12% was used to rinse patients’ mouths for 2 min prior to surgery.
Briefly, via crestal and vertical incisions and muco-periosteal flap elevation, a lateral window was prepared with a dental carbide bur, followed by a wide-diameter diamond bur, to avoid sinus membrane perforation. The lateral window was dissected and reflected inward after the sinus mucosa was detached completely from the maxillary sinus walls (Figure 1).