Orthodontics, born in Italy as a pioneering branch of dentistry in the ‘50s, with Masters such as Professors E. Muzi, G. Maggio, O. Hoffer, developed over time: with the first Italian Study Group of Orthodontics (GISO - 1967), with the Italian Society of Orthodontics (SIDO - 1968), with the first Postgraduate in Orthodontics (University of Cagliari - 1973) followed by many others, and finally with Masters and Courses. Starting from a restricted number of pioneers and arriving to several thousands of professionals. Hence the need for this series in which each book has a monographic character. Iconography has been given a lot of space in order to facilitate the use as a text-atlas and promote its practical application. The text, always concise, was prepared with scientific and bibliographic rigor, and with a logical and valid design. Being easy of consultation the user can take full advantage of it. With great satisfaction this series passed a few years ago the silver mark of the 25th issue, heading towards new goals, a really unexpected thing when it shyly started with the first issue in 1996. The credit for this succes goes to all the Orthodontic programs in Italian Universities and to the experience of the private professionals, who promptly and enthusiastically joined the initiative, enriching it in all these years with important and highly significant monographs, committed to provide the best of the results in their specific fields of research. For the past several years, the series has been improved by an extraordinary event: it was also simultaneously printed in English, thanks to the foresight and courage of Dr. Alfredo Martina and his sons Vincenzo and Nadia.

The presentation of a book in which one of the authors is your own son is always delicate but I‘m really honored to introduce the number 39 of this series, curated by the excellent orthodontic schools of Ferrara and Insubria. The topic of this monograph is extremely interesting for its great relevance in current dentistry and will certainly arise great interest, because it is the first time that this issue is treated in this series and because it is still not discussed enough, also internationally.
In my opinion, the topic of this book is one of the most important aspects of clinical research in dentistry, namely the implant site development.

Obviously, being this an orthodontics series the topic has been developed from an orthodontic standpoint, but simultaneously involves different disciplines: implantology, prosthetics, oral surgery, periodontics, microbiology up to the biopharmaceutics.This is an evidence of the fundamental importance of study and research, especially in its inter- and multidisciplinary aspects. The two Schools, along with Italian professionals trained in North America, put up a long and calibrated scientific work in which they were able to provide a text of great validity, both practical and clinical.

As it often happens after the extraction of a tooth, the remaining alveolus undergoes deep structural changes, and it is often impossible to insert an implant in the same anatomical context, because it would result in insufficient function and impaired periodontal esthetics. This prompted the authors to describe their rehabilitative orthodontic clinical approach.
I’m sure the readers will find this book very interesting. The rich iconographic documentation and the clarity of the texts make it particularly useful not only for orthodontists but also by other professionals.

I’d like to renew my praise and gratitude to Edizioni Martina for the unlimited energy and enthusiasm that they keep providing. To the Authors I offer my most sincere congratulations for the results produced over the years.

Prof. Damaso Caprioglio
Professor and Former Chairman
Department of Orthodontics
University of Parma
Dean of Italian Specialists in Orthodontics
damaso.caprioglio@dentalchildren.net

With the advent of new available techniques, the clinical orthodontic extends its scientific basis gradually with the knowing of bone structure, metabolism and function of oral tissue with our clinical experience that will not have a mono specialistic approach but multidisciplinary.

The authors, that I know and appreciate from many years, with this inner meaning want to give us their clinical experience, but especially, a new clinical approach to solve a set of orthodontic problem linked to surgery and implant site. The initial works on this topic evaluated only structural and technical aspects, reflecting orientation of the research in odontostomatology in those years, where the different branches analyzed their knowledge in a closed way, without communication between the branches of dentistry.

Only in the last years, in dentistry, you can find usually a dealing with different fields of learning and only now is taught at the university.

These are the reasons whereby I accepted to introduce this book that is at the vanguard for the topic treated but also it could be chosen in the italian school of orthodontics like example of a new approach multidisciplinary in orthodontics.

This “new subject” taught from years at the Ferrara’s school by Dr. Davide Mirabella, is going to bear his fruit trough the young student that today looking a different way to solve problems respect to the past. This book, maybe is a response to a demand of the pupils themselves, I’m sure it will also help professionals in their own daily work.

Prof. Giuseppe Siciliani
Chairman - Post-Graduate Program in Orthodontics,
University of Ferrara

PRESENTATION

FOREWORD

CHAPTER 1

1. POST-EXTRACTION ALVEOLAR BONE REMODELING

1.1 ALVEOLAR BONE ANATOMY
1.2 POST-EXTRACTION ALVEOLAR BONE HEALING

1.2.1 Bone resorption classification
1.2.2 Implant insertion timing

CHAPTER 2

2. HOW TO PREVENT BONE REMODELLING

2.1 PRE-IMPLANT SURGICAL APPROACH

2.1.1 Biomaterials
2.1.2 Membranes
2.1.3 Post-extraction alveolar preservation techniques
2.1.4 Surgical bone regeneration techniques

2.1.4.1 Guided bone regeneration
2.1.4.2 Onlay bone grafting
2.1.4.3 The split crest technique
2.1.4.4 Osteodistraction

2.1.5 Surgical procedures: advantages - disadvantages - limits

2.2 ORTHODONTIC PRE-IMPLANT VERTICAL MOVEMENT

2.2.1 Clinical protocol for orthodontic extrusion in the esthetic zone
2.2.2 Clinical case 1
2.2.3 Clinical case 2
2.2.4 Biomechanical principles of orthodontic extrusion
2.2.5 Clinical case 3
2.2.6 Soft tissue responses
2.2.7 Hard tissue responses
2.2.8 Advantages and disadvantages
2.2.9 Clinical case 4

2.3 ORTHODONTIC PRE-IMPLANT HORIZONTAL MOVEMENT

2.3.1 Clinical case 5
2.3.2 Clinical case 6
2.3.3 Clinical case 7

CHAPTER 3

3. NEWS IN ORTHODONTIC MPLANT SITE DEVELOPMENT

3.1 3D ROOT MOVEMENT

3.1.1 Clinical case 8

3.2 COMBINED SURGICAL-ORTHODONTIC APPROACH: ROARS TECNIQUE (Rapid Orthodontics After Ridge Splitting)

3.2.1 Clinical case 9

CHAPTER 4

4. SUMMERY CASE

4.1 Clinical case 10

CHAPTER 5

5. CONCLUSION

BIBLIOGRAPHY