IMPLANTS: A NEW OPPORTUNITY

The implants are pure titanium snails that we put in the jaw bone and that, once accepted by the bone as their own, they can withstand the load of the crown or the denture that we screw into the same implants. In other words, the implants act like artificial roots.

Today, technology has the main challenge to ensure that there is no difference between taking an own tooth or an implanted one, not chewing or aesthetically.

PHASE PRIOR TO THE COLLISION OF THE IMPLANT.

1. POSSIBLE CONTRAINDICATIONS TO BE ACCOUNTED.

  • Pregnancy
  • Take immunosuppressant’s.
  • Diabetes greater than 180
  • Psychiatric illnesses not well controlled
  • Tobacco: If you smoke more than one daily package, the treatment is not advised, as it usually fails.

2. RADIOGRAPHY REGULAR STUDY.

After the study of the patient’s background, we proceed to analyze in depth the x-rays performed to ensure that:

First, there is enough bone about the hypothetical position of the implants.

Second, that the placement of the implants will not cause any added problem, such as nerve or vascular lesions, or aesthetic deficits difficult to solve once the implants have been placed.

3. SURGICAL PHASE.

The sequence of surgical treatment with implants is simple:

For implant placement within the bone, the degree of trauma is the equivalent to that of a routine dental intervention: we use the same anesthesia, for example, for dental extraction.

An amount of tissue equivalent to the size of the implant chosen is removed from the bone and it is screwed with a small friction: it is necessary to keep in mind that during the first 15 days the implant will use this force to maintain -to get in your place. As of the 3rd week, the biological union with the bone is the biggest force in implant retention.

After 4 or 5 weeks, we evaluate the degree of integration of the implant into the bone, and if we consider it correct, we can take the measures to make the tooth, the bridge or the denture.

4. PHASE OF COLLOCATION  OF THE PROSTHESIS.

Normally two tests of the prosthesis are made: one of the structure, metallic or ceramic, that will support the set. The other of the ceramic coating that will give the final result, aesthetic and functional.

Once the dental team and patients are satisfied with the aesthetic and functional results of the prosthesis, proceed to the lodge for an interim period of time, to be sure it works as expected and patient satisfaction.

If everything is correct, after two or three weeks is definitely places the prosthesis: you use a tool that gives the snail-bonding implant prostheses appropriate pressure.

If after a few years you want to disassemble to check the status can be done routinely.

AN EASY AND ILLUSTRATIVE CASE OF IMPLANTS

We present here the simplest case of implants: the placement of a single implant in the maxilla inferior. CLICK ON THE IMAGES TO SEE THEM WITH MORE DETAIL

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  • Photo 1: In this photo we see the reason for the extraction: chronic infection of the mesial root of the tooth, intractable despite the endodontics done long ago.
  • Photo 2: Here we have the extraction of the tooth already done, where there is a bony bridge between the holes that have left the roots.
  • Photo 3: In this photo we can see the implant already placed in the bony bridge that had remained after the extraction in order to obtain the maximum stability but leaving wide empty spaces. In addition, it is important that we take into account that the implant is perfectly centered in the available space and totally vertical. This position is best because once the implant is loaded with the crown and ready to chew, the chewing forces are vertical to the axis of the tooth which is exactly where we put the implant. For this reason, we do not take advantage of a space of a root we put eccentric.
  • Photo 4: Here we see how we have placed a commercial preparation membrane to regenerate the bone, which can be, synthetically, of animal or human origin, both from the patient or from the tissue bank.
  • Photo 5: Then we suture.
  • Photo 6: Here we have the regenerated genome, having spent months for both the gum and the bone to regain their normal state to be able to proceed to the prosthetic phase, taking measures to make the crown.

The Bone Regeneration process, also described in this link, allows us to prevent the loss of the bone that gains. That’s why we must avoid exactly what is usual: proceed to the extraction and wait a while to put the implants; It is precisely at this time that more bone is lost and when we put the implants we will not have enough space.

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  • Photo 7: We see the protective rod put on the implant: the central spot is the place where we passed the screw to fix the crown in the implant: only this distance is visible; Under normal conditions, it is invisible.

By placing the screwed crown, not cemented, we always know where the screw is and we can remove the composite seal when appropriate in a matter of seconds.

COMPLEX IMPLANTOLOGY: PRIOR BONE REGENERATION TO THE COLLIXATION OF IMPLANTS

This is a fairly frequent situation: where natural teeth are lacking and having bone to implant is exactly where we have less bone. In the mouth we have two types of bone: a basal bone that belongs to the skeleton, and an alveolar bone that belongs to the teeth: if we lose these pieces, the bone is usually lost. This causes that, when we have lost teeth and we have not replenished them with implants, time has gone in favor of losing bone: when we want to put our teeth, we have no bone. We are in favor of, first, not extracting any dental piece if it is not fully justified; second, perform an immediate Bone Regeneration to the extraction to maintain the bone volume; and third, put the implant as soon as possible.

In the case we present, implants must be placed that rest the four premolars above:

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On the left picture, we see the previous situation: observe the lack of bone just in the place where we have to place the implants.

On the center image, we see implants placed once the bone regeneration has matured and generated bones where there were none.

On the right, we see the prosthetic crowns placed and with perfect aesthetic and functional performance.

IMMEDIATE IMPLANT

Many times our smile is unexpectedly compromised and we must act quickly.

We present here the case of a sudden upper lateral incisor, which by the type of fracture requires dental extraction and replacement by an implant that is required immediate aesthetics, which we aim to achieve as can be seen in Images.

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