Until the 80s, the solution to the partial or total loss of the teeth was based on the placement of removable devices or bridges that required the amputation of healthy teeth.
Dr. Bränemarck’s work open a new era in oral reconstruction by allowing the dental replenishment on a base of titanium screws inserted into the jaws. These screws are intimately attaches to the bone in a process called osseointegration.
The ultimate goal of this technique is to obtain a denture with the maximum esthetics and function possible. This will be determined by the tissues on which we’ll perform the implantation and it will determine the type of prosthesis that can be performed.
Implants as a prosthetic solution present the following advantages over removable prostheses:
- They do not require amputation of other teeth…
- The affected part is the only one replenish.
- Implant-supported prostheses allow a natural function.
- They allow the conservation of the bone structure, avoiding the bone atrophy that causes the loss of teeth avoiding the ageing of the face.
- They allow a greater self-esteem and safety in patients, due to not depending on removable devices.
- Once osseointegration is achieved, implant-supported prostheses can last for many years (some cases up to 30 years).
Implant placement is commonly performed with local anesthesia, in exceptional cases, sedation or general anesthesia will be required depending on the patient and the type of surgery to be performed.
The objective is to be able to make a fixed temporary prosthesis anchored on the implants immediately, if the primary stability of the implants allows it.
There are times when the lack of bone blocks the normal placement of an implant or prosthesis as natural as possible.
In these cases, the use of the patient’s own bone is desirable to rebuild the lost bone mass.
It consists in making a few buts to the bone and, by placing some devices, start separating these fragments in a controlled manner in order to regenerate bone and gum at the same time.
In cases where the bone in the posterior maxillary area has little bone height, we can regenerate the area by lifting the sinus membrane and placing bone graft in that space. It is classically done by the anterior area of the face, which causes inflammation and pain.
We are currently doing this operation by the palate, avoiding pain and inflammation. This allows our patients to live a normal life from the beginning.
LATERALIZATION OF THE NERVE
Many times, in the posterior portion of the mandible, we’ve had no bone above the inferior dental nerve to place the implants. In such cases, we can release the jaw nerve and be able to use the entire mandibular height to place the implants without the need of bone grafts.
In cases of severe maxillary atrophy, and in order to avoid bone grafts, zygomatic implants are an alternative in the implant-prosthetic rehabilitation.
We currently make prosthesis right after the surgery, allowing us to give back the chewing and aesthetics to the patient.