Dental Implant - Conventional and Immediate Loading
RESTORE YOUR SMILE’S FUNCTIONALITY AND APPEARANCE WITH DENTAL IMPLANTS
Today, Dental Implants are considered the standard of care for prosthetic replacement of missing teeth in dentistry. A dental implant is a surgical fixture that is placed into the jawbone and allowed to fuse with the bone over the span of a few months. The dental implant acts as a replacement for the root of a missing tooth. Today, the success rate for dental implants is close to 98%.
Two Categories of Dental Implants Are Used In Our Practice :
A. CONVENTIONAL DENTAL IMPLANTS
HOW ARE CONVENTIONAL DENTAL IMPLANTS PLACED?
There are two distinct phases for every implant procedure – the first is the surgical procedure for placement of the implant and the second is the prosthetic procedure to load the implant(s) with missing tooth/teeth.
SINUS LIFT / AUGMENTATION
Sinus augmentation can help correct this problem by raising the sinus floor thereby providing provision for increased bone height providing an ideal scenario for placement of dental implants.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.
Surgical stents may be used to assist in guiding the placement of implants at the right place. The implants are placed into bone as previously planned. The gums are then sutured back. Absorbable sutures do not require removal whereas non-absorbable ones have to be removed after about a week. Check X rays are taken at various stages to confirm the position of the implant.
HEALING (OSSEOINTEGRATION) PERIOD
During this phase, the surrounding bone attaches and integrates onto the implant surface by a process called “osseo-integration”.
This surgery is less invasive than the first, but still may require local anesthesia. An incision is made in the gum to expose the head of the implant. Then, the “cover screw” is replaced with a “healing abutment”, which protrudes above the gum. This allows the gum to heal in the correct shape around the abutment before the crown, bridge or denture is attached.
FINAL PROSTHETIC RESTORATION
An impression of the abutments is made for the lab technician to make the new implant-supported crowns / bridgework. The final prosthetic tooth/teeth may be screwed into place or cemented.
WHAT CAN DENTAL IMPLANTS DO?
HYBRID IMPLANT BRIDGE
They are an excellent long-term option for restoring a perfect smile and functionality.
LATEST DEVELOPMENTS IN DENTAL IMPLANTS
B. BASAL DENTAL IMPLANT
Basal Dental Implantology is an advanced implantology system which utilizes the basal – cortical portion of the jaw bones for retention of the dental implants which are uniquely designed to be accommodated in the basal – cortical bone areas. It is highly dense, corticalized and offers excellent support to implants.
ADVANTAGES OF THE IMMEDIATE LOAD BASAL DENTAL IMPLANTS
- Immediate loading
- Avoidance of bone grafting
- Single piece implantology
- Basal / Cortical bone support
- Minimally invasive (‘key hole’ impantology)
- Solutions for unfavorable bone situations
- Extremely low failure rates
- Virtually no incidence of Peri-implantitis…
Peri-implantitis is the single most common cause for failure of conventional implants. This happens mostly because of the rough implant surface as well as the interface problems between the multiple parts of the implant. Judicious use of monobloc, smooth surface basal implants eliminate the threat of peri-implantitis by almost 98%.
Medically compromised situations
Basal implants work fine in controlled diabetics, in smokers, in patients suffering from chronic destructive periodontitis and in patients who have little or no bone for conventional implants.
basal implants work absolutely well in controlled diabetic patients because they are smooth surface implants which do not permit bacterial colonization on the implant surfaces. In addition, the fact that these implants take support from the basal bone is an added advantage as the load bearing areas of the implant (Basal cortical bone areas) are far away from the areas where bacteria attempt to invade (crestal alveolar bone).
is known to negatively affect the implant procedure because it cuts down the blood flow to the oral tissue like the gums, teeth and bone, which in turn results in slower healing of the implant site.. In case of basal implants, since the load bearing areas are far away from the areas of the mouth affected by smoking, they take up well. However, it should be borne in mind that smoking immediately after implant surgery will be unfavorable for wound healing even in the case of basal implants.
Acute Destructive Periodontitis
dental implants are contra indicated in patients with acute periodontitis and those with history of destructive gums diseases (often hereditary and run in families). This is because of the high risk of the patient to contract gingival infections leading to failure of the implants. These patients often present with multiple mobile teeth and painful, inflammed gums which bleed easily. However, smooth surface basal implants work wonderfully well in such patients owing to the fact that they are less prone to bacterial attack (the load bearing area is far away from the area prone to infections in the gum regions and the smooth surface implants do not permit bacterial colonization and multiplication).
- Post treatment care– there are no excessive oral hygiene requirements which patients need to observe
- Cost savings– Avoidance of the bone grafts and second stage surgery, in addition to the phenomenal reduction in the total treatment time helps save costs in a big way.
Thus, with Basal Implants,
* Every patient can get fixed teeth almost immediately after implantation, without undergoing bone grafting / augmentations / sinus lifts etc. & without waiting periods for healing of the implant surgery sites (which can take upto 1 year after implant surgery with bone grafting & conventional implants). There is no requirement of intermediate dentures too.
* Basal implant specialists utilize cortical / basal bone in all areas of the facial skeleton. This bone is resorption-stable and strong. This reason why basal implants permit fixation of bridges soon after surgery by splinting the basal implants.
* Specialized dental technicians helps provide safe and sound bite through the basal implant supported bridges.
* The patient can start chewing / eating soon after the bridges are installed!
COMPARISION BETWEEN CONVENTIONAL & BASAL IMPLANTS
|CRITERIA||CRESTAL (AXIAL / SCREW) IMPLANTS||BASAL IMPLANTS|
|Shape and structure|
Root form – designed to imitate roots of a tooth
The implants look like an inverted T
|Endosseous section||Screw shaped with machined / sandblasted / HA coated surfaces.||Flat / blade like surfaces with spaces permitting bone in growth.|
|Technique||Insertion thro’ crestal bone and communication with oral cavity much more than basal implants||Insertion thro’ lateral aspect of basal bone. Load bearing area of implant has no communication with the oral cavity.|
|Bone requirement||Vertical bone – both crestal and rarely a small portion of basal bone.||Basal bone is what is needed. Horizontal aspects of the bone are fully utilized along with the inner and outer cortices.|
|Armamentarium||A large set of instruments are necessary for procedures||Instrumentation is completely different and are mostly surgery related|
|Bone grafting procedures||Essential in cases of deficiency in bone height. Grafting procedures give unpredictable results||Not required|
|Bone displacement||Considerable bone substance displacement / loss occurs and varies with size and length of implant. Crestal bone is more susceptible to resorption||Displace upto 60% less bone substance. Bone integrity and perfusion are barely impaired. Basal bone – highly resistant to resorption|
|Mucosal penetration diameter||Larger. Chances of peri implantitis, vertical bone loss, crater like bone loss and infections are relatively high||Smaller (1.9 – 2.3mm. only). The whole vertical implant part is polished – hence, chances of problems seen as in the case of crestal implants relatively very low.|
|Anatomy – proximity to Maxillary Sinus & Inf.Alveolar Nerve||Very important consideration and technique is to be modified accordingly. Bone augmentation essential in most cases.||Overcoming unfavorably placed Maxillary Sinus and Inferior Alveolar Nerve is possible|
|Abutment angulations||Two piece implants have to have pre-angulated abutments. KOS single piece implants provide angulated as well as bendable abutment provisions.||All BOI implants have bendable abutments.|
|Loading||Two piece implants often require delayed loading & two surgical phases at times||Immediate loading|
|Healing||Prolonged healing time – clinically significant||Bone healing time not clinically significant|
|Masticatory forces||Act in the vertical direction along the sides of the screw structure||Transferred to the basal plate deep into the cortical bone areas which are able to accept large loads and have great capacity for regeneration.|
|The Bone-Implant Relationship||The bone needs to be modified to suit the implant which is selected for the site of implantation||The implant selected for the site can be modified to suit the available bone height and width|
|Applications in destructive periodontitis & after multiple extractions of teeth||Placement nearly impossible and success is unpredictable.||Placement of implants very much possible and results are excellent.|
|Smoking patients||Failure rate is nearly 100%||Best option for smoking patients|
|Controlled diabetic patients||Crestal implants always run a risk of failure in cases where there are blood sugar variations||Blood sugar variations may not affect the survival of the implant at all.|
IMPLANTED SUPPORTED BRIDGE
If you happen to see more missing teeth, Then you will be advised to go for implanted supported dental bridge. It is a surgical method to substitute false tooth instead of the missing tooth.