Dental implantation is firmly entrenched in the list of ways to restore single teeth and dental arches. A lot of information is available on this treatment method. And there is a need for the correct analysis of all data: clinical, radiological and array of orthopedic knowledge.
Dental implant is a product of titanium or zirconium in the form of a cylinder or a cone with an external screw thread which is embedded in the jaw bone and acts as the root of the tooth. The length and diameter of the implants are different which makes it possible to choose the size individually depending on the specific clinical picture. An abutment is attached to the implant with a screw on which the crown of the tooth is located.
From the point of view of mechanics an implant-supported prosthesis is a fairly simple design. But from the point of view of anatomy, physiology, biomechanics of the mastication process, hygienic maintenance of the prosthesis on the implant is much more complicated. The restoration of teeth or dental arches with the help of dental implants requires participation of the whole team of specialists from the area of dentistry and dental-mechanical practice in the rehabilitation of a patient.
Unfortunately, quite often the talk about implant fixation occurs when more than 6-12 months have passed since the extraction of a tooth. In such situations, dentists have “lack of bone” to install implants. It is necessary to restore the tissue surrounding the implant: the bone of at least 1.5–2 mm in all directions and a sufficient amount of soft tissue. Procedures for bone buildup are conditionally divided into bone augmentation and 3D-reconstruction.
Augmentation in surgical dentistry is a bone buildup, a type of bone grafting. The augmentation of osteoplastic material more often occurs along with the installation of the implant otherwise 3D-reconstruction requires a step-by-step treatment. For relatively small restorative manipulations bone crumbs are enough (own or other origin). For 3D-reconstructions titanium-reinforced bone blocks, PTFE membranes, and titanium meshes are used.
Usually in every clinical situation there are several working solutions. Our surgeons, together with the patient and the orthopedic dentist choose the most rational ways to restore teeth and surrounding tissues.
Sinus floor elevation
Sinus floor elevation sounds more and more familiar; this term means the rise of the sinus that is the floor of the maxillary antrum. One of the types of bone grafting is subantral augmentation that is bone volume increase under the maxillary sinus. Osteoplastic material is placed above the alveolar ridge of the upper jaw by inserting into the cavity of the maxillary sinus. During this operation the mucous-periosteal array of tissues is peeled off in the sinus while maintaining their integrity. Depending on the specific conditions a closed or open sinus floor elevation is done.
Closed sinus floor elevation is usually accompanied by implants placing and is carried out through the opening formed for the implant installation. In the case of open sinus floor elevation access to the maxillary sinus is formed through the anterior (lateral) bone wall. Open sinus floor elevation is used when there is a need to restore a larger amount of bone tissue. The possibility of implant installation simultaneously with open sinus floor elevation is determined individually in each particular case and depends on many factors. Now, both open and closed sinus floor elevations are applied frequently which positively affected the development of manual skills of surgeons and the predictability of the operation itself.