Planning Dental Implantology
I would like to discuss some parameters on the basis of what implants are chosen during the planning of a case of dental implantology:
1. Depending on their shape can be tapered or straight, can be threaded like screws or be smooth, and then with various connections to the crown. According to its surface, can be in many ways, as an example of a rough surface (sandblasting or etched), or smooth, treated with fluoride, or hydroxyapatite, etc. .. This is one of the most distinguishing, in my opinion, between the various houses that sell dental implants. The surface in some of the best brands (also more expensive), strongly influences the time of osseointegration, very valuable, because the sooner I finish this period, before it can lay wreaths to the implants. It is also a period in which the implant is exposed to any movements that may compromise their survival. Depending on their size may also have different diameters and lengths, useful to overcome various anatomical structures, either nerves or cavities inside the bone where the implant will be housed.
2. But we can divide the type of implant that we made based on the time of placement when it is first necessary to extract a tooth. If placed immediately after tooth extraction, or expected to remaining in the socket after tooth extraction bone heals (4 months approx.) For the former, unlike the conventional, immediate implants are called “post-extraction. These implants immediately after extraction has the advantage that it saves considerable time, and the disadvantage that they are more susceptible to failure during the osseointegration because virtually no primary stability. You obviously have to assess the viability well in each case.
3. They may be classified according to whether dental implants when placed leaving the implant head poking through the gum or not. An implant of two phases mean that the implant is completely buried under the gum (1 st phase) and later when he goes to the crown of metal / porcelain, makes a small incision in the gum to get the implant and to tighten the crown at the same (2 nd phase). In the case of implants at an early stage would not be necessary this incision, the latter are a little longer to complete that part that goes from bone to that poke through the gum. Also, the suitability of either statement must be valued.
4. So far we have discussed the type of implant themselves referring to the part implanted in the bone. Another aspect that serves to classify dental implants is the time of placing the crown over the placement of the implant. It is usual to fix the implant in the bone and after waiting a period of 3 to 4 months to heal it and osseointegration (which merges chemically with the bone), this is what is called lazy loading. But today is also practiced the so-called immediate loading, ie the patient leaves the consultation with implants and crowns as well. You can not always do the latter manner, only in certain cases.
5. Another issue closely related, and the first thing you should think about when planning implant treatment, the prosthesis is indicated for the patient. Depending on what you want and what you can afford, we have to assess whether the best for that patient is compatible from the point of view of health, function and aesthetics. That said, we have fixed or removable prosthesis, the former have obvious advantages. Within the fixed prostheses, they can be unitary, bridges may be partial or complete dentures. Sometimes the latter have to compensate by adding pink resin (to simulate the gum) in the bone defects, the latter being very sensitive in the smile zone in patients showing gingival smile (smiles high or gum). It is also important to consider the thickness of the bone, and that the defect in it can force us to make dentures, because if we want to hold the prosthesis on his lip aesthetic position that would be incompatible with hygiene under it, why we have to do either removable or schedule prior to implant a bone graft to raise it (which changes the course of planning 180 ยบ).
Conclusion: A well-placed implant solves a major problem and today is the best solution for missing teeth. However, a misplaced implant is very difficult to remove because it is tightly bound (chemical bonding) to the bone by a mechanism called osseointegration, ie it is a very serious problem, which sometimes can only be solved by hard bone reconstructions of the jaws. So only qualified professionals should plan their implants. Furthermore it is always necessary to carry out an assessment of the feasibility taking into account related to dental periodontics.