POSSIBILITY FOR PROSTHESIS OF DENTAL DEFECTS THROUGH INTRAOSAL IMPLANTS
Dr. Hr. Hristov, T. Todorov
(XXVII polyclinic - Sofia; I clinical hospital "Dr. K. Havezov")
The method of intraosseous implantation in the oral cavity has more than 40 years of history. In recent years, interest in it in both patients and dentists - surgeons and orthopedists, has grown. The problem went beyond a sensational novelty and began to acquire a scientific and practical focus.
One of the main points in implantation is the correct definition of the indications. There are indications for placement of intraosseous implants in the following cases:
1. When the prosthesis, made by the classical methods of orthopedic dentistry, does not satisfy the patient in functional and aesthetic terms.
2. When wearing the prosthesis adversely affects the patient's psyche.
3. When the prosthesis interferes with the social and labor performance in certain professions.
Contraindications are general and local. The presence of severe damage to the body, preventing any surgery, as well as a number of local diseases of the oral mucosa and jawbone of inflammatory and other nature, are contraindications for the use of intraosseous implants.
Another key point in implantation is the choice of implant material. So far, various scientific implantation materials have been proposed and used in practice in the scientific literature: plastics, porcelain, alloys, bio-ceramics, bio-glass, etc. (Popov, 1982).
The requirements for implant materials are tolerance of tissues, not to be toxic, not to act carcinogenic, and to be resistant to tissue fluids, to have mechanical strength, to be able to process them without changing their structure, to be X-ray contrast and be able to sterilize them.
Chromium-cobalt-molybdenum alloys are the most available implant material in practice, which meets the above requirements (Muller, 1978).
Another important point in implantation is to use a routine surgical technique, taking care of the correct and highly qualified implementation in practice, and, of course, not least, we must explain in detail to the patient about the risk of ejection from the body and take his consent.
So far, we have applied 13 intraosseous Linkow knife-shaped implants and T-shaped implants of our own design. Patients ranged in age from 25 to 45 years.
We made the implants individually in a dental laboratory from chromium-cobalt-molybdenum alloy by casting with a special technology. The shape and size of the implants, as well as the area for implantation in the jaw were determined on a diagnostic X-ray. Consideration included the degree of bone atrophy, the structure of the spongiosa, and the distance from the ridge of the alveolar ridge to the maxillary sinus and mandibular canal.
The superstructure - bridge prosthetic structure, we made by the method of model casting of the same alloy in terms not longer than 2-3 weeks after implantation, in view of the early functional load of the implant. Before the operation, we rehabilitated the oral cavity. In addition, we removed all available amalgam fillings and replaced them with Evicrol fillings, and replaced the crowns and bridges with a model cast chrome-cobalt-molybdenum alloy.
For clinical monitoring and evaluation of the results, we defined the following criteria:
1. Signs of inflammation of the gingiva around the implant.
2. Percussion pain.
3. Implant mobility.
4. X-rays (immediately after the operation, in the third month and then once a year).
The postoperative period in all implants went smoothly except for one in which we found neglected oral hygiene. The post-prosthetic period in all implants went smoothly. Only after a few days and in some of the patients the process of adaptation was completed. They felt the bridge like natural teeth and could eat well.
The length of stay of the implants by years and months is as follows:
4 implants with a stay of 7 years and 2 months
1 implant with a stay of 6 years
4 implants with a stay of 5 years
1 implant with a stay of 1 year and 2 months
1 implant with a stay of 3 months
2 implants with a stay of 4 months
Clinically, patients have no subjective complaints. Radiologically, in cases with a stay of more than 4 years, we observe poor bone resorption around the neck of the implant, without shaking.
In conclusion, we must point out that modest clinical experience in this regard cannot be the basis for serious and in-depth conclusions. However, we believe that it is sufficient to be able to recommend the method of intraosseous implantation as an option for prosthetic defects of the dentition, taking into account its negative aspects.
With the right indications, the use of good implant material and compliance with certain principles, we can use the implants successfully.
(XXVII polyclinic - Sofia; I clinical hospital "Dr. K. Havezov")
The method of intraosseous implantation in the oral cavity has more than 40 years of history. In recent years, interest in it in both patients and dentists - surgeons and orthopedists, has grown. The problem went beyond a sensational novelty and began to acquire a scientific and practical focus.
One of the main points in implantation is the correct definition of the indications. There are indications for placement of intraosseous implants in the following cases:
1. When the prosthesis, made by the classical methods of orthopedic dentistry, does not satisfy the patient in functional and aesthetic terms.
2. When wearing the prosthesis adversely affects the patient's psyche.
3. When the prosthesis interferes with the social and labor performance in certain professions.
Contraindications are general and local. The presence of severe damage to the body, preventing any surgery, as well as a number of local diseases of the oral mucosa and jawbone of inflammatory and other nature, are contraindications for the use of intraosseous implants.
Another key point in implantation is the choice of implant material. So far, various scientific implantation materials have been proposed and used in practice in the scientific literature: plastics, porcelain, alloys, bio-ceramics, bio-glass, etc. (Popov, 1982).
The requirements for implant materials are tolerance of tissues, not to be toxic, not to act carcinogenic, and to be resistant to tissue fluids, to have mechanical strength, to be able to process them without changing their structure, to be X-ray contrast and be able to sterilize them.
Chromium-cobalt-molybdenum alloys are the most available implant material in practice, which meets the above requirements (Muller, 1978).
Another important point in implantation is to use a routine surgical technique, taking care of the correct and highly qualified implementation in practice, and, of course, not least, we must explain in detail to the patient about the risk of ejection from the body and take his consent.
So far, we have applied 13 intraosseous Linkow knife-shaped implants and T-shaped implants of our own design. Patients ranged in age from 25 to 45 years.
We made the implants individually in a dental laboratory from chromium-cobalt-molybdenum alloy by casting with a special technology. The shape and size of the implants, as well as the area for implantation in the jaw were determined on a diagnostic X-ray. Consideration included the degree of bone atrophy, the structure of the spongiosa, and the distance from the ridge of the alveolar ridge to the maxillary sinus and mandibular canal.
The superstructure - bridge prosthetic structure, we made by the method of model casting of the same alloy in terms not longer than 2-3 weeks after implantation, in view of the early functional load of the implant. Before the operation, we rehabilitated the oral cavity. In addition, we removed all available amalgam fillings and replaced them with Evicrol fillings, and replaced the crowns and bridges with a model cast chrome-cobalt-molybdenum alloy.
For clinical monitoring and evaluation of the results, we defined the following criteria:
1. Signs of inflammation of the gingiva around the implant.
2. Percussion pain.
3. Implant mobility.
4. X-rays (immediately after the operation, in the third month and then once a year).
The postoperative period in all implants went smoothly except for one in which we found neglected oral hygiene. The post-prosthetic period in all implants went smoothly. Only after a few days and in some of the patients the process of adaptation was completed. They felt the bridge like natural teeth and could eat well.
The length of stay of the implants by years and months is as follows:
4 implants with a stay of 7 years and 2 months
1 implant with a stay of 6 years
4 implants with a stay of 5 years
1 implant with a stay of 1 year and 2 months
1 implant with a stay of 3 months
2 implants with a stay of 4 months
Clinically, patients have no subjective complaints. Radiologically, in cases with a stay of more than 4 years, we observe poor bone resorption around the neck of the implant, without shaking.
In conclusion, we must point out that modest clinical experience in this regard cannot be the basis for serious and in-depth conclusions. However, we believe that it is sufficient to be able to recommend the method of intraosseous implantation as an option for prosthetic defects of the dentition, taking into account its negative aspects.
With the right indications, the use of good implant material and compliance with certain principles, we can use the implants successfully.