University of Zagreb. School of Dental Medicine. Department of Oral Surgery.
Abstract
Dentalni implantati su titanski vijci koji se ugrađuju u kost gornje ili donje čeljusti te služe kao zamjena za korijen izgubljenog zuba. Oni objedinjuju kirurgiju, estetsku stomatologiju, protetiku, parodontologiju i zubotehnički laboratorij.
Svrha ovog rada je na kliničkom slučaju prikazati postupni proces postave implantata te konačni rezultat implantoprotetskog rada u području fronte gornje čeljusti.
S obzirom na defekt bukalne kosti koji je nastao nakon vađenja zuba, implantacija je odgođena te je učinjena augmentacija rezidualnog alveolarnog grebena. Nakon šest mjeseci dobiveno je novo ležište za implantat sa zadovoljavajućom količinom nove kosti. Prilikom preparacije utvrđena je kvaliteta kosti različita od polazišne, no uz ležište koje sidri oko 4mm, budućnost implantata je dugoročna. Nakon sljedećih šest mjeseci, oseointegracija je bila zadovoljavajuća, a pričvrsna gingiva formirana. Navedeno je dalo dobru podlogu za izradu prvog privremenog nadomjestka, modelaciju gingive te izradu individualne nadogradnje implantata s privremenom krunicom. Uslijedila je otisna tehnika s očuvanjem izlaznog profila implantata te završni otisak i izrada konačnog implantoprotetskog rada kojemu je cilj predvidljiv s dobrom dugoročnom prognozom. Postojeći defekti su u potpunosti rekonstruirani i postignuti su svi atributi prirodne, zdrave i estetske gingive. Bez odgovarajuće koštane potpore je nemoguće postići željenu harmoniju mekih tkiva.
Kod estetske analize u stomatologiji, promjene uvjetovane dobi zahvaćaju zube i parodontne strukture te usnice s okolnim mekim tkivima. Pravilno postavljen implantat, vođena regeneracija mekih tkiva i tehnike očuvanja interdentalne papile te pravilan odabir materijala u konačnici dovode do skladnog implantoprotetskog rada i zadovoljnog pacijenta.Dental implants are titanium screws that are built into the bone of the upper or lower jaw and serve as a substitute for the lost tooth's root. They unite surgery, aesthetic dental medicine, prosthodontics, periodontics and dental laboratory.
In the paper, the process of making and final result of an implant-prosthodontic procedure in the area of upper jaw's front is shown.
Taking the occurrence of a defect of the buccal bone into account, the implant process had to be postponed and an augmentation of the residual alveolar bone was made. After six months, there was a new slot position of our implant and a satisfying amount of the new bone.
During the preparation the conclusion is made that the bone quality is not the same as the original one, but with the slot that anchored about 4 mm, the implant will last in the long-term.
After the next six months, the osseointegration was more than good and the fixed gingiva was formed. That was a good basis for making the first temporary replacement, modelling of the gingiva, making an individual upgrade of the implant with a temporary crown. What followed were print techniques with the conservation of the outside profile as well as the final print and making of the final implant-prosthodontic procedure that as a goal has predictable and with a long term prognosis, total reconstruction of current defects. The attributes of a natural, healthy and aesthetic gingiva were achieved.
One has to have in mind that without a fitting bone support, it is impossible to achieve a wanted soft tissue harmony.
With aesthetic analysis in dental medicine, the changes caused by age attack the teeth and parodontal structures as well as lips with the surrounding soft tissues. A regularly put in implant, guided regeneration of the soft tissues and techniques of caring for interdental papilla and finally, a proper choice of material lead to a harmonious implant-prosthedontic procedures and a satisfied patient
