1. Зreparation of the patient and the oral cavity for the operation
2. Simulation of an individual design of implants for the particular patient's case
3. In the presence of movable teeth that cannot be restored, they are removed, implants are immediately installed in their place
4. If the teeth are already missing, then the bed is formed by the puncture method, and then the implants are implanted into the bone by the compression method
5. The orthopedic surgeon makes an impression, models and manufactures a prosthesis
6. The tops of the implants (abutments) are fixed at the required angle for the subsequent installation of the prosthesis
7. On the third day after implantation, a fixed metal-plastic prosthesis is installed on the structure, which is adjusted to the patient's bite
8. The patient can start using new teeth
Let's move on to the dental implantation itself. Classic implants were invented 10 years earlier than the basal ones. They have a significant difference both in the setting process and in the biochemical principle of stabilization in the jaw. The classic implant has a rough, sometimes sandblasted surface and is mainly installed in the alveolar ridge of the upper or lower jaw using a thread. The principle of engraftment of a classical implant is that in the spongy layer, there will be an overgrowth of bony septa around the implant, thereby ensuring tight fixation of the implant, wherefore it is necessary to follow certain “golden” rules when installing the implant. The distance between the implants should be at least 3 mm and from the tooth 2 mm, so as not to disturb the nutrition of the spongy layer and not to block the capillaries. In addition, you have to wait 3-6 months for osseointegration, after which you can only start prosthetics. Classic implants, as a rule, are two-stage, or two-piece: the implant itself and the abutment separately. The latter is screwed to the implant with a special screw. With significant atrophy of the alveolar ridge or its absence, certain problems arise when installing classical implants. We have to do osteosynthesis, create bone volume, do closed or open sinus lifting on the upper jaw. On the lower jaw in the posterior regions, where the mandibular nerve lies, implantation is sometimes not possible.
This problem can be solved with basal implants. They are one piece: implant and abutment. In other words, there is no need to screw anything onto the implant. The implant itself is a mirror polished titanium. Microbes do not adhere to polished metal, the risk of infection of the basal implant is excluded. A classic implant can become infected, as it has a rough surface. Our body is all saturated with microbes, but protected by the immune system. If the immune system fails or malfunctions, the risk of intraosseous infection around the implant increases.
The basal implant with its discs plunges into the basal bone and is very firmly fixed in it. Since the basal bone is very dense and not subject to atrophy, the polished implant stem passes through the spongy bone and exits through the upper cortical layer to the gum surface b in the form of an abutment. Due to the fact that it is the basal bone that carries the entire bearing load, it should not be denied this function. Immediately, a crown must be made on the abutment and forced to participate in chewing. This takes about 3-5 days after taking the impression. Crowns or bridges are made in dental laboratories in Moscow. In the absence of bone, when the alveolar process has “melted” in the projection of the maxillary sinus, we should not forget that we still have the basal bone in the upper jaw. It is behind the sinus, in the area of the tubercle of the upper jaw and the pterygopalatine bone, and in front of the sinus, in the area of attachment of the zygomatic bone and the bottom of the sinuses, that there is a very strong and thick basal bone. In these areas, we will position the basal implants, and in 3-5 days we will make the patient's teeth. At first, they will be temporary made of plastic, but you can chew and smile with them in full. Then, after 8-10 months, we will replace them with more aesthetic metal-ceramic or zirconium crowns. It should be noted that when installing basal implants, we will bypass the maxillary sinus. This method is very convenient for patients with chronic problems inside the sinus. On the lower jaw in the posterior regions, where the mandibular nerve passes closely, with complete atrophy of the alveolar process, subbasal implants (commercial name TOI) are placed. They have a paw that sits above or below the nerve. During surgery, everything is monitored using an orthopantomogram image. There is no need for expensive R-scans such as MRI or CT.
For the upper jaw, an overview image with a control 5 mm R-contrast ball is sufficient. Also, with basal implantation, there is no need to take antibiotics, which we prescribe before and after the operation, since the adhesion of microbes to the polished surface of the implant is excluded. In diabetes, changes occur in the spongy layer, the basal implant does not affect it in any way, since the polished neck passes through the spongy layer without exerting any influence on it.
Basal implant care features
The lifetime of crowns and implants depends on their care. It is simple and includes the implementation of just a few recommendations:
brushing with a soft toothbrush with toothpaste twice a day
rinsing mouth with warm water or antibacterial solutions after eating
regular check-ups at the dentist in order to correct the changes if necessary.
It is very important not to allow or timely treat various diseases of the oral cavity, as well as other diseases that may affect the implants.
If you are interested in basal implantation, and you have questions for me, then you can get detailed advice and a treatment plan at our clinic. Contact us and we will definitely help you.