The term "basal implant" refers to the principles of using basal areas of bone resorption, free of infections and the occupation of cortical bone areas. The concept of basal implantologyis necessarily linked to the immediate load.
This approach stems from orthopaedic surgery and own experience teach us that cortical areas are structurally necessary because they are resistant to resorption and can reconstituted themselves with ease. At the same time, the load resistance of the cortical bone is several times higher than the spongy part.
In basal implants, the vertical (which connects base plate with the pillar) does not participate in the primary transmission of the bone load. By using the horizontal, vertical and oblique bone support, these devices can be inserted into any anatomical condition, even with immediate extraction.
Bone reconstruction is not necessary and this allows us to avoid having to carry out an increase of it, including sinus elevations. All these properties meet the requirements for our patients to have a faster and lasting treatment.
The evolution of implantology in recent years has improved materials, optimized implant design and developed simpler and more predictabletreatments. New surgical techniques for bone grafts and biomaterials development. From a biological point of view, do less damage to the tissue is a priority.
Nowadays the search for less invasivetreatments inthe different areas of healthcare, improve the chances of success being less invasive, making the patient feel more comfortable. Concepts that tend to simplify treatment and to predict more effectively satisfactory results seem to have today a space on oral implantology.
It performs the evaluation of the state of gingival tissue to plow the implant bed. A small incision is made and through this incision the implant will be placed with the non-traumatic technic without flap.
Patients without bone can also get dental implants thanks to the advances in the design of titanium implants and the three dimensions planning that facilitate 3D CT scan. Due to that we can offer implant treatment for all our patients, even if they have low bones.
Generally, proper planning and the use of special implants, allows us to place implants to patients with low bone without having to use grafts.
The posterior regions of the maxilla have some difficulty as a result of the shortage of bone implant placement due to the presence of maxillary sinuses.
This problem is currently solved using a technique called maxillary sinus lift or "sinus-lift." This procedure is performed under local anaesthesia and involves separating a membrane that exists within the maxillary sinus bone and implanting an artificial bone graft. The postoperative remains painless, but accompanied by a slight swelling that lasts two or three days.
The maxillary sinus lift, has a very high success rate, and it’s defined as a simple and common implant process, which allows satisfactory solution to patients in this region.
Currently, we prefer the use of angular and/or “tubero-pterygoid" implants with immediate load, as shown by the following 3D radiography. So we do not use filler in maxillary sinus grafts, we use the mentioned before as a consequence of being a less bloody surgery with a shorter treatment time from 6 to 9 months. For all these reasons we advise and chose the technique of immediate load with basal and/or compressiveimplants.
Splinting with short fixed prosthesis within a week or inserting temporary prosthesis with electro-welding (intraoral welding of titanium) and final prosthesis after three months.
There are clinical situations where we can place implants and crowns (fixed dentures) in the same session we perform the extraction of a tooth or the a residualroot. This is what we call immediate implantsor post-extraction and is commonly known as teeth in one day (a few hours).
Patients who come to our clinic for a dental extraction, leave a few minutes after with a tooth fixed (temporary crown) implant without nuisance or inflammation.
The immediate load in implantology is defined as the placement of the prosthetic and the implant at the same time.
The evolution that has undergone the surface treatment of implants and patients increasing demand for restoration as soon as possible, have shorten the waiting time for bone integration. These implants are not integrated to the bone according to the traditional concept, but they have a series of conditions that enable the success rate to be very high.
The concept of immediate loading was put into practice by Branemark, through his system Novum. This system is based on thesplintingof the implants placed using a titanium platform to make loads distribute the chewing pressure.
The factors that allow to determinate that immediate load, not just basing on Novum-Branemark system even on unity restorations, depend on multiple factors as the patient or the technic that should be used in the implant placement.
The immediate load is the placement of the dental prosthesis on the implant during the same surgery, allowing to place a dental prosthesis in all the teeth including maxilla and mandible in just one day.
Advances in recent years both in implant planning and in implantmorphology design and its surface have allowed an important step in the quality of implant treatments and one of the most notable benefits is the development of immediate loading.
The immediate load consists of the placement of the implant or implants and the adaptation of fixed dentures, the immediate load prosthesis are made of resins, are temporary and should be replaced with a definitive prosthesis when the period of bone integration has ended.
The benefits for the patient in immediate load implant are many, as not having to wear a removable prosthesis during the time of integration of the implants.
During your visit we will thoroughly examine your mouth, make panoramic radiographs (x-ray) with the 3D CT scan that will allow us to determine the type, quantity and location of bone available for a future implant placement, it is also necessary impressions orstudy models for the research of aesthetic and functionality of the prosthesis and the placement of surgical guide. All of these are essential for the study of proper diagnosis and an appropriate treatment for each patient.
The treatment plan must consider and reduce potentialnegative load factors such as cantilever, occlusal or lateral contacts, bad occlusions or parafunctional habits as bruxism. In some situations it is more suitable a spatial triploid setup that allows the splinting of the implants and distribute loads when chewing. The pieces of the opposing arch are extremely important in transmitting load forces to these surfaces.
The conditions of an adjacent soft tissue must be taken in consideration when we think about aesthetic results.
The dental industry has not escaped one of the great revolutions in medicine: the image. And here right now the three dimensions is the king, even though the 3D sector came later than other dental medicine tools.
It have only been used in Spanish dental treatments for 3 years, the normalization of 3D diagnostics has been a slow process. The 3D implant planning are made with informatics program that enable to know witch model, type, measure and position of the implants have to be used. Also allows the implant placement the without opening the gum and with immediate load charges.
If we also take into account the minimal invasive surgery, we can do painless and immediate implantology.