3D digital technology, guided implant surgery and CAD-CAM design and fabrication have transformed the lives of these patients as they allow solutions with definitive dental rehabilitation in less time and with less surgical complexity.
Dr Juan José Ruiz Massera, Head of the Oral and Maxillofacial Surgery Service at Quirónsalud Córdoba Hospital, explained that edentulism – tooth loss – produces significant bone changes in the upper and lower jaw over time. This bone loss, known as bone atrophy, can become excessive and severe over the years, so it is essential to correct this condition to improve the patient’s quality of life.
Dr. Ruiz Massera shows a polyamide replica of an adapted subperiosteal implant (ISC).
Dental prosthesis rehabilitation in these patients often involves the placement of dental implants, which for more than 30 years have been the best tool to replace missing teeth. But when there is damage to the jaw bone, it may not be enough to be able to implant, so some bone regeneration surgery must be done with graft placement, to increase the maxillary bone, the necessary implants. for appointment. These surgeries require longer healing times and, in addition, some techniques are complicated and may require a second surgery to obtain grafts from other areas of the body.
In the most extreme cases, patients with loss of all teeth and severe bone atrophy suffer a progressive decline in their quality of life due to premature aging of their features and inability to chew. Occasionally, severe bone atrophy may be the result of a previous unsuccessful transplant or bone graft treatment. In these extreme cases, where extensive areas of the jaw cannot be invaded by the lack of bone and the existence of anatomical structures that prevent us from having conventional dental implants, patients are forced to wear removable prostheses. , which are uncomfortable in many cases. And it is difficult to adapt because of the loss of retention in the gums.
Solutions for the dental rehabilitation of these patients have been provided by technological advances in materials and design and fabrication of structures, and their application to implant surgery. Thus we use zygomatic implants to rehabilitate atrophic upper jaw. Among them, guided surgery followed by 3D planning has allowed them to be placed with greater precision in a shorter surgical time, reducing their complexity and surgical and prosthetic complications. Zygomatic implants “allow us to do immediate loading, so the patient can have dental rehabilitation in 24-48 hours after surgery”, explained the doctor.
In addition, customized subperiosteal implants (ISCs) have emerged in recent years, which are plate structures printed in sintered titanium that are screwed into the maxillary bone and have incorporated an implant platform to which dental prostheses can be attached. . These structures are personalized and designed in 3D software from the patient’s CT scan. Its recovery after surgery is very fast and “ISC allows rehabilitation of both maxillary and extremely atrophic mandibles with full arch fixed dental prostheses, and they are also an option for rehabilitation of partial sections where grafting techniques are complicated or previously have failed since”, according to Dr. Ruiz Massera.
These techniques, which are performed in the Oral and Maxillofacial Surgery Service of the Kironsalud Córdoba Hospital, represent a significant technological advancement and improve the quality of life of these patients with severe maxillary atrophy and in whom other techniques have not been practiced. can go.
Source and image: https://www.quironsalud.es
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