Diagnosis and planning for implant treatment
Any implant treatment should start with the diagnosis, consisting of information about your medical condition, dental examination, radiological confinement, laboratory tests. After completing a detailed clinical and radiological examination of dental system we proceed to the geometric arrangement of implants using three-dimensional planning. Only after all these steps I do the implantation and / or bone grafting.
1. Information about somatic state is an integral part of diagnosis in implant treatment.
When collecting information about the medical condition it is very important to get information about the usage of nicotine. Consumption of more than 10 cigarettes a day can lead to undesirable complications in the postoperative period, especially at aesthetically significant areas (frontal section of the jaws).
Relative contraindications include the following diseases: radiation therapy, severe forms of diabetes, cardiovascular disease, bleeding diathesis, thyroid dysfunction and other pathological conditions (Addison's disease, asthma, atopic dermatitis, autoimmune diseases, etc.), treatment of which is associated with prolonged intake of corticosteroids, which contributes to osteoporosis, and the emergence of risk with the implantation and bone grafting.
American Association of Anesthesiologists offers ASA-classification, which gives evidence for treatment on an outpatient basis:
ASA1-healthy patients without significant risk factors.
ASA2-patients with mild disease without affecting the general vital functions.
ASA3-patients with serious diseases with the violation of vital functions.
ASA4-patients with diseases that threaten life.
ASA5-dying patients.
Patients ASA1 ASA2 and can be treated at outpatient clinics, the ASA3patients can only be treated in hospital.
2. Dental examination is an equally important part of diagnosis in implant treatment.
At the stage of dental examinations, I will carefully listen to your needs and expectations. This is a very important step, because various sources of information, including the Internet, increase your awareness and it often leads to extreme and unreasonable increasing of demands to the implantation.
Discussion of issues such as form, function and aesthetics will allow us to assess the aesthetic risk and determine your readiness for a compromise result.
At the stage of the survey it is important to check the height of your smile line (the higher the smile line, the more visible the gums with a smile are, the higher the aesthetic risk is), gum biotype (the thicker the gums are the more predictable aesthetic outcome is), the shape of the remaining teeth (square shape of teeth reduces the aesthetic risk), presence of infection in the upcoming implantation area (periodontitis, pulpitis, dental caries, the overhanging edges of fillings, non-contiguous restorations are a source of infection, which may adversely affect the postoperative period and the aesthetic result of the width and height of alveolar bone and soft tissue (presence of defects in bone and soft tissues are a significant factor in the aesthetic and functional risk, such defects must be addressed prior to implantation).
3. Radiological conclusion is the most important stage of diagnosis in implant treatment.
a) Spot X-raying gives an accurate representation of the anatomy of the roots and the bone crest position within three teeth. Often used with the direct implantation of the front section of the upper jaw.
b) Orthopantomogram (panoramic X-ray) is designed to assess the state of dentition as a whole and the location of important anatomical structures (inferior alveolar nerve, chin hole, the lower nasal passage, the maxillary sinus).
c) Computed tomography (CT) a three-dimensional image which gives the ability to see accurately the anatomical structures and to plan future provision of restorations (crowns) on implants with Wax-up model and fabricate a surgical template for correct positioning of the implants during surgery.
d) Radiography of the skull in the oblique projection is a subsidiary picture and provides information on the temporomandibular joint position impacted teeth, anatomical formations of the skull, etc.
The first three methods are the most commonly used.
4. Planning for implant treatment.
After a detailed clinical and radiological examination for further implantation and / or reconstruction of bones I am planning the implant treatment.
The first system of three-dimensional implant treatment planning is the SimPlant-System (Materialise Dental, Belgien) which appeared more than 10 years ago and allows virtual positioning of tomogram implants and fabricating a surgical template, which is fixed to the teeth or the jaw during operation and helps the surgeon to properly install the implants in the bone.
There are other methods of implant treatment planning and manufacturing workplaces 3D-templates, such as Beim med3d (med3d, Deutschland), coDiagnostiX-System (IVS These techniques are aimed to the exact computer positioning of the implants and surgical template manufacturing by a milling machine, through which the surgeon is able to install you the implants with great precision and without any complications.
Nowadays navigation systems are widely used during planning implant treatment in implantology. For example, when fully edentulous (complete absence of teeth), a surgical template is made and, using the surgical navigation kit the implants are being installed without cutting soft tissues, and during the same visit a provisionally orthopedic construction is fixed (temporary plastic teeth), made beforehand by a pre-dental technician. (See Section ”Implantation under a complete loss of teeth”)
You will receive one visit set with acrylic implants teeth without a single incision.