Implantology

What is “All on four”?

All on four is a new treatment of implants indicated for all those who suffer the total or partial loss of their teeth or have very deteriorated. Now, with this innovative technique, everyone can recover the aesthetics and functionality of his or her mouth, which ultimately will result in a better quality of life.

What is the “All on four” technique?

It is about placing only four implants that provide optimal and safe support to place a bridge (prosthesis).

It is a simple process: Once your case is planned, the patient enters the clinic in the morning, undergoes a surgery that usually lasts between 2 and 3 hours and comes out with the four implants placed. The provisional prosthesis will be set the next day. Months later the final prosthesis is made. This technique is usually highly recommended for total rehabilitation of the mouth.

With “All on four” everything is an advantage; it is a definitive solution, the smile and functionality of the mouth are recovered, and with only four implants we restore a full arch.

For what patients is it indicated and what care should a patient have?
It is indicated for all types of patients. What “All on four” contributes, is that rehabilitation is done with four implants, even those patients with little bone to which until recently they had to perform bone grafting.

Concerning care, the prosthesis and implants must be put on, and the patient must follow a semi-soft diet. As for daily hygiene, you should brush as if you were your teeth. Irrigator brushes are highly recommended so that food remains can be cleaned under the prosthesis. With the final prosthesis, you have to maintain the same hygiene; there is even a specific dental floss for this type of prosthesis. As far as food is concerned, the patient must maintain a regular diet.

Zygomatic Implants

Patients without bone can be placed Zygomatic implants thanks to advances in both the design of titanium implants, as in planning in three dimensions.

Zygomatic implants achieve dental reconstruction in 24 hours in people who have lost bone.

Usually, proper planning and the use of special implants (pterygoid, zygomatic) allow placing implants in cases of patients with little bone without the need to resort to performing bone grafts.

In more specific cases, the realization of bone grafts for reconstruction may be an option that provides greater aesthetics or comfort to the patient.

The assessment of each specific case will allow us to choose among the most suitable methods available in dental implants, depending on the anatomical characteristics and the expectations of the patients.

Advantages of Zygomatic implants

The introduction of Zygomatic Implants complemented with pterygoid implants, or conventional implants allows us to offer a revolutionary treatment in those patients with bone atrophy of the upper jaw, providing them with a prosthetic solution that includes safety, comfort, and aesthetics, giving patients an optimum quality of life.

You do not have your upper denture; you have searched for implants, and anyone has given you a solution. This is a type of treatment that allows having fixed upper teeth in more complex cases where the bone of the jaws is insufficient.

Hybrid Prostheses in Zirconia or Titanium Ad Modum Prostheses

If you have been suffering from bad teeth or significant dental problems, have failed teeth, there are missing many teeth, or you are using a total removable prosthesis, you may have wondered what to do to improve your ability to chew food comfortably, talk with clarity and smile with confidence. The total bridges over implants (implant bridge) may be the solution you have been looking for!

The loss of teeth can cause speech impediments. The tongue is not able to function effectively since the air in the gaps can interrupt with normal speech. Eating will also become a more difficult task once you have lost one of your teeth, as each tooth has a specific function.

The loss of one of the incisors will prevent proper cutting and biting the food into pieces. A molar that has been lost will make it difficult for you to grind your food correctly and aid your digestion.
Apart from its biological functions, the loss of teeth can also cause repercussions on your social life. Many people withdraw from social interactions, merely because they are ashamed of having lost their teeth.
There are several options for replacing these missing teeth, and in this debate, I will cover the possibilities of a person who has lost all of their teeth, or who is going to lose all of their teeth.

If someone has not yet lost all of his or her teeth and his or her teeth need to be removed by an illness, an immediate denture is an option. This type of prosthesis is made of acrylic. It covers the roof of the mouth and extends as far into the mouth as possible at the top and bottom to give the highest amount of surface to help support the prosthesis. A day before the natural teeth are removed, an immediate prosthesis is performed so when the patient’s teeth are extracted the new denture can be taken home. Since there are no changes in healing after removal of the natural teeth the prosthesis is inserted, there are usually pain points and the need for many adjustments until the denture becomes comfortable.

A better option is a prosthesis on implants. Dental implants reduce bone loss. The implants are large since they do not allow the bone to wear away like the standard prosthesis. There are two options for prostheses anchored with implants. One possibility is removable, and one is fixed (it does not come out).

The removable option allows the patient to remove the denture. The prosthesis is made of acrylic, typical prosthesis and usually has the size and shape of a conventional denture.

The fixed option does not allow the patient to remove the denture because the prosthesis is cemented or screwed into the implants by the dentist. This option requires at least four implants per one arch. This prosthesis is typically made of acrylic with a metal structure. Because the prosthesis is attached to the patient through the implants, the dentures can be made quite small. Both the upper part and the lower prosthesis are smaller, and the upper denture does not cover the roof of the mouth, this being a significant advantage. All acrylic options wear out and need to be replaced.

The latest innovation in fixed implant restorations is the Bridge Implant Zirconia. This is similar to the fixed acrylic option but has some key differences. The bridge is made of zirconia and not acrylic. Zirconia has many key advantages. It is solid, so it can be made smaller than the acrylic options. Due to its strength, it does not wear out. It is a natural white material, and therefore an ideal replacement for natural teeth. It does not stain or fracture like acrylic and is exceptionally biocompatible. The Implant Bridge Zirconia is the most natural and functional option when replacing teeth.

The advantages of Implant Bridge Zirconia

Zirconia is the preferred material due to the following benefits, and it provides to our patients:

• Zirconia is completely biocompatible with the human body.
• Zirconia is the strongest dental material available.
• Zirconia does not splinter
• Zirconia does not crack
• Zirconia will not break
• Zirconia is the color of the tooth and does not discolor over time
• Zirconia does not stain

What is a Bone Grafting?

An increase in the ridge is a common dental procedure often done after tooth extraction to help recreate the natural contour of the gums and jaw that may have been lost due to the loss of bone mass as a result of the removal of a tooth, or for another reason.

The alveolar ridge of the jaw is the bone that surrounds the roots of the teeth. When a tooth is removed, a gap is left in the bone of the alveolar ridge. In general, this empty basin heals on its own, being filled with bone and tissue. Sometimes, when a tooth is removed, the bone surrounding the alveoli is unable to improve on its own. The height and width of the gap will continue to deteriorate.

The reconstruction of the height and thickness of the alveolar ridge is not medically necessary but may be required for the placement of dental implants, or for aesthetic purposes. Dental implants need bone to support their structure, and an increase in the ridge can help rebuild this bone to receive the implant.

This is what happens when you lose a tooth, watch the video.

How is the crest increase carried out?

An increase in the ridge is carried out by placing bone graft material in the tooth cavity. It is often done immediately after removing the tooth, to avoid the need for a second subsequent procedure. Next, the gum tissue is placed over the graft and fixed with sutures. Oralcorp® may choose to use a space maintenance product on top of the graft to help restore the height and width of the space created by the tooth and bone loss, and in which new bone must grow. Once the graft has healed, the alveolar ridge can be prepared for the placement of dental implants.

A crest increase is a procedure that is usually performed in Oralcorp under local anesthesia. Some patients may also request sedative medication, depending on the case.

Maxillary Sinus Elevation

What is the maxillary sinus?

The maxillary sinuses are behind the cheeks and on the upper part of the upper teeth. These sinuses are empty and full of air spaces. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often only a thin wall of bone that separates the maxillary sinus and mouth. Dental implants need bone to hold them in place. When the breast wall is fragile, it is impossible to place dental implants in this bone.

Increase of the maxillary sinuses. Process

The key to a successful and long-lasting dental implant is the quality and quantity of bone to which the implant is attached. If bone loss has occurred due to periodontal injury or disease, a breast lift may elevate the floor of the breast and allow the formation of new bone.

In the most common procedure of sinus lift, a small incision is made in the premolar or molar region to expose the maxillar bone. A small opening is cut in the bone, and the membrane lining the sinus is pushed up. The underlying space is filled with bone graft material, either from your own body or a biocompatible bone. Sometimes, synthetic materials are used that can mimic bone formation. After the bone is implanted, the incision is sutured, and the healing process is initiated. After several months of healing, the bone becomes part of the patient’s bone, and dental implants can be inserted and stabilized in this new maxillary bone.

If a sufficient amount of bone between the crest of the maxillar and the underside of the sinus is available to stabilize the implant, sinus elevations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be done first. Then the graft will have to mature for several months, depending on the type of graft material used. Once the graft has evolved, the implants can be placed.

The breast implant makes it possible for patients to have dental implants, when years ago there was no other option, besides using loose dentures with much discomfort.

Dental Implants

If you lose one or more teeth due to periodontal disease, or other cause, there is hope. Dental implants are changing the way you live. They are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost the teeth recovers the ability to eat almost anything and can smile with confidence, knowing that the teeth look natural and that the facial contours will be preserved. Patients with dental implants can smile with confidence.

What are dental implants?

Dental implants are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost the teeth recovers the ability to eat almost anything and can smile with confidence, knowing that the teeth look natural and that the facial contours will be preserved. The implants themselves are tiny titanium posts that are surgically placed in the jaw bones where teeth are missing. These metal anchors act as substitutes for the tooth root.

There is osseointegration which is the union of bone with titanium, creating a solid base for artificial teeth. The small poles protruding through the gums are then attached to the implant. These provide stable anchors for artificial replacement teeth. Dental implants also help to preserve the facial structure, preventing deterioration of the bone that occurs when teeth are missing.

Evaluation

Like many others, if you feel that Implantology is the option for you, we ask that you undergo a dental and/or radiological examination and health history. During these consultation visits, Oralcorp ® will take care of your specific needs and considerations. Your questions and concerns are important to us, and our team will work with you very closely to help make your procedure a success.

We will also discuss the fees and insurance at this time. We will be happy to assist you in obtaining the benefits to which you may be entitled.

At Oralcorp we use state-of-the-art technology, making guided surgery possible, which consists of placing the dental implant with a strict Surgical Guide. In other words, the dental implant is previously placed in software, where it is joined, the scan of the patient’s mouth, the 3D tomography and a guide is printed that directs the ideal position of the implant.

The surgical procedure

For most patients, the placement of dental implants involves two surgical procedures. First, the implants are placed in the maxillary bone. The healing time after surgery varies from person to person and is based on a variety of factors, such as the hardness of the bone. In some cases, the implants can be restored immediately after placing them.

During the first three to six months after surgery, dental implants are below the surface of the gums until osseointegration occurs. You should be able to use temporary dentures and eat a soft diet at this time. At the same time, your restorative dentist designs the final bridge or denture that will ultimately improve functionality and aesthetics.

After the implant has been attached to the jaw bone, the second phase begins. You will discover the implants and connect a small healing pillar. After two weeks your Prosthodontists will be able to start making your new teeth. An impression must be taken. Then the abutments can be connected to the implants. The replacements of the teeth are then made on the final pillars. The entire procedure takes between six and eight months. Most patients do not experience any interruption in their daily life.

What types of prostheses are available?

An implant-supported fixed prosthesis (crown over implants) is used to replace a missing tooth – each prosthetic tooth is connected to its implant. (bottom photo)

An implant-supported fixed partial denture (fixed bridge over implants) can replace two or more teeth and may require only two or three implants.

A complete dental implant prosthesis (full fixed bridge) replaces all the teeth in your upper or lower jaw. The number of implants varies depending on what type of complete prosthesis is recommended (removable or fixed).

A removable prosthesis on implants (overdenture) is attached to a bar or spheres that are the abutments and is removable, while a fixed prosthesis is permanent and removable only by a professional.

Oralcorp® performs dental implant surgery in the office with a hospital-style operating room, thus optimizing the level of sterility. Implant surgery in the hospital is for patients who have special medical or anesthetic needs or for those who need a full bone graft of the jaw, hip or tibia
The Oralcorp® specialists have received extensive training in Dental Implantology. Through full-time postgraduate studies as well as continuing education. Our specialists are aware of the most current information on implant dentistry.

Surgical advances

Using the most recent advances in dental implant technology, in Oralcorp ® we can place implants in a single stage. These implants do not require a second procedure to discover them, but they do not need a minimum of six months of healing before placing artificial teeth. There are even situations in which the implant can be placed at the same time as a tooth extraction minimizing further the number of surgical procedures.

Dental implant placement is a team effort between an Implantologist, Periodontist and an Oral Rehabiliter. In Oralcorp ®, real implant surgery, initial dental extractions, and bone graft are carried out if necessary. The oral rehabilitation fits and makes the permanent prosthesis. It will also make any temporary prosthesis needed during the implant process.

Why dental implants?

Dental implants can significantly improve your life. When you lose several teeth – if it is a new situation or something that has lived for years – you most likely never want to go back to your previous state. Dental implants can be the gateway to renewed self-confidence and a new lifestyle. A Swedish scientist and orthopedic surgeon, Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation more than 35 years ago. With his pioneering research, Dr. Branemark opened the door to a lifetime of renewal, comfort, and self-confidence for millions of people facing the frustration and embarrassment of tooth loss.

Why choose dental implants instead of more traditional types of restorations?

There are several reasons: A dental bridge can sacrifice the healthy structure surrounding neighboring natural teeth to replace the missing tooth. Also, all removable prostheses have to be removed at night which can be an inconvenience, not to mention the loose dentures that can be uncomfortable and quite embarrassing.

Are you a candidate for implants?

If you are considering implants, your mouth should be thoroughly examined and your medical and dental history reviewed. If the mouth is not ideal for implants, there are ways to improve the results, such as bone grafts, which can be recommended.

What kind of anesthesia is used?

Most dental implants and bone grafts can be performed in our office under local anesthesia, with or without general anesthesia.

Do implants need special care?

Once the implants are in place, these will serve you well for many years, if you take good care of them and keep your mouth healthy. Good oral hygiene (brushing and flossing) and going to regular appointments with your dental specialist is key to the long-term success of dental implants.

Other alternatives

Bone Grafts

Bone grafts are commonly used to repair bony defects in the jaws, which can arise as a result of traumatic injuries, traumatic exodontias, tumor surgery, congenital disabilities, periodontal disease, and usually after one year of the loss of a larger tooth. Since the bone of the jaws assimilates the missing teeth and atrophies or it is reabsorbed.

This often leaves a condition in which there are low quality and quantity of bone for the placement of dental implants. Therefore, patients in this situation are not candidates for the installation of dental implants.

Today, we can grow bone where necessary. This not only gives us the opportunity to place implants of appropriate length and width but also provides us with the chance to restore functionality and aesthetic appearance. Then the bone grafts are used to prepare the site for the correct placement of the implant.

The bone can be obtained from a tissue bank or using the patient’s bone. The most common donor sites are the jaw, hip, tibia, skull.

Besides, individual membranes can be used to protect the bone graft and stimulate bone regeneration. This is known as guided bone regeneration or guided tissue regeneration.

Preservation Socket Measures

Preserving jawbone after extraction

The removal of the teeth is sometimes necessary because of pain, infection, bone loss or fracture of the tooth, in which the teeth are irreparable. The bone that holds the tooth in place (the alveolus) is often damaged by the disease and/or infection causing alveolar deformation after the tooth is extracted. Besides, when the teeth are removed, the surrounding bone and gums can shrink and regress very quickly after extraction resulting in ugly defects and collapse of the lips and cheeks.

These bone defects can create enormous problems in the performance of restorative dentistry if your treatment consists of dental implants, bridges or dental prostheses. Deformities in the bone after tooth extraction can be prevented and repaired by alveolar preservation, which can significantly improve the appearance of your smile and increase your chances of success of dental implants for years to come.

Several techniques can be used to preserve bone and minimize bone loss after an extraction. In a standard method, the tooth is removed, and the alveolus is filled with bone or bone substitute. It is then coated with an artificial membrane, or tissue, by stimulating the proteins to help the body’s natural ability to repair the alveolus. With this method, the elimination of the contraction and collapse of the surrounding gums and facial tissues, are prevented. The new bone in the alveolus also provides a foundation for an implant to replace the tooth. If your dentist has recommended the removal of your teeth, be sure to ask if alveolar preservation is necessary. This is especially important if you are planning on replacing the anterior teeth.