{"id":35295,"date":"2019-10-31T22:03:28","date_gmt":"2019-10-31T19:03:28","guid":{"rendered":"https:\/\/prohoster.info\/blog\/sinus-lifting-i-odnomomentnaya-implantatsiya\/"},"modified":"2019-10-31T22:03:28","modified_gmt":"2019-10-31T19:03:28","slug":"sinus-lifting-i-odnomomentnaya-implantatsiya","status":"publish","type":"post","link":"https:\/\/prohoster.info\/cs\/blog\/news\/sinus-lifting-i-odnomomentnaya-implantatsiya","title":{"rendered":"Sinus-lifting a okam\u017eit\u00e1 implantace","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

\"Sinus-lifting
\n
\nV\u00e1\u017een\u00ed p\u0159\u00e1tel\u00e9, v p\u0159edchoz\u00edch \u010dl\u00e1nc\u00edch jsme si pov\u00eddali \u2014 jak\u00e9 jsou moudrostn\u00ed zuby<\/a><\/noindex> a jak prob\u00edh\u00e1 samotn\u00e9 odstran\u011bn\u00ed t\u011bchto zub\u016f<\/a><\/noindex>. Dnes bych se r\u00e1d na chv\u00edli odvr\u00e1til a promluvil o implantaci, a konkr\u00e9tn\u011b o okam\u017eit\u00e9 implantaci \u2014 kdy je implant\u00e1t um\u00edst\u011bn p\u0159\u00edmo do jamky vytr\u017een\u00e9ho zubu, a o sinus-liftingu \u2014 zv\u011bt\u0161en\u00ed objemu kostn\u00ed tk\u00e1n\u011b na v\u00fd\u0161ku. To je nezbytn\u00e9 p\u0159i um\u00edst\u011bn\u00ed implant\u00e1t\u016f v oblasti 6., 7. a m\u00e9n\u011b \u010dasto 5. zub\u016f na horn\u00ed \u010delisti. Augmentace kosti je pot\u0159ebn\u00e1, proto\u017ee na horn\u00ed \u010delisti se nach\u00e1z\u00ed dutina \u2014 Maxil\u00e1rn\u00ed sinus. Ten v\u011bt\u0161inou zab\u00edr\u00e1 v\u011bt\u0161inu horn\u00ed \u010delisti a vzd\u00e1lenost od okraje kosti k dnu t\u00e9to dutiny nen\u00ed dostate\u010dn\u00e1 pro um\u00edst\u011bn\u00ed implant\u00e1tu po\u017eadovan\u00e9 d\u00e9lky. <\/a><\/noindex><\/p>\n

\"Sinus-lifting
\n
\nNa po\u010d\u00edta\u010dov\u00e9 tomografii je jasn\u011b vid\u011bt, \u017ee v oblasti chyb\u011bj\u00edc\u00edho zubu je propad.<\/p>\n

\u010casto sly\u0161\u00edm, jak dokto\u0159i \u0159\u00edkaj\u00ed, \u017ee \u2014 \"Ne-ne-ne, implant\u00e1t nelze ihned um\u00edstit! Nejd\u0159\u00edve odstran\u00edme zub a jak se to zahoj\u00ed, pak se um\u00edst\u00ed!\". Rozumn\u00e1 ot\u00e1zka \u2014 pro\u010d? Kdo to v\u00ed. M\u011b to zaj\u00edm\u00e1. Bu\u010f z d\u016fvodu nejistoty v progn\u00f3z\u00e1ch, nebo ze strachu z komplikac\u00ed, kter\u00fdch je ve skute\u010dnosti stejn\u011b jako p\u0159i klasick\u00e9 operaci. Samoz\u0159ejm\u011b s podm\u00ednkou, \u017ee v\u0161e je provedeno spr\u00e1vn\u011b. V m\u00e9 praxi je procento okam\u017eit\u00e9 implantace v\u016f\u010di klasick\u00e9mu p\u0159\u00edstupu p\u0159ibli\u017en\u011b 85% ku 15%. Souhlas\u00edte, to nen\u00ed m\u00e1lo. Kdy prakticky ka\u017ed\u00e1 operace, p\u0159i n\u00ed\u017e je indikov\u00e1no odstran\u011bn\u00ed zubu, kon\u010d\u00ed implantac\u00ed. V\u00fdjimkou m\u016f\u017ee b\u00fdt pouze akutn\u00ed z\u00e1n\u011bt v oblasti zubn\u00edho d\u016fvodu, kdy doch\u00e1z\u00ed k hnis\u00e1n\u00ed sm\u00ed\u0161en\u00e9mu s r\u00fdmou. Nebo kdy\u017e je implant\u00e1t opravdu nestabiln\u00ed a houp\u00e1 se v jamce, jako tu\u017eka ve sklenici. Finan\u010dn\u00ed mo\u017enosti hraj\u00ed tak\u00e9 nemalou roli. Ka\u017ed\u00fd utrat\u00ed pen\u00edze ochotn\u011bji za cokoliv jin\u00e9ho, ale ne za zuby. S t\u00edm se ned\u00e1 polemizovat. Ale je tu jedno \u201eale\u201d! Mus\u00edte ch\u00e1pat, \u017ee \u010d\u00edm d\u00e9le uplyne \u010das od okam\u017eiku odstran\u011bn\u00ed zubu do zah\u00e1jen\u00ed protetick\u00e9ho o\u0161et\u0159en\u00ed, t\u00edm hor\u0161\u00ed jsou podm\u00ednky pro um\u00edst\u011bn\u00ed tohoto implant\u00e1tu. Jak se \u0159\u00edk\u00e1: \u2014 \u201epr\u00e1zdn\u00e9 m\u00edsto nez\u016fstane pr\u00e1zdn\u00e9\u201d. Postupem \u010dasu se objevuje \u0159ada z\u00e1va\u017en\u00fdch probl\u00e9m\u016f, kter\u00e9 je tak\u00e9 nutn\u00e9 \u0159e\u0161it. A to v\u017edy p\u0159in\u00e1\u0161\u00ed dodate\u010dn\u00e9, \u010dasto nemal\u00e9 n\u00e1klady. Chcete to?<\/p>\n

No co! P\u0159ejd\u011bme k p\u0159\u00edklad\u016fm.<\/p>\n

Nejjednodu\u0161\u0161\u00edm p\u0159\u00edpadem okam\u017eit\u00e9 implantace je jednokorov\u00fd zub. A\u0165 u\u017e se jedn\u00e1 o horn\u00ed nebo doln\u00ed \u010delist.<\/p>\n

Tato po\u010d\u00edta\u010dov\u00e1 tomografie byla po\u0159\u00edzena p\u0159edt\u00edm, ne\u017e zub \u00fapln\u011b zbyl.<\/p>\n

Co vid\u00edme?<\/p>\n

\"Sinus-lifting
\n
\nHorn\u00ed lev\u00e1 p\u011btka, nepodl\u00e9haj\u00edc\u00ed ani terapeutick\u00e9, ani ortopedick\u00e9 l\u00e9\u010db\u011b. Co budeme d\u011blat? Spr\u00e1vn\u011b \u2014 odstran\u00edme zub a za\u0161roubujeme \u0161roub.<\/p>\n

\"Sinus-lifting
\n
\nProvedl jsem velmi jemn\u00e9, atraumatick\u00e9 odstran\u011bn\u00ed zubu a nainstaloval implant\u00e1t s formova\u010dem d\u00e1sn\u011b.<\/p>\n

\"Sinus-lifting
\n
\nFormova\u010d d\u00e1sn\u011b je n\u011bco jako n\u00edzk\u00fd (v pr\u016fm\u011bru 3 mm v\u00fd\u0161ky) kovov\u00fd pah\u00fdl, kter\u00fd trochu tr\u010d\u00ed nad \u00farovn\u00ed d\u00e1sn\u011b, \u010d\u00edm\u017e formuje jej\u00ed obrys p\u0159ed um\u00edst\u011bn\u00edm korunky. Vypad\u00e1 p\u0159ibli\u017en\u011b takto:<\/p>\n

\"Sinus-lifting
\n
\nA takhle vypad\u00e1 samotn\u00fd implant\u00e1t:<\/p>\n

\"Sinus-lifting
\n
\n\u0160ed\u00e1 \u010d\u00e1st je samotn\u00fd implant\u00e1t. Modr\u00e1 \u010d\u00e1st je takzvan\u00fd do\u010dasn\u00fd abutment, na kter\u00e9m lze upevnit do\u010dasnou korunku, pokud je implantace doprov\u00e1zena okam\u017eit\u00fdm zat\u00ed\u017een\u00edm. Tento abutment v\u011bt\u0161inou slou\u017e\u00ed jako dr\u017e\u00e1k implant\u00e1tu. Po instalaci implant\u00e1tu se abutment vy\u0161roubuje jako stavebnice \u2014 speci\u00e1ln\u00edm \u0161roubov\u00e1kem, a na jeho m\u00edsto se za\u0161roubuje z\u00e1tka. Ta je instalov\u00e1na v p\u0159\u00edpad\u011b, \u017ee nen\u00ed mo\u017en\u00e9 ihned um\u00edstit formova\u010d d\u00e1sn\u011b. Pak je implant\u00e1t a v\u0161echny jeho sou\u010d\u00e1sti zcela pod d\u00e1sn\u00ed, co\u017e znamen\u00e1, \u017ee po operaci v \u00fastech nic neuvid\u00edme. No, a\u017e na stehy a... ostatn\u00ed zuby, pokud n\u011bjak\u00e9 je\u0161t\u011b zbyly. V takov\u00e9m p\u0159\u00edpad\u011b se formova\u010d um\u00edst\u00ed a\u017e pot\u00e9, co se implant\u00e1t osv\u011bd\u010d\u00ed.<\/p>\n

D\u00e1le zvol\u00edme dal\u0161\u00ed \u00farove\u0148 obt\u00ed\u017enosti, kdy\u017e je t\u0159eba odstranit 6. zub na doln\u00ed \u010delisti. Tento zub m\u00e1 dva ko\u0159eny. Samoz\u0159ejm\u011b, \u017ee nebudeme instalovat jeden implant\u00e1t do oblasti ka\u017ed\u00e9ho ko\u0159ene, jak si n\u011bkdo mohl myslet. I kdy\u017e jsem vid\u011bl podobn\u00e9 p\u0159\u00edpady. Doktorovi z\u0159ejm\u011b ho\u0159el \u00fav\u011br na hypot\u00e9ku.<\/p>\n

Tak\u017ee, pot\u0159ebujeme nainstalovat jeden implant\u00e1t, ale p\u0159esn\u011b uprost\u0159ed. M\u00ed\u0159it budeme na kostn\u00ed p\u0159ep\u00e1\u017eku mezi dv\u011bma ko\u0159eny.<\/p>\n

\"Sinus-lifting
\n
\nInstalujeme implant\u00e1t. Po jeho lev\u00e9 a prav\u00e9 stran\u011b jsou na sn\u00edmku jasn\u011b viditeln\u00e9 jamky po pr\u00e1v\u011b odstran\u011bn\u00e9m zubu, kter\u00e9 se b\u011bhem hojen\u00ed zacel\u00ed.<\/p>\n

\"Sinus-lifting
\n
\nNyn\u00ed nastal \u010das pod\u00edvat se na p\u0159\u00edpad, kdy je nutn\u00e9 odstranit zub, nainstalovat implant\u00e1t a prov\u00e9st augmentaci kostn\u00ed tk\u00e1n\u011b na horn\u00ed \u010delisti \u2014 sinus lifting. A \u00farove\u0148 slo\u017eitosti se mezit\u00edm zvy\u0161uje. Samoz\u0159ejm\u011b to nen\u00ed mise s vrtuln\u00edky z Vice City, ale je t\u0159eba b\u00fdt o n\u011bco opatrn\u011bj\u0161\u00ed ne\u017e v p\u0159edchoz\u00edm p\u0159\u00edpad\u011b.<\/p>\n

\"Sinus-lifting
\n
\nPamatujete, jak jsem \u0159\u00edkal, \u017ee implant\u00e1t by m\u011bl b\u00fdt um\u00edst\u011bn ve st\u0159edu? Trojcroot\u00fd zub nen\u00ed v\u00fdjimkou. Implant\u00e1t je um\u00edst\u011bn, stejn\u011b jako v p\u0159edchoz\u00edm p\u0159\u00edpad\u011b, do p\u0159ep\u00e1\u017eky, ale t\u0159et\u00edho ko\u0159ene zubu. Jak vid\u00edme, v\u00fd\u0161ka kosti v t\u00e9to oblasti je p\u0159ibli\u017en\u011b 3 mm. Tento objem je nedostate\u010dn\u00fd pro um\u00edst\u011bn\u00ed implant\u00e1tu optim\u00e1ln\u00ed d\u00e9lky, a proto je t\u0159eba objem zv\u00fd\u0161it. Manipulace se prov\u00e1d\u00ed pomoc\u00ed speci\u00e1ln\u00edho \u201ekostn\u00edho materi\u00e1lu\u201c. N\u011bkdo mu \u0159\u00edk\u00e1 \u201ekostn\u00ed pr\u00e1\u0161ek\u201c, nezam\u011b\u0148ujte ho s \u201eb\u00edl\u00fdm pr\u00e1\u0161kem\u201c, a\u010dkoli je b\u00edl\u00fd, ale je prezentov\u00e1n sp\u00ed\u0161e ve form\u011b granul\u00ed. Dod\u00e1v\u00e1 se bu\u010f v jednoduch\u00fdch sklen\u011bn\u00fdch n\u00e1dob\u00e1ch,<\/p>\n

\"Sinus-lifting
\n
\nnebo v pohodln\u011bj\u0161\u00ed podob\u011b \u2014 speci\u00e1ln\u00edch st\u0159\u00edka\u010dk\u00e1ch, s jejich\u017e pomoc\u00ed se l\u00e9pe pracuje a vkl\u00e1d\u00e1 materi\u00e1l do opera\u010dn\u00edho pole.<\/p>\n

\"Sinus-lifting
\n
\nJe chybou se domn\u00edvat, \u017ee sinus lifting je operace \u201eV\u201c v maxil\u00e1rn\u00ed (Heimrov\u011b) dutin\u011b. Ve skute\u010dnosti se manipulace prov\u00e1d\u00ed \u201ePOD\u201c n\u00ed. Jak jsme ji\u017e zjistili, dutina je prostor v horn\u00ed \u010delisti, pr\u00e1zdnota, chcete-li, kter\u00e1 je zevnit\u0159 vystl\u00e1na tenkou sliznic\u00ed s \u0159asinkov\u00fdm epitelem. Tak\u017ee, abychom operaci \u00fasp\u011b\u0161n\u011b provedli, m\u00edstn\u011b se odloup\u00e1v\u00e1 sliznice od kostn\u00ed tk\u00e1n\u011b a do vytvo\u0159en\u00e9ho prostoru mezi dnem dutiny a sliznic\u00ed se jako do ob\u00e1lky umis\u0165uje \u201ekostn\u00ed materi\u00e1l\u201c. V tomto p\u0159\u00edpad\u011b se sou\u010dasn\u011b instaluje implant\u00e1t.<\/p>\n

\"Sinus-lifting
\n
\nA nyn\u00ed p\u0159\u00edklad sinus liftingu a implantace, ale dva m\u011bs\u00edce pot\u00e9, co byl odstran\u011bn \u0161est\u00fd zub na horn\u00ed \u010delisti. Tato pacientce byl p\u0159ed asi t\u00fddnem v jin\u00e9 klinice odstran\u011bn \u0161est\u00fd zub. Asistentka provedla po\u010d\u00edta\u010dovou tomografii.<\/p>\n

\"Sinus-lifting
\n
\nVzhledem k tomu, \u017ee od odstran\u011bn\u00ed uplynul pouze t\u00fdden, na sn\u00edmku vid\u00edme \"tmavou d\u00edru\", jako tu, kterou v tv\u00e9m srdci zanechala b\u00fdval\u00e1. Na m\u00edst\u011b, kde byl zub. To znamen\u00e1, \u017ee v t\u00e9to oblasti nen\u00ed \u017e\u00e1dn\u00e1 kostn\u00ed tk\u00e1\u0148. K operaci jsem p\u0159istoupil po 2 m\u011bs\u00edc\u00edch. Opakovanou po\u010d\u00edta\u010dovou tomografii po zhojen\u00ed d\u016flku jsme neprov\u00e1d\u011bli, ale v\u011b\u0159te, \u017ee se v\u0161e zahojilo dostate\u010dn\u011b na to, aby bylo mo\u017en\u00e9 prov\u00e9st operaci. B\u011bhem operace se n\u00e1m nepoda\u0159ilo dos\u00e1hnout tvrd\u00e9 stabilizace implant\u00e1tu, proto jsem se rozhodl nainstalovat z\u00e1tku, nikoli formova\u010d d\u00e1sn\u011b. Pro\u010d? Proto\u017ee pokud by pacientka za\u010dala kousat suchary, mohlo by na implant\u00e1t, zejm\u00e9na na formova\u010d, p\u016fsobit siln\u00e9 zat\u00ed\u017een\u00ed, co\u017e by mohlo zp\u016fsobit, \u017ee se implant\u00e1t uvoln\u00ed nebo \"ulete do\" dutiny. A tak\u00e9 by se vyhodila osmi\u010dka.<\/p>\n

\"Sinus-lifting
\n
\nA posledn\u00ed p\u0159\u00edklad na dnes \u2014 odstran\u011bn\u00ed 2 zub\u016f, instalace 2 implant\u00e1t\u016f a sinus-lifting.<\/p>\n

\"Sinus-lifting
\n
\nJak vid\u00edme, podm\u00ednky jsou v tomto p\u0159\u00edpad\u011b o n\u011bco hor\u0161\u00ed, cca 2 mm. Ale to n\u00e1m nezabr\u00e1nilo prov\u00e9st operaci v pln\u00e9m rozsahu.<\/p>\n

\"Sinus-lifting
\n
\nM\u016f\u017eete se pt\u00e1t: -\"Pro\u010d jsou 2 implant\u00e1ty, a ne 3?\" \"Bude mostn\u00ed prot\u00e9za?\" \"Jak to bude s rozlo\u017een\u00edm zat\u00ed\u017een\u00ed?\" atd.<\/p>\n

\"Sinus-lifting
\n
\nVe skute\u010dnosti probl\u00e9m p\u0159et\u00ed\u017een\u00ed souvisej\u00edc\u00ed s mostn\u00edmi prot\u00e9zami se t\u00fdk\u00e1 pouze vlastn\u00edch zub\u016f. Proto\u017ee zuby maj\u00ed vazivov\u00fd apar\u00e1t. To znamen\u00e1, \u017ee zub nen\u00ed pevn\u011b spojen s kost\u00ed, ale jakoby pru\u017e\u00ed v n\u00ed. Tady je sch\u00e9ma:<\/p>\n

\"Sinus-lifting
\n
\nP\u0159i p\u0159\u00edtomnosti mostn\u00ed prot\u00e9zy podporuj\u00edc\u00ed zuby p\u0159eb\u00edraj\u00ed jak svou vlastn\u00ed z\u00e1t\u011b\u017e, tak zat\u00ed\u017een\u00ed chyb\u011bj\u00edc\u00edho zubu. T\u00edmto zp\u016fsobem doch\u00e1z\u00ed k p\u0159et\u00ed\u017een\u00ed zub\u016f, a pot\u00e9 se ocitnou u zubn\u00ed v\u00edly. U implant\u00e1tu v\u0161ak takov\u00e1 vazba nen\u00ed. Ten se pevn\u011b spojuje s okoln\u00edmi tk\u00e1n\u011bmi, proto podobn\u00e9 probl\u00e9my, jak\u00e9 se vyskytuj\u00ed u vlastn\u00edch zub\u016f, nejsou. Ale to neznamen\u00e1, \u017ee na dva implant\u00e1ty lze nainstalovat obrovsk\u00fd most p\u0159es celou \u010delist. To jedin\u00e9, co trp\u00ed p\u0159i p\u0159\u00edtomnosti mostn\u00edch prot\u00e9z \u2014 je hygiena, o tu se bude muset pe\u010dliv\u011b starat. Proto\u017ee p\u00e9\u010de o samostatn\u011b stoj\u00edc\u00ed zuby je mnohem snaz\u0161\u00ed ne\u017e o podobn\u00e9 prot\u00e9zy.<\/p>\n

\"Sinus-lifting
\nTo je pro dne\u0161ek v\u0161e. R\u00e1d odpov\u00edm na va\u0161e ot\u00e1zky!<\/p>\n

Z\u016fsta\u0148te na p\u0159\u00edjmu!<\/p>\n

S \u00factou, Andrej Da\u0161kovi\u010d.
\n
Zdroj: habr.com<\/a><\/p>","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"excerpt":{"rendered":"

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