Good afternoon dear friends! Today I would like to tell you, and most importantly, show you how the implant installation procedure is carried out, with all the tools and other things. If about , in particular - I already told you, it's time to talk about something more serious.
WARNING!-Uwaga!-Pažnju!-Attention!-Achtung!-Attenzione!-WARNING!-Uwaga!-Pažnju!
Below are photos taken during the operation! With views of teeth, gums, blood and dismemberment. The faint of heart, please refrain from reading this article.
Are you still here? Then let's go!
Consultation and examination
In addition to visual inspection:
We need to do an x-ray. In this case, a simple OPTG (Panoramic Dental Imaging) will not be enough for us. Required CBCT (Cone Beam Computed Tomography).
What is the difference?
OPTG (Orthopantomogram) - an overview image of the dentoalveolar system. This image is planar, which means that every detail of the image is superimposed layer by layer on top of each other. Therefore, it is impossible to consider the object of study, in particular the place of the planned implantation, in all planes, from a different angle or other projection.
CBCT (Cone Beam Computed Tomography) - a 3D volumetric image, on the contrary, gives us such an opportunity.
In this case, the volume of bone tissue is sufficient to stabilize the optimal size of the implant, and the quality of the gum makes it possible to form an aesthetic contour without additional procedures:
After carrying out the necessary examinations, we proceed directly to implantation.
It all starts, of course, with anesthesia. Nobody wants to scream in pain during surgery, right?
In order to minimize all the discomfort and the injection of the needle was less painful - the so-called application anesthesia
Next is carried out infiltration anesthetic in the area of the planned operation. The photo shows a reusable cartridge syringe, which, of course, is sterilized after each patient, like any other instrument. Two disposable anesthetic cartridges and two needles of different lengths:
What it looks like in the mouth:
After the anesthesia, with the help of a scalpel, - cut, and the so-called raspator - bone skeletonization. (separation of the periosteum from the compact substance of the bone).
Incision:
Skeletonization of the bone:
Next, the preparation of the hole for the implant (preparation) is carried out.
Below is a set of one of the German implant systems that I use in my practice.
In addition to the surgical kit, we have a special device called a physiodispenser:
Unlike a conventional dental drill, it allows you not only to precisely adjust the speed and cool the cutting tool with saline, but also control the torque.
Implantation begins with marking. This is done using a spherical bur:
Further, using a pilot cutter with a diameter of 2 mm, the axis of the socket of the future implant is set, which is controlled using pins*
*Thing to control the position of the implant
Further, since the axis of the hole is set correctly, we can only bring the hole to the desired diameter. For this, the main working cutters are used. The first one is 3.0 mm in diameter:
After that, position control using the implant analogues included in the set:
Next in line is the following cutter, with a diameter of 3.4 mm:
And now the most important stage is in turn - the finishing cutter for our implant with a diameter of 3.8 mm. Now we lower the speed on the physiodispenser to a minimum in order to avoid overheating and trauma to the bone tissue, after which we very, very carefully pass the hole:
We check everything again with the help of implant analogues. As they say, measure seven times, stick one:
We brought the hole to a depth of 11 mm and a diameter of 3.8 mm. But the preparation of the hole does not end there.
And all because the bone tissue is an elastic medium, and in order to relieve stress from the cortical plate (and prevent peri-implantitis), we use a special cortical cutter:
When working with very dense bone tissue, we additionally use a special tap:
Now you can start installing the implant.
An implant of the required size (3.8x11 mm) is fixed on a hexagonal key, after which it is installed in the prepared hole:
Check the position of the implant again:
Next, we remove the temporary abutment, which in this case served as an implant holder:
The next step is the installation of the gum former:
Taking into account the clinical conditions, we selected the Slim shaper (without extensions) 3 mm high for the installed implant:
We finish our operation with suturing:
And a control snapshot:
It takes an average of 4 months to integrate an implant. At the same time, the formation of soft tissues is underway, so after about 12 weeks we will have a system ready for the installation of a crown.
That's all for today.
Thank you for attention!
Sincerely, Andrey Dashkov
What else to read about dental implants?
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Source: habr.com