Peculiarities of Dental Implant Insertion by Immediate Implantation and Immediate Occlusal Loading.

Osseointegration Osseointegration derives from the Greek osteon, bone, and the Latin integrare, to make whole. The term refers to the direct structural and functional connection between living bone and the surface of a load- bearing artificial implant. Osseointegration has enhanced the science of medical bone and joint replacement techniques as well as dental implants and improving prostethics for amputees.

Osseointegration is also defined as: "the formation of a direct interface between an implant and bone, without intervening soft tissue"

The patient S., born in 1960, turned to the clinic with complaints of the absence of teeth in the mandible in order to install permanent orthopaedic construction supported by implants. The anamnesis of the patient described long-term use of removable partial prosthesis. The opposing jaw has permanent metal ceramic bridge prostheses supported by the teeth 16, 14, 13, 12, 11, 21, 22, 23, 24 and 27. In order to determine the possibility of manufacturing permanent orthopaedic construction supported by the dental implants, a computer tomography has been conducted (Fig.1).

Computer tomography before implantation.

The examination proved that the patient has bone tissue of type I according to the Lekholm and Zarb classification. The side areas where the implants were inserted the alveolar crest was 10,63 mm in width and 12,60 mm in height. The distance between the cortical plate and the mandibular canal was only 4,84 mm. It has been decided to manufacture the permanent orthopaedic construction supported by 8 implants.

Fig. 2. The computer tomography after the implant insertion (A – right side, B – left side) Fig. 3. The computer tomography after the implant insertion (A – central area, B – right side)

Fig. 4. Clinical presentation of the oral cavity on the second day after implantation Fig Immediate prosthetics with fixed metal plastic constructions on the third day after the surgery.

The conducted surgical step of the dental implantation implied immediate functional loading with the temporary fixed combined prosthesis with plastic coating which the patient was able to use on the third day after the conducted surgery. After 6 months of using the temporary construction the patient did not express any complaints, therefore, the temporary construction was substituted with the permanent which was fixed in the oral cavity. (Fig.12) The material for the permanent prosthesis is High Performance Polymer (Bio HPP) due to its bio- compatibility, similarity to the mechanic properties of the bone skeleton, considerable durability, optimal polishing and low susceptibility to dental calculus.

Fig. 11. The computer tomography 6 months after the implant insertion (A – central area, B – right side area, C – left side area of the alveolar ridge)

Fig. 12. Fixing the permanent orthopaedic construction in the oral cavity

Thus, the detailed planning of the surgery along with computer tomography ensured no complications of the dental implantation and the detailed planning of the orthopaedic step virtually eliminated such risks as reduction of prosthesis retention reliability, fractures of the implant and inadequate functional loading on the implant.

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