Implantology

Missing teeth, chewing problems, aesthetic problems: over 30 years, the solution for a long-lasting result has been osseointegrated implants.

The average success rate for each implant is over 90%. In experienced hands, in most cases, it is now a minimally intensive operation that does not force us to change our daily habits (minimal postoperative discomfort).

The inserted implants are then used to replace one or more missing teeth, avoiding touching the adjacent healthy elements.

Immediate Loading

The modern implant techniques we use enable nearly all patients to be treated with a non-invasive approach, and provisional fixed dentures to be placed immediately after surgery or within the following two days (immediate load).

Hence, timing is shortened and so is the duration of the treatment.

Needless to say, such rehabilitation is only possible after a thorough evaluation of your personal clinical status.

Minimally-invasive surgery

The advantages of minimally invasive surgery are a very rapid recovery, with no risk of bleeding and swelling in the post- operative period, and the absence of pain.

With this approach, no gum is cut, no tissue is dislodged, and there are no stitches. Since post- operative recovery is almost immediate, you can return your daily activities within 24 hours after surgery.

Minimal-invasive surgery is particularly indicated in patients who are scoagulated or compromised in terms of general health.

Maximum comfort and shorter times.

Bone grafts

Prolonged dental absence, peridontitis, trauma or inflammatory processes can lead to a significant jaw bones re- absorption. Reconstruction of lost bone (Bone Regeneration – Sinus Lift etc.) may be necessary proper placement of osseointegrated implants. )

To ricreate the lost bone volume, various materials/substances are used, including the bone of the patient himself or scientifically tested and approved substitute materials.

In the hands of a specialist, the success rates of bone grafts are very high.

Fixed prosthetics

A very effective therapeutic solution: it replaces all missing teeth with a complete restoration that is fixed to only four/six implants.

Characteristics:

  • Complete rehabilitation with only a few implants.
  • Possible immediate function (fixed temporary bridge).
  • Shorter treatment times resulting in reduced costs.

COMPARED TO TRADITIONAL DENTURES ON IMPLANTS IT OFFERS THE FOLLOWING ADVANTAGES:

  • Free palate, allowing appreciation of food favour.
  • Increased chewing strength, enabling to eat a wide variety of foods.
  • Long-term support of hard and soft tissues around the mouth for a more youthful facial appearance.
  • No need for adhesive pastes or removal of the prosthesis during the night.
  • No risk of gum ulceration or vomiting.

Computer-guided implantology

Computed-assisted surgery allows, through a dedicated software, to virtually plan implant position by processing the CT radiographic data, in absolute respect of anatomical structures.

CAD-CAM technology thus makes it possible to set up surgical guides that allow for the precise and safe placement of implants without the need for incisions and gum dislocation and stitches.

Advantages:

  • Optimisation of the result.
  • Minimally invasive (reduction of post-operative pain and swelling).
  • Maximum precision.
  • Extreamely accurate diagnosis and treatment planning.

Failures - Implant rejections

At first, the rejection of dental implants does not exist, it is a FAILURE.

Rejection refers to a reaction by the immune system to something recognised as foreign (non-self). Dental implants are made of sterile biomedical titanium: an extremely biocompatible metal that our body identifies as a bioinert, and therefore attaches firmly to it, activating the “osseointegration” process.

The use of poor quality titanium implants; failure to observe sterile conditions during surgery; incorrect treatment planning; inadequate preparation of the surgeon are all factors that can, individually or together, lead to implant failure.

Peri-implantitis is an inflammation of the gingival tissues with progressive resorption of the supporting bone tissue around an implant, caused by bacterial infection due to inadequate oral hygiene and is favoured by smoking and the presence of previous periodontitis (pyorrhoea).
It is therefore advisable to undergo regular check-ups to prevent the onset of the disease or to treat it promptly.

Failure to treat a peri-implantitis leads inexorably to the loss of the implant.

Fears and phobias

Fear or dread of surgery, needles, pain and/or blood: nowadays, thanks to conscious sedation, it is finally possible to forget all this.

Many patients do not get treatment or postpone treatment for too long, leading to very serious situations, because they cannot overcome this deep state of anxiety.

Conscious sedation is the ideal solution for patients who are afraid of undergoing surgery, anxiouspatients,thosesuffering from panic attacks or those who have had a traumatic experience at the dentist.

Conscious sedation is an outpatient technique to achieve an intermediate state between wakefulness and sleep by administering anxiolytic drugs, which induce deep neuro- muscular relaxation. It is called conscious because the patient, although very relaxed, remains alert, still able to maintain verbal contact and collaborate with the surgeon.

Oral surgery

Oral surgery includes all procedures that can be performed under local anaesthesia in the oral cavity.

Oral surgery therefore includes dental avulsions of elements that can no longer be treated, avulsions of included and/or malpositioned teeth, treatment of abscesses, amputations of root apices (apicoectomies), removal of cysts and benign tumour pathologies, periodontal and implant surgery, bone reconstructive surgery (bone grafts, GBR).

Complex extractions

In certain cases, unfortunately, dental avulsion is an indispensable intervention to keep the mouth healthy.

All dental elements may require avulsion for a variety of reasons such as: malposition, for orthodontic purposes, periodontal pocket formation (mobile and painful tooth – pyorrhoea), destructive caries or as a result of trauma.

When a tooth is no longer able to perform its function, or causes infections (such as abscesses) or damagetootherteeth,itmustbe extracted.

Some teeth, due to their position or shape, are not removed intact, but only after being sectioned. This procedure is very common in multi-rooted posterior teeth.

Surgical removal of dental elements must, however, be considered a last resort and should only be performed when strictly necessary.

Wisdom teeth

These teeth, due to their position, are often difficult to keep clean and are more prone to caries and gum inflammation.

When a third molar does not have enough space to erupt completely or has an abnormal position, inflammation of the gingiva, deep periodontium, bone and neighbouring tooth, whichiscalledpericoronaritis, easily occurs. Third molars included in close proximity to a second molar almost always result in damage to the latter’s tissues (caries and/or pockets) and are sometimes such as to lead to its loss. The later one intervenes, the more irreversible the injuries to the second molar may become. Therefore, although third-molar surgery is generally a dreaded event for patients and therefore to be avoided or at least procrastinated, it is advisable not to postpone it when necessary.

We speak of complex extractions of wisdom teeth when the roots present abnormalities in their shape or size either because they are in close contact with the inferior alveolar nerve or because they are totally included in the bone.

The extraction of wisdom teeth generally involves a minor oral surgery procedure performed under local anaesthesia and completely painless. Extraction is performed at all ages, but it is farlessinvasiveandlessriskyif done at a young age (before the age of 20) when the roots of these teeth have not yet fully formed, the bone is relatively elastic, and the periodontal ligament is loose.

Wisdom teeth are often removed before orthodontic treatment because at best they would be a slowing factor in the treatment itself if not an absolute impediment.

Also, impacted or partially erupted wisdom teeth can be a direct or indirect cause of neuralgia and must therefore be removed.

However, have no fear at least wisdom teeth do not cause other teeth to shift!

Canine Disinclusion

Inclusion of teeth (dysodontiasis) is the failure of a tooth to erupt in its proper place within the normal growth period. The upper canine, after the wisdom teeth, is the tooth that most frequently presents this anomaly.

The canine is generally considered an irreplaceable element within the oral cavity. Functionally, it plays a primary role in lateral movements. From an aesthetic point of view, it also plays a fundamental role both in terms of its characteristic shape andtheprominenceofits projection along the smile line.

Anche dal punto di vista estetico svolge un ruolo fondamentale, sia per la sua forma caratteristica che per la prominenza della sua proiezione lungo la linea del sorriso.

In the case of inclusion of a healthy canine, the best treatment option, if possible, is surgical disinclusion followed by orthodontic treatment to correctly position the tooth in the arch. During the procedure, the retained tooth is partially exposed, an orthodontic retainer (usually a bracket) is attached to it and through this the correct extrusive forces that will bring the tooth into the arch are applied.

Periodontology

Periodontology deals with the treatment and prevention of periodontal disease (periodontitis)longagoknown as ‘pyorrhoea’, i.e. inflammation of the periodontium, i.e. the supporting tissues of the tooth: gingiva, periodontal ligament and bone tissue. This inflammation is almost always due to poor or incorrect oral hygiene which, if prolonged over time (resulting in increased bacterial plaque and tartar formation) leads to the development of gingivitis or periodontitis. Which can therefore cause:

  • halitosis (bad mouth odour),
  • ingival recession (apparent elongation of teeth),
  • destruction of the supporting bone and in the worst cases even mobility and loss of the tooth.

periodontitis is a multifactorial disease. The main co-factors include: the genetic predisposition, smoking and alcohol, stress (which causes a lowering of the immune system), various illnesses (such as diabetes, leukaemia and immunodeficiency), pregnancy (disrupts the gums due to hormonal imbalances), and prolonged intake of certain categories of drugs.

Periodontitis can manifest itself in various ways, such as: reddened gums and

bleeding (especially when brushing teeth), halitosis, tooth sensitivity, discomfort and/or pain when chewing. The mouth in this state requires urgent and specific treatment, depending on how advanced the pathology is.

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