Tag: cirurgia

Full Arch implants: 11 stages of treatment

Full arch dental implant treatment steps

Learn about the stages of treatment for full arch implant rehabilitation. A full dental implant is a treatment designed to rebuild a new smile when all the teeth in an arch or mouth have been lost. This type of treatment is also popularly referred to as a protocol prosthesis or All on four dental implants, the latter if it involves 4 implants.

The ImplArt Dental Clinic has extensive expertise in full-arch implant treatments, using the best materials to produce the fixed prosthesis for full arch implants in its own dental laboratory, using state-of-the-art computerized techniques. In this way, we offer our patients a choice of different types of dental implants, with different healing times. In addition, patients can choose between 5 different types of fixed prosthesis to be fitted over their implants.

The most modern prostheses today are made of zirconia and use a computerized system to create these highly resistant and aesthetically pleasing prostheses. In addition to zirconia prostheses, there is also the option of zirconia implants.

Most full arch implant cases follow the following treatment steps:

1 – An individual assessment of the case for full arch/full mouth implantation is carried out

Considering the patient’s general and oral health, the volume and quality of bone in the mandible/maxilla, aesthetics, gum shape, among other aspects. To assess bone volume, radiological examinations such as panoramic radiography and computed tomography will be requested.

This stage also verifies the need for bone grafting prior to implant surgery, as well as the need for medical supervision if the patient has pre-existing diseases that could interfere with the success of dental implant rehabilitation.

2 – Treatment proposal

Depending on the information collected and the patient’s expectations, we will present some alternatives for full arch implant treatment with different stages of treatment, techniques and possible materials. The recommended types of dental implant will be presented according to the patient’s case, and they will be able to choose according to their preference. Today there are very modern dental implants and healing times can take between 1 and 6 months, depending on the type. Implants from the Swiss brand Straumann are the ones with the shortest healing times.

3 – Preparing the mouth

With the aim of eliminating sources of infection, such as professional cleaning, treatment of cavities, tooth extractions and periodontal scraping.

4 – Preparation and molds

For provisional prostheses for total implants. The ImplArt dental clinic takes digital impressions with intraoral scanners (without mass).

5 – Installation of full arch implants

Through simple and painless surgery, the implants that will support the fixed prosthesis are inserted. The surgery takes place in a doctor’s office and the patient can go home immediately afterwards. There are modalities with local anesthesia, or with intravenous sedation, if the patient prefers.

There is also the option of performing dental implant surgery using the computerized guided surgery technique.

This technique eliminates the need to make large cuts and sutures in the gums, making the post-operative period easier and the recovery quicker.

The surgical guide acts as a template with indications of where the incisions should be made to place the dental implants. The surgical guide is custom-made according to the patient’s CT scan images, using a 3D printing method.

*Learnmore about dental implants: How is a dental implant done? How to get a dental implant ?

6 – Installation of the temporary prosthesis

On the same day or after a few days. This is one of the most important stages of treatment. The prosthesis can be fixed or removable, depending on the case. The preference is for a fixed temporary prosthesis, unless this is technically impossible.

This first provisional prosthesis for total implants does not always meet all the requirements of aesthetics and function because it is made under adverse conditions, such as pre-existing teeth that make molding difficult. If necessary, we will make new prostheses.

7 – Waiting period

It takes between one and six months for the implants to integrate into the bone (osseointegration) and for the gums to heal.

8 – Start of the definitive prosthesis for total implants

If the implants are hidden under the gums, the first step is reopening surgery. This is a simple procedure that aims to expose the implants in the mouth. Then molds are made.

9 – Studies for the definitive prosthesis

For total implants, the aim is to find out which characteristics will be important in order to obtain the best aesthetics and functionality. When the characteristics of the final prosthesis are discussed, the color of the teeth, the shape of the teeth, the volume of the prosthesis and whether or not artificial gums are needed will be defined. The patient takes part in this process and will be able to see the stages of the treatment beforehand, as well as the final aesthetics. The dental implant prosthesis can be made of Zirconia, Porcelain or Resin, each with different characteristics, and the patient’s choice is made right at the start of treatment, so that planning is already carried out in anticipation of the definitive prosthesis.

10 – Delivery of the total implant prosthesis

With the approval of the patient and the dentist, the protocol prosthesis is then given as completed and all stages of the proposed treatment have been fulfilled.

11 – Total implant control and maintenance

Once all the treatment stages have been completed and the protocol prosthesis has been delivered, the patient should return every six months for a check-up and cleaning. Every twelve months we will request a panoramic radiograph to monitor the case internally. Even though the patient has had implants and, in many cases, has had all their natural teeth removed, they should still visit the dentist regularly every 6 months.

Dental implants

If you have any questions about the stages of dental implant treatment, please contact us through one of the channels below or make an appointment at the ImplArt dental clinic. We specialize in total implants and prosthetic protocols and will be happy to assist you!

Find out more about treatments at Clinica ImplArt

To find out more about the treatments at Clinica Dentaria ImplArt, check out the images of our treatments on Instagram https://www.instagram.com/clinicaimplart/.
Our videos on Youtube: https://www.youtube.com/@ImplArtImplanteseestetica
See our Pinterest page: https://br.pinterest.com/implante/

To see our photo gallery of our treatments, click here!
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Dr. Roberto Markarian, Implant Dentist

Text written by DR. ROBERTO MARKARIAN – CRO-SP 73.583
Founder and Director of the ImplArt Dental Clinic – Dr. Roberto’s Linkedin profile

implantodontista — Full Arch implants: 11 stages of treatment

Dr. Roberto Markarian is a reference in dental implants and computerized dental prostheses in Brazil. As well as having more than 10,000 implants installed, he is a researcher who produces knowledge that is published worldwide in renowned scientific journals in the field of dentistry. He is responsible for promoting knowledge and high technology applied in all the treatments offered by the ImplArt Clinic.

Post-Doctorate in Implant Dentistry – Univ SL Mandic (Campinas-SP) – 2020
PhD in Implant Dentistry – Doctor of Implant Dentistry, Univ SL Mandic – 2017
Dr. Roberto Markarian Specialist in Dental Implants at USP (Implant Dentist) – 2008
Specialist in Prosthodontics (Prosthodontist ) by the CFO – 2006
Master in Prosthodontics, USP – 2005
Graduated as a Dental Surgeon from USP (São Paulo) – 2001
Member of the Clinical Staff of Hospital Alemão Oswaldo Cruz

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Full Arch implants: 11 stages of treatment

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Computer-guided implant surgery

Computer-guided implant surgery is certainly a technique that makes implant surgeries less invasive, precise and comfortable. Currently, the most modern materials are zirconia protocols and porcelain protocols on total implants.

Surgical guide for guided implant surgery

Full arch implant with zirconia and porcelain prosthesis

This technique eliminates the need to make large cuts and sutures in the gums, making the post-operative period easier and the recovery faster.

CT makes it possible to analyze the bone volume of all regions of the maxilla and mandible in order to select the best distribution of implants. In this way, it is also possible to choose the most suitable implants, taking length and diameter into account.

Another advantage of computer-guided implant surgery is that it helps to avoid surgical accidents, such as hitting delicate structures like nerve pathways.

GUIA CIRÚRGICO — *Photo of a surgical guide for guided implant surgery*

The patient can leave the office with temporary teeth or with the mobile prosthesis they were already wearing over the implants until the definitive prosthesis is finished (in 3 to 6 months), or with an immediate load in up to 72 hours.

Immediate loading ranges from the guided implant surgery for placing the implants to the fixing of the fixed dental prosthesis, usually of the dental protocol type. The patient can quickly speak, smile and eat safely (the masticatory effort should progress little by little, according to the surgeon’s instructions).

Learn more about total implants

Indications for a computer-guided implant surgery:

Any completely edentulous patient, whether recent or having worndentures for years, who has good bone availability is likely to be a good candidate for this technique.
Diabetic and/or hypertensive patients who generally have no indication for surgery or when it should be performed with caution due to bleeding. Computer-guided total implant placement surgery is, in principle, an excellent option for this patient, as bleeding is less with this technique.

Contraindications to guided surgery:

– Very advanced bone atrophy makes it impossible, in principle, to place neodent dental implants. In some cases, this problem can be solved with another technique, bone grafting.

The entire procedure is carried out with great peace of mind and safety. Computer-guided implant surgery represents a major advance in dental surgery and our team at the ImplArt dental clinic, led by Dr. Roberto Markarian – a doctor in dental implants and a specialist in prosthetics – has full command of the techniques.

To find out if you could benefit from this technique, our team needs to carry out a thorough assessment of your case. Contact us and make an appointment at the ImplArt dental clinic to see other cases and photographs. We will be happy to try to solve your problem.

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Immediate loading – Indications and planning

The topic of implants with immediate loading has always been very present when it comes to dental implants. The term is related to pressure, i.e. loading on the newly installed implant, therefore immediately after surgery. It is important to note that the decision on whether or not to perform immediate loading on the implant should be made by the implant dentist. Assuming that this is the main desire of all patients, it is the implant dentist who must certainly assess the conditions conducive to the use of this technique.

Currently, implant surgery is studied beforehand by the implant dentist (dental implant specialist) through the patient’s panoramic X-ray and CT scan. It is therefore possible to assess whether the patient has favorable bone conditions for the use of this technique. However, it is at the time of implant surgery, by locking the implant, that it is possible to guarantee that the immediate loading technique can be carried out. In this way, the professional can also change the technique used to make the prosthesis if the necessary implants are not locked during surgery. Although the bone structure is studied beforehand through examinations, it is only during surgery that the real bone situation can be gauged.

How is immediate loading surgery with dental implants performed?

Surgery is performed to install dental implants in the jawbone. The surgery should take place like a conventional dental implant surgery. Prior to the surgery, plans are made for an immediate temporary prosthesis, so that the patient will never be without teeth. There are prerequisites for using the installed implant:

Sufficient torque (greater than 35 N.cm)
Long implant (longer than 11 mm)
Implant with sufficient diameter: Larger than 3.75 mm
Planning a prosthesis compatible with the implant‘s ability to withstand forces
Sufficient number of implants
Good distribution of implants in the arch
Patient without bruxism symptoms
People without symptoms of diseases that compromise tissue and bone healing (e.g. diabetes)
Non-smoking patient (smoking greatly reduces the chance of implant success)

Learn more about immediate loading

immediately loaded implant — Immediate loading means that the implant will be loaded with the crown as soon as it is inserted. In practice, loading occurs with the placement of the tooth, which will transmit the force of chewing through the implant to the bone.

This means that not all cases are good for immediate loading. Sometimes, only during implant installation will we be able to tell if the implant has met the requirements for immediate loading. Therefore, in some cases immediate loading can be aborted to allow the implant to heal in a conventional way (between 3 and 6 months).

If the surgery goes well, you can then start on the provisional or even definitive prosthesis, which requires molds and measurements of the arch. Immediate loading is usually carried out with a temporary prosthesis and, after the implants and gums have healed (between 3 and 6 months), the definitive prosthesis is made.
Watch the video below where we show the total implant surgery and the installation of the protocol prosthesis.

Although it is possible to carry out the treatment with the definitive material initially, we consider it better to make a temporary prosthesis, as the gums must swell and the bone changes shape during the initial three months of healing after surgery.

Best material for fixed prostheses

Currently, the most modern material for fixed prostheses is zirconia. Zirconia is a biocompatible material in line with the biological dentistry trend, which seeks to avoid the use of metals in dental treatments. It is also highly resistant and can be designed using computer graphics, which gives a much more natural aesthetic result compared to other types of dental prosthesis materials.

If you have any questions, please contact our team.

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Immediate loading - Indications and planning

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ImplArt serves all dental specialties

At the ImplArt Dental Clinic we strive to offer quality care and the greatest possible convenience. That’s why our team is made up of professionals from all dental specialties. They are:

Implantology

Implantology is the area of dentistrydedicated to the treatment of edentulism (the absence of one or more teeth) with prosthetic rehabilitation supported or retained by dental implants, which can be made of titanium or even ceramic. This is the new, modern ceramic implant, the white implant, for those looking for a metal-free implant. Read more

Orthodontics

Orthodontics is the specialtyresponsible for correcting the position of teeth and jawbones for proper occlusion and alignment. The main objective of orthodontic treatments is functional improvement (chewing, articulation, speech, breathing and to avoid “opportunistic” periodontal diseases such as cavities and plaque build-up and tartar formation), but it also aims to restore an aesthetic and harmonious smile. Learn more

Dentistry

The specialty of dentistry focuses on aesthetic dental restoration. The most popular procedures are: teeth whitening, resin or porcelain restorations, dental contact lenses or porcelain veneers. Learn more

Oral and Maxillofacial

Correction of facial anomalies of the jaw or mandible, reconstruction of bone defects, problems of the temporomandibular joints (TMJ), orthognathic surgery, treatment of retained teeth, tumors and cysts.

Read more: The role of hospital dentistry

Dental prosthesis

The specialty of prosthodonticsaims to make dental prostheses to replace lost teeth, with the aim of restoring oral function and aesthetics. It is considered dental art, since this specialty has the mission of creating prostheses that are increasingly similar to natural human teeth (in shape, color, translucency and texture). Dental prosthesis models range from the mobile type (dentures), protocol prosthesis, to dental crowns that are fixed to dental implants. Learn more

Endodontics

Endodontics is the area of dentistry responsible for treating diseases of the dental pulp, root canal system and periapical tissues. It carries out root canal treatment with the aim of maintaining the tooth and avoiding its extraction. Read more

Periodontics

Periodontics isresponsible for identifying and treating periodontal diseases, the most common of which are caries, gingivitis, plaque build-up, tartar formation and periodontitis (inflammation of the bone tissue that supports the tooth). This specialty also performs surgery to correct gummy smiles. Learn more

Dental Radiology

Dental radiology is of fundamental importance, especially for diagnosing functional problems and oral diseases using X-ray images. It also helps other specialties to plan dental implant surgery and monitor the progress of treatment or surgery that has already been carried out. These exams include panoramic radiography and computed tomography. Find out more.

In addition, the structure of the ImplArt Dental Clinic includes the main technologies used in modern dentistry, both for diagnosis and for treatment and follow-up. At Clinica Dentaria ImplArt you will find:

Two of the main computerized systems for digital smile design, Cerec and 3Shape
Own prosthetic laboratory
Digital radiology with computed tomography
Surgical ultrasound for implants and grafts

One Stop Dentistry and dental specialties

This breadth of dental specialties guarantees peace of mind and convenience for the patient, who doesn’t have to travel to different locations to undergo their full treatment or radiological examinations. If you have any questions, make an appointment or contact us. We’ll be happy to help you. For those coming from far away, you should know that it is possible to make an online appointment and even plan your dental implant surgery remotely, and organize your Day Clinic.

Topics in this article about dental specialties and ImplArt dental clinic

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What is dental implant surgery like?

Dental implant surgery is not a complicated process. Certainly, with current techniques, it’s a common procedure with no unforeseen problems. Implant surgery can take as little as half an hour in the simplest cases, is done in the clinic, in the implant dentist’s own office, with local anesthesia and the patient feels no pain.

Here at the ImplArt Clinic, we get a lot of questions from patients, especially about how dental implants are done in practice. So, to answer this and other questions about implant surgery, we’ve prepared this article to answer all your doubts about the treatment.

What is the best dental implant?

Today there are various types of dental implant with different technologies and healing times. There are even implants that heal in 30 days, called fast-healing implants, such as the Slactive implant, from the Swiss company Straumann, which is a fast-healing dental implant. In addition to this implant, there is the option of the ceramic implant, the only zirconia implant available on the market that is titanium-free and more biological, making it an excellent option for those who don’t want to have metals installed in their mouths.

This ceramic dental implant option has been increasingly sought after at Clinica Dentaria Implart by patients who want metal-free implant treatment.

Dental implant surgery can also be performed with intravenous sedation, for those patients who have a phobia of dentists, or even for those looking for extra comfort.

How to do a dental implant procedure

Is it dangerous to have dental implants? Dental implant surgery is a more straightforward procedure than you might think

Dental implant surgery is a safe procedure, and increasingly has more modern resources to make it faster and more comfortable. Here at Clinica Dentaria ImplArt, we have modern systems and expertise.

Here’s a step-by-step guide to the implant procedure:

Step 1 – The procedure consists of making a small incision in the gum in order to expose the bone bed. The dentist needs to have good access to the area in order to install the implant correctly. If the dental implant surgery is performed with a Surgical Guide, it will be a blunt dental implant surgery
Step 2 – Small drills are then used to perforate the bone. The process is carried out in such a way as to progressively expand the cavity so that it can receive the implant of the size selected by the dentist.
Step 3 – The implant is then inserted into the cavity and given a protective cap.
Step 4 – The area is sutured, or in cases of Guided Surgery, the surgery is completed without the need for stitches.

Are you afraid of dental implant surgery?

Find out what resources are available at the ImplArt Dental Clinic so that you can have a very smooth surgery.

Watch the video below explaining how dental implant surgery is performed:

Como é a cirurgia de implante dentário - dente unitário - Clínica em São Paulo - SP

In the classic implant treatment, the pin is surgically fixed into the bone and then the gum is sutured. The site is left to rest for around one to six months, depending on the type of implant used. The implant screw remains inside the bone tissue and must therefore undergo the osseointegration process, protected from chewing forces and food residue.

Shortly after the waiting period, a small cut is made in the gum and then the implant receives a piece called a healer, this process is called reopening. The implant cap can remain exposed in the mouth while the implant heals. Afterwards, the healer is removed without anesthesia (because it is not necessary), and a metal abutment is adapted to receive the prosthesis.

Recovery from dental implant surgery / after dentalimplants?

During the rest period, the patient can use a temporary prosthesis for day-to-day activities. This also helps prevent bone resorption, which would require the use of bone grafts in the future. In some selected cases, the implant can be inserted without cutting, through a small circular opening made in the gum.

This greatly favors the healing of the area as well as patient comfort. Implant surgery should be performed by a dentist specializing in implant dentistry, who certainly has the experience and knowledge in the field to determine the best treatment for each patient. In order to have a good post-operative period, people who undergo this procedure should follow the dentist’s instructions, take care of their oral hygiene and avoid smoking, which can compromise the success of dental implant treatment.

After dental implant treatment, it is always important to carry out cleaning and prophylaxis every 6 months, as a way of looking after the results achieved and monitoring oral health.

Get in touch with us to schedule your appointment or ask any questions you may have. We at the ImplArt Dental Clinic are here to help you!

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Gum grafting to improve the aesthetics of teeth

What is gum grafting?

Gum grafting is used to try and reconstruct an area of the mouth that has suffered from receding or lost gum tissue. Gum recession can occur due, for example, to brushing too hard, gum disease, bruxism or prolonged use of braces. To reduce the effect of the problem, gum grafting is usually indicated.

This is a surgical procedure that consists of removing a piece of mucosa from the patient’s own palate (roof of the mouth) and then placing it over the defect. The material is removed under local anesthesia and the person feels no pain, only slight discomfort.

Update: It is now possible to perform gum grafting without removing gum from the roof of the mouth, using a synthetic material for this purpose.

When healthy, the gums form a protective collar around the tooth. There are two types of gum: the inserted gum, which is a pink, thicker tissue that surrounds the tooth and is adhered to by the bone tissue, and the mucosa (non-inserted gum), a thin, soft and highly mobile tissue that forms the inside of the cheeks and lips. When the gums are unhealthy, we first need to restore their health by removing the bacteria with a periodontal scraping.

Gum defect needs grafting

A gingival defect (receding gums) usually occurs as a result of gum inflammation, caused by a tooth fracture for example. It happens when the gum tissue retracts, almost always due to excessive force when brushing the teeth. The retraction of the gum tissue leaves the tooth root exposed, causing tooth sensitivity and compromising the aesthetics of the teeth. In the case of dental implants, receding gums can expose the base of the implants.

There can also be gum loss due to trauma, accidents or periodontal disease. In these cases, the gums lose their original shape and the aesthetics of the smile can be compromised, especially in the area of the front teeth. In some cases, the placement of dental implants leaves the gums with an inappropriate shape, and this defect can also be corrected with the gum grafting technique.

It is important to note that the gingival grafting procedure does not guarantee success. Even if the procedure is carried out perfectly in terms of technique, there may be tissue necrosis and a consequent loss of the grafted tissue.

After gum surgery

To prevent pain, the patient uses medication (anti-inflammatories) before and after surgery. The dentist can also use “surgical cement”, a protective barrier that is fixed in place where the operation took place. It sticks to the teeth and gums for around five days.

The donor area is not left unprotected after the procedure, as it is sutured (stitched) and this protection helps to maintain its aesthetics and shape, even after a small piece has been removed. Among the main precautions after gum surgery, diet is the most important. The patient should follow the post-surgical recommendations, which are the same as for implant surgery, eating soft, cold food for the first few days to avoid bleeding, infections, and to help with analgesia and healing.

Acidic foods should also be avoided so as not to irritate or sting the gums. As an alternative to gum grafts, prostheses can be made to disguise the aesthetic problem, either with more favorable tooth shapes or with prostheses containing artificial gum. Each case is assessed individually.

If you have any questions about gum grafting, treatments or treatment prices, please contact our team. We at ImplArt Dental Clinic are happy to help you.

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Gum surgery: what is it for?

Gum plastic surgery is an option for people who are dissatisfied with their smile and also with the shape and size of their gums, mainly due to the lack of gums.

Gingival plastic surgery and tooth reshaping with composite resin

When they are very apparent, they influence the harmony of the smile and the self-esteem of some people. Gingivalaesthetics influences the smile through its relationship with the teeth, color and thickness of the gums. With this procedure it is possible to correct gum deformities by removing excesses and reconstructing areas that have little gum using gum grafts. The surgery is simple, performed under local anesthesia and carried out in the dentist’s office.

How is gum grafting done?

In general, gum tissue is taken from another part of the mouth, such as the roof of the mouth or behind the wisdom teeth. However, today it is also possible to use an artificial gum graft, obtained from pig tissue. After the procedure, the patient is instructed on how to perform oral hygiene for the first few days, as well as the medication they should take (usually antibiotics, anti-inflammatories and painkillers).

cirurgia gengival — Caso a estética da gengiva não esteja ideal há recursos que podem ajudar a aumentar ou diminuir seu volume.

They also receive recommendations on diet, especially to avoid eating foods with potential irritant reactions, such as acidic, very salty or spicy foods. The healing period depends on each case, but total internal gum rehabilitation takes place after six months. Many patients resort to this surgery due to gum disharmony, which can be related to excess or lack of gums.

Can the gums grow?

Growth can be caused by the use of medication such as antihypertensive drugs based on alodipine, anticonvulsants based on hydantoin, and fixed braces associated with poor brushing.

Gum recession or retraction is a change in the position of the gums as the root of the tooth becomes longer and more sensitive. This situation can occur due to strong traumatic brushing, malocclusion, when the bite is overloaded on the tooth with recession, bruxism and periodontal disease.

For this type of correction, gingival grafting may be indicated. The tissue used is taken from the mucosa of the roof of the mouth (palate). Surgery is contraindicated for patients with untreated cardiovascular problems, active periodontal disease, blood problems and mouth cancer.

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