Tag: osso

Full Arch Dental Implants – All-on-4 – All-on-6 – All-on-X

Full Arch Dental Implants is a Full Mouth Reconstruction treatment, that can be done in the mandible (lower arch) and maxilla (upper arch), although there are important anatomical differences that interfere with the planning of dental implant surgery. Fixed prostheses on dental implants can be made of Zirconia, Pure Zirconia, Porcelain(metal-ceramic), as well as Resin.

This treatment is also known as Fixed Full-Arch Prosthesis or Implant-Supported Denture. This type of implant treatment for all teeth, allows patients to regain their smile and chew.

Dental implant surgery is currently a fairly straightforward operation, carried out in an office or hospital environment, with hospitalization for the patient’s comfort. Implants make it possible to replace missing teeth even in large areas of the arch, including in patients with all their teeth compromised by periodontal disease.
They can also be used in patients with bone loss, who may need bone grafting before or during the installation of the dental implant.

It is important to note that there are currently different types of dental implants, and the most modern ones, cone morse implants, allow for faster healing.

*Read more about how dental implants are done: How are dental implants done? How to get a dental implant ?

Full Arch Dental Implants . Implant-Supported Denture step by step

With regard to the end result, the aim is to obtain fixed dental prostheses that will remain supported on the implants. This will allow the patient to regain their masticatory function and aesthetics.

Of course, as Fixed Full-Arch Prosthesis are screwed onto dental implants, the result is a very efficient dental prosthesis for chewing, as well as excellent aesthetics and comfort.

It is therefore a much better solution than a removable prosthesis, as it provides excellent fixation and stability. In the upper arch, the full arch dental implants treatment has the added advantage of completely uncovering the palate (roof of the mouth), which improves patient comfort.

Unlike removable prostheses (dentures), which cover the roof of the mouth to allow them to be fixed and make it difficult to perceive the taste of food, All-on-X prostheses with implants are thin and occupy only the region of the dentition, leaving the rest of the mouth free, similar to the situation found when there are natural teeth. Currently, the most modern materials are the Zirconia Fixed Full-Arch Prosthesis and the Porcelain Prothesis on a Full Arch DentalTreatment.

*Learn more about dental implants All on Four: 8 common mistakes to avoid when getting dental implants All on Four

Fixed Full-Arch Prosthesis- Full Arch Dental Implants

This type of treatment is usually also called a Fixed Full-Arch Prosthesis ou All-on-4, even All-on-6 and All-on-X.

Visit the total implant photo gallery by clicking here

Full Arch Dental Implants .Examinations and planning

After radiographic examinations and a CT scan of the jaws, the dental implant specialist will be able to analyze the ideal planning for the case and thus indicate bone complements such as grafts to better prepare the bone if necessary.

The jaw bone (lower arch) is more rigid and resistant, so dental implants can be installed in most cases. The upper jaw bone, on the other hand, is less dense and delicate and has a more complex anatomy.

Certainly the proximity to the nose, the maxillary sinus cavities and the greater bone loss require further study.

Full Arch Dental Implants With or Without Bone Graft ?

If bone grafting is necessary, don’t be alarmed – it’s very common. Of course, dental grafting for full archa implants is not necessarily complicated, invasive or large. On the contrary, most of the time the bone graft for a full arch implant is simple, small and restricted to the position of the implant.

Less invasive implant surgery: in our clinic we use current concepts of minimally invasive surgery for dental implants, which make the procedure faster and offer greater comfort during the procedure and especially during the healing phase of the dental implant.

Computer-guided implant surgery: this is a type of dental implant surgery offered at our clinic that is planned by computerized scans of the jaws.

For example, computed tomography, in conjunction with a digital mold of the arch (scanner), generates guides for the quick and safe positioning of implants. Click here to learn more about guided surgery for total implants.

Total implant and protocol prosthesis

Full Mouth Reconstruction Prosthesis and other types

Certainly the most common prosthesis for implanting all the teeth in a full arch is the so-called protocol prosthesis. This is a resin prosthesis with a metal reinforcement bar inside.

Over time, however, more modern ways of making complete implant prosthesis have emerged. At the ImplArt Dental Clinic, we offer more technological implant materials, which are completely made on our premises and in our own dental prosthesis laboratory (see more):

Zirconia prosthesis for total implants (metal-free total implants)
Fixed dentures with one tooth at a time
Ceramic protocol – (Porcelain prosthesis)
Prosthesis bars in lighter metals (Titanium bar)
Computerized execution (3D printers)
Rapid dental prostheses (Day Clinic)

If you have any questions, please make an appointment or contact us and make an appointment with our clinical director, Dr. Roberto Markarian, an implant dentist. We will be happy to assist you. The ImplArt Dental Clinic has a modern structure to serve patients and highly specialized professionals.

implantodontista — Full Arch Dental Implants - All-on-4 - All-on-6 - All-on-X

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

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 to 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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Will I lose my dentures during dental bone grafting?

Before answering this question, it is necessary to explain that there are different dental bone grafting techniques, each with its own complexity and extent. This directly influences the guidelines for the post-operative period and recovery time.

Learn all about bone grafting with implants

In most cases it is possible to use a prosthesis while the graft heals

Dental bone grafting to allow the placement of just one implant, where the patient has teeth to be used as support for the prosthesis, is not the same as block grafting to place several implants in a full arch, which is considered more complex.

However, in many cases, it is possible to attach a temporary resin prosthesis, which is suitable for helping the tooth graft recover and heal, as well as allowing the patient not to be without teeth for the duration of the treatment.

After the recovery period, the temporary prosthesis is replaced by a permanent prosthesis made from the material chosen jointly by the patient and the dentist (resin, metal-ceramic or fully esthetic zirconia).

Read about graftless implants

Types of tooth graft

Particulate Graft

Particulate grafting is used in small reconstructions, such as filling in a site where there has been bone loss or in the maxillary sinus lift technique. The biomaterials used in particulate bone grafting are implanted to replace or repair atrophied tissue.

They can be of natural origin (a small amount of crushed human bone from the patient themselves or from a tissue bank for transplants, or freeze-dried bovine bone powder).

The particulate graft can also be made of synthetic material produced in the laboratory, fully biocompatible with osteoconductive properties (attraction of bone tissue-forming cells) or synthetic vitreous materials (synthetic hydroxyapatite).

The particulate dental graft is deposited in situ and then covered with a collagen membrane. In favorable cases, the dental implant can be placed on the same day as the graft, followed by a temporary prosthesis.

Block Grafting

This technique is indicated for more extensive reconstructions. The block-shaped tooth graft can be taken from another part of the patient’s body. When only one block is needed, it can be taken from the mandible.

When more blocks are needed, they can be taken from the pelvis or skullcap. None of the donor sites suffer from bone loss. The blocks are fixed in the jawbone with titanium screws and will thus allow more dental implants to be placed.

The possibility of using a prosthesis in this type of graft is therefore assessed on a case-by-case basis. The ImplArtDental Clinic has extensive experience in dental bone grafting techniques.

If you have any questions, please contact us or book an appointment.

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What are bone grafts?

Bone grafts are techniques to supplement the bone lost in the patient’s jaw. They can be performed simultaneously with the insertion of the dental implant, or require a healing period. Each indication will depend on an analysis of the patient’s case. But rest assured, today’s bone grafting techniques are very modern and painless for the patient. The results are certainly worth it because dental implants are the best solution for restoring missing teeth!

Know everything about dental bone grafts

Bone grafts are used to reconstruct the area that has lost height or thickness

In some cases, it is not possible to place dental implants without first doing bone grafts. People who have lost one or more teeth due to accidents or extractions always think about reconstructing their dental arch in order to smile without embarrassment and for this, dental implant placement is certainly an excellent option.

When people lose their teeth and don’t replace them immediately, they experience bone resorption. As a result, the bone in the area becomes thinner and taller, or has defects in its shape. In the upper jaw, the size of the maxillary sinus can increase, which in principle prevents implants from being placed. In addition, with tooth loss, expressions become limited, the mouth shrivels, chewing becomes difficult and speech can also be altered.

In this way , bone grafting serves to rebuild enough structure to allow the implant to be made, restoring the lost volume to the atrophied bone. For this technique, the dentist can use the patient’s own bone material, taken from the mouth (for small reconstructions) or taken from other sites, such as the hip bone (iliac) and skull cap (for large extensions).

There are different bone grafting techniques, each with its own particularities

In the case of smaller, more common grafts, the bone grafting procedure can be done in the office using local anesthesia. For larger areas, the surgical intervention is performed in a hospital by a larger, multidisciplinary team under general anesthesia. The patient does not lose teeth while the bone graft heals.

It is also possible to use a xenogenous bone graft crystal, when the bone comes from animals (freeze-dried bovine bone – Genox or Bioss), human bone from bone banks (bone transplant) or synthetic vitreous materials (synthetic hydroxyapatite). However, the most easily regenerated material is bone graft taken from the person themselves (autogenous bone).

Types of bone graft materials

The procedure can be carried out in fragments or as a block. Many people are afraid of undergoing a bone graft, but in fact the procedure can be very simple. All the materials are biosecure and undergo strict controls to prevent contamination.

Smaller bone grafts are non-invasive and can be used to supplement the bone around a newly placed implant. However, in people who have lost their teeth many years ago, larger bone grafts may be necessary. ImplArt’s philosophy is to avoid bone grafts and has mastered alternative techniques such as:

Short implants
Implant + simultaneousgraft
All on four” technique for full arches
Inclined implants
Surgeries with surgical ultrasound (piezo)

Bone loss: causes

Bone loss can occur for a number of reasons, but the most common is tooth loss or extraction without immediate replacement. When a person loses their teeth, the body resorbs the bone in the maxilla or mandible because it understands that the bone no longer has a function (which was to provide support for the teeth). This loss is progressive and over the years the person has little bone volume in terms of height and width, which at first makes it difficult to place dental implants.

upper arch bone grafts — What are bone grafts?

Maxillary sinus lift or sinus lift

A sinus lift is a surgical procedure for bone grafting in the posterior region of the upper jaw. The aim is to increase the amount of bone in height so that a longer dental implant can be placed.

When a person loses one or more teeth in the upper arch, there is a loss of bone in height and the maxillary sinus shrinks (fig.1). The procedure is carried out in this way: First, a small opening is made in the gum in the lateral region of the bone defect (fig.2).

A variable amount of bone regeneration precursor material is then placed inside this opening (figs.3,4). The surgery is quick and usually takes no more than 30 minutes with an experienced surgeon. Bone regeneration takes between 4 and 9 months (fig.5), and then the implants are placed (fig.6), but radiographic examinations are carried out beforehand to check the progress of bone regeneration.

Materials used in bone grafts

Nowadays we have a variety of materials that can be used for bone grafts in the maxillary sinus:

Bovine freeze-dried bone – Genox
Autogenous bone (from the person)
Synthetic hydroxyapatite (bone precursor)
Bone bank homologous bone (bone transplant)
Synthetic vitreous materials – Bioss
Grafts with biological stimulators such as fibrin (PRF), platelets (PRP), or bone proteins (BMP)

Studies show that all materials are favorable for this type of graft, depending only on the surgeon’s preference.

enxerto_osseo_antes_e_depois_41kb — Bone Graft Before and after

radiografia_enxerto_osseo_antes_depois_42kb — Bone Graft Before and after – X rays

The ImplArt Clinic has experience in various grafting techniques

Dr. Roberto Markarian, coordinator of Clinica Dentaria ImplArt, is an experienced dental implant specialist with thousands of implants installed. Due to his extensive clinical and surgical experience, he has been able to carry out countless cases of rehabilitation without the need for bone grafting and which had been indicated for grafting by other specialists.

Each case is assessed individually during a consultation. If you have any questions about the price of treatment, values or planning, please contact us or schedule a consultation 📲WhatsApp(11) 3262-4750. Bone grafts are different from gum grafts in terms of techniques and objectives.

Read all about bone and gum grafting

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Planning for dental implants – how is it done by the dentist

How the Dental Implant Procedure is planned

Improve your quality of life and self-esteem with dental implants

Dental implants must be planned by a specialist in order to achieve the desired success. Initially, when studying dental implants, examinations are carried out in order to:

Planning the final aesthetics of the dental prosthesis.
Finding out if there is enough bone for the implant.
Check for diseases that may contraindicate implants.
Estimate whether it will be possible to immediately load the implants (place a fixed provisional).
Plan the sites for inserting the implants, as well as their size (short or normal implants or zygomatic implants), diameter, quantity and inclination.
Ensure that the correct number of implants is placed (between 1 and 8 implants).
Imagining the best strategy for oral rehabilitation in conjunction with the prosthetics laboratory.
Check which materials are best for finishing dental prostheses.
Decide according to the patient’s general health whether the implant procedure will be done in the office or in hospital.
Intraoral examinations to determine current dental conditions. The examinations mainly involve casts to analyze the arch, X-rays and CT scans.
Digital panoramic radiography and computed tomography make it possible to observe general oral conditions and a detailed analysis of the bone and adjacent structures such as nerves, maxillary sinuses and teeth. These examinations can be carried out at ImplArt Odontologia (at a separate cost).

What resources can dentists use to plan implants?

It is important to explain that the dentist uses photos, examinations and clinical assessment in an integrated manner for precise dental implant planning.

Initial Photos: Photos of the mouth and smile at the start of treatment capture the oral anatomy and help to visualize the general condition of the mouth, including the position of adjacent teeth and facial aesthetics.
Radiographic examinations: Panoramic radiographs and CT scans also offer a three-dimensional view, allowing bone quality to be assessed, anatomical structures to be identified and pathologies to be detected.
Clinical Evaluation: Detailed intraoral examinations reveal more in-depth periodontal conditions, the presence of infections and specific characteristics of the oral tissue, providing crucial information for implant success.
Precise measurements: Using specific measurement software, the professional assesses the thickness and height of the available bone, thus ensuring the proper selection of the implant.
Virtual Planning: Specialized software allows for virtual simulations, making it easier to choose the ideal position for the implants, considering aesthetics and function.

The combination of these elements also allows the dentist to carry out personalized planning, increasing the predictability and success of the dental implant procedure.

Planning is important for successful dental implant treatment

Dental implants are performed in the dentist’s office under local anesthesia, with care and attention from the implant dentist. Even those who are afraid of the dentist can have bone implants without any problem. Titanium implants are placed inside the bone and you have to wait three to six months for osseointeraction (calcification of the implant in the bone).

Once healing has taken place, the patient can wear a temporary prosthesis which allows them to better maintain their daily activities and also prevents the process of bone resorption (when the area is left without teeth for a long time, it can lose bone volume). Also during this period, the dentist makes the molds for the fixed dental prosthesis that will be placed after the implants have osseointegrated.

Temporary prosthesis for dental implants – planning

Despite the initial discomfort due to the implants and also the temporary prosthesis, the patient should wear it most of the time to facilitate adaptation. At first, the patient may feel nauseous, produce more saliva than usual and their pronunciation may also be strange. Of course, any discomfort in the meantime is temporary and must be overcome in order to achieve the best possible result.

However, in some cases, the dentist may opt to carry out the immediate loading procedure, in which the temporary prosthesis is fixed immediately after the implants are placed. This takes a maximum of 72 hours and, like all treatments, must be planned in advance to avoid problems in the future.

Read more: Dental implant recovery time

See specific techniques for implanting the front tooth.

dental implant fixed zirconia crowns — Fixed zirconia crowns

porcelain fixed prosthesis dental implant — Fixed zirconia crowns

Permanent fixed prosthesis for implants

Finally, a permanent prosthesis will be fixed a few months after the implants have healed and the person will experience a significant improvement in chewing, quality of life and the aesthetics of their smile. The materials for the permanent prosthesis can also be chosen by the patient together with the dentist.

There are several options for implant materials, especially in the case of full arches, the so-called protocol prosthesis. Contact our clinic or make an appointment if you have any questions about the treatment, average price or techniques. We’ll be happy to help you!

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5 Biggest Risks for Dental Implants

Are there any risks for dental implants? We’ll find out about 5 of them in this article. Dental implants are a more up-to-date, modern and low-risk alternative for tooth replacement than a fixed prosthesis on teeth or a removable prosthesis, the old dentures.

The technique for inserting dental implants is very safe, with an estimated 92% chance of success in non-smoking patients with good health and healthy habits. There are several types of dental implants available today, the most modern of which is the metal-free ceramic implant, an excellent option for those looking for metal-free implant treatment.

The single tooth implant, or total dental implant, is used to replace the root of one or more missing teeth and will serve as a support for an artificial tooth called adental prosthesis or dental crown.

Know more about the risks and dangers of dental implants

Crucial to the success of the procedure is the thorough planning of the implant surgery and the choice of specialist professionals who are qualified to carry out the dental implant surgery. This increases the chance of success of this important treatment, and therefore the chances of any complications are minimal.

So rest assured that you can enjoy all the benefits that this rehabilitative and safe treatment offers patients. The implant-supported prosthesis is made to resemble the person’s other natural teeth and also offer similar chewing strength.

Oral rehabilitation with dental implants is usually the best option for re-establishing the patient’s aesthetic and chewing functions, a treatment called total dental implantation.

But in very few cases, there can be some risks with dental implants. Here are the 5 main risks of dental implants:

1 – Risk of implant breakage

Patients who grind or clench their teeth (bruxism) can exert a lot of force on the implants, with an increased chance of breakage or fracture of the implants or the parts that make up the implant prostheses.

Patients who bruxism also increase the risk of loosening the screws that fix the implant crown. When this happens, the patient reports that the implant is “soft”. However, we mustn’t confuse the prosthesis becoming loose with the implant pin coming loose from the bone (which is much more serious).

Most commonly, when the problem is just the loose implant tooth, the patient feels no pain, while when the implant is lost there is always pain. If the implant fractures or comes loose from the bone, it must be replaced, starting the dental implant process all over again.

Check complete PODCAST about 5 biggest risks for dental implants:

Is it the dentist’s fault that my implant fractured?

There are several factors to consider, some of which would be the material of the prosthesis, the number and positioning of the implants, correct surgical technique, material of the dental implant, type of prosthetic components chosen, type of prosthetic connection chosen.

Assuming that the professionals are working to do their best, it’s rare that there will be any negligence in this regard. What really counts is the willingness of the patient and the professional to start again, perhaps trying to improve or perfect one of the strategies.

riscos do implante dentário — Apresentação das partes do implante dentário: implante (no osso), pilar + coroa dental (dente artificial)

2 – Inflammation in implants and risks

Inflammation can occur in a dental implant, manifesting itself as pain, swelling, pain when chewing, bleeding, and even the formation of pus in the implant. Please note that in any area of medicine where an artificial part is used inside the human body, there can be an adverse reaction of rejection.

This rejection phenomenon can occur in relation to the dental implant or an associated material such as a bone graft or a protective membrane. Bacterial infection can also occur in the implants, which can even prevent bone integration.

one of the risks of dental implants is peri implantitis — The implant on the left in the image has inflammatory bone loss, while the implant on the right has a normal bone level

That’s why all treatments at ImplArt begin with a thorough oral cleaning, as well as the removal of any infectious diseases such as cavities and periodontal disease. The patient will only have implant surgery if their mouth is clean and their oral health is good.

This is possible even if the patient doesn’t have all their teeth yet. When the prostheses on implants are finished, we teach the patient how to properly clean the dental implant. This correct hygiene is very important and certainly contributes to the chances of success of the dental implant.

3 – Risk of facial nerve damage

If the surgery is not well planned, with the use of CT scans and other imaging tests for mapping, damage to the jaw nerve can occur during dental implant surgery. In the area at the back of the mouth in the lower arch, there is a nerve that can be very superficial, especially if the patient has been without teeth for many years.

In patients with advanced periodontal disease, bone loss can also put the nerve at risk due to its proximity. To reduce the risk of nerve damage and paresthesia, the implant dentist will carry out imaging tests. The most commonly requested exam is a panoramic X-ray, but a cone beam CT scan helps to measure the bone and plan the implant.

Computer-guided surgery – reducing risks

To minimize the risks even further, we can perform computer-guided partial or total implant surgery, which offers little invasiveness and allows for perfect positioning of the dental implant, with no room for error.

Crooked or poorly positioned implants can have poor bone integration or even rejection. It is not in all cases that we are able to recover the patient from oral nerve damage or poorly placed implants.

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Depending on the severity of the problem, an injury to the jaw nerve can lead to sequelae such as numbness in the jaw or loss of sensation in the tongue or to the sensation of tastes (gustation).

At the ImplArt dental clinic, 100% of cases are operated on with a CT scan, which can be done in our own radiology center.

4 – Risks in the bone around the implants

Bone loss can occur in an implant that has suffered infection while healing in the bone. In addition, in cases where immediate loading is carried out, i.e. a temporary or permanent tooth is placed in position immediately after surgery, there is a greater risk of bone and implant loss.

This is because the newly placed dental implant does not yet have a mature attachment to the bone and needs to rely exclusively on its mechanical locking into the bone in order to fix itself. Most of the time, if the indication and technique are correct, immediate loading works well.

But in cases of immediate failure, the consequences can be serious, for example leading to major bone loss in the area. There are more advanced dental implant models that have improvements to the fit of the tooth and also in the chemistry of the surface so that healing in the bone occurs faster and more efficiently.

Today we have dental implants that allow you to have a permanent tooth in 1 month! Get to know the dental implant models with the best advances, such as Straumann implants, Neodent cone-morse implants (national), SIN implants (national).

dental implant risks — *Implant shapes and models have to do with clinical indications*

5 – Increase in risk factors – patient health and habits

There are risks to the success of implant treatment that don’t depend on the professional or the materials used, but on patient factors. Failure to clean the teeth,smoking and diabetes increase the chance of problems with the dental implant.

In this article, we only discuss the RISKS in dental implants, however the success rates of dental implants are very high, especially for current implant dentistry techniques performed by a dental implant specialist.

Dental implants are an excellent treatment if they are well indicated, planned and executed.

Come and see our work! The ImplArt Dental Clinic has been dedicated to implant dentistry and oral rehabilitation for 18 years. We are located in São Paulo, Brazil.

DR. ROBERTO MARKARIAN IMPLANTODONTISTA SITE — 5 Biggest Risks for Dental Implants

Text written by DR. ROBERTO MARKARIAN – CRO-SP 73.583 – updated on 26-08-2024
Founder and Director of the ImplArt Dental Clinic – Dr. Roberto’s Linkedin profile

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 Dental Clinic.

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