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).
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.
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.
For provisional prostheses for total implants. The ImplArt dental clinic takes digital impressions with intraoral scanners (without mass).
Full Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatmentFull Arch implants: 11 stages of treatment
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 thecomputerized 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.
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.
The first image shows the proof of the zirconia structure in the mouth, and the second shows the finished prosthesis with porcelainand a thin layer of artificial gum
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.
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.
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:
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.
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.
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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!
The topic of implantswith 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:
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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