Implant prosthodontic possibilities of edentulous jaw rehabilitation

Gubitak zubi uvelike smanjuje kvalitetu života. Osim funkcijskog i estetskog nedostatka, pogođen je i psihosocijalni život pojedinca. Konvencionalni nadomjesci, tj. potpuna proteza, često ne mogu zadovoljiti očekivanja pacijenta, stoga implantoprotetika omogućava zadovoljavajuću retenciju, stabilizaciju, funkciju i estetiku. Rehabilitacija potpune bezubosti vrlo je složen postupak te zahtijeva dobru komunikaciju s pacijentom i preispitivanje njegovih želja, zahtjeva i motiva. Na temelju toga, kliničke i rendgenske dijagnostike, donosimo plan terapije. Nadomjesci na implantatima mogu biti fiksni i mobilni. Odabir ovisi o anatomskim uvjetima, stanju tvrdih i mekih tkiva, međučeljusnim odnosima, liniji osmjeha te željama i financijskim mogućnostima pacijenta. Fiksni nadomjestak može biti u obliku mosta koji zamjenjuje samo krune zubi, krune i dio korijena ili zube i meka tkiva. Na implantantnu nadogradnju može biti cementiran ili pričvršćen vijcima. Mobilni nadomjesci razlikuju se po načinu opterećenja, stoga razlikujemo pokrovne proteze potpuno poduprte implantatima i proteze s kombiniranim opterećenjem. Što se tiče oblika same suprastrukture, mogu biti konvencionalne, reducirane i skeletirane. Postoje različiti sustavi retencijskih elemenata čiji odabir ovisi o željenoj krutosti veze, postojećem prostoru, samom pacijentu, ali i doktoru i tehničaru. To su sustavi na kopčanje (kugle, lokatori, SFI sidro), teleskopski sustavi (klasične teleskopske i konusne galvanizirane krunice), prečke (individualne, konfekcijske) i magneti. Na temelju odabrane suprastrukture i CT analize, određujemo broj i mjesto postavljanja implantata. Njihovo opterećenje može biti imedijatno, tj. odmah nakon implantacije, rano, konvencionalno kasno i odgođeno kasno. Za dugoročni uspjeh važno je pratiti pacijenta, procijeniti rizične čimbenike ta ga uključivati u redovite kontrole.Tooth loss greatly diminishes the quality of life. Besides functional and aesthetic deficiency, psychosocial life is affected, too. Conventional substitutes, i.e. full dentures, often cannot meet patient's expectations, therefore implant prosthodontics enables satisfying retention, stabilization, function and aesthetics. Rehabilitation of complete toothlessness is a very complex procedure which demands good communication with patient and reconsideration of his desires, requirements and motives. Based on the previously mentioned, together with clinical and X-ray diagnostics, we create the plan of therapy. Replacements used on implants can be fixed or mobile. The choice depends on anatomic conditions, condition of hard and soft tissues, interarch relationships, smile design, desires and patient’s financial opportunities. Fixed dentures can be shaped in the form of bridge that replaces only teeth crowns, crowns and a part of root or teeth and soft tissues. It can be cemented or screwed to abutment. Ovedentures vary according to the way of encumbrance, therefore we distinguish overdentures completely supported by implants and dentures with combined encumbrance. In regard to the shape of superstructure, it can be conventional and reduced. There are different systems of retention elements. Which one will be chosen depends on desirable firmness of connection, existing space, on the very patient, but also on doctor and technician. These are the following systems: clasping system (balls, locators, SFI anchor), telescope systems (classical telescope and conical galvanized crowns), bars (individual, ready-made) and magnets. Based on the chosen superstructure and CT analysis we define the number and place of putting an implant. Their encumbrance can be immediately after placing the implant, early, later conventional and delayed later. For the long-term success, it is important to monitor the patient, evaluate risk factors and involve patient in regular recal