Four implant treatment of complete edentulism

Terapija bezubosti moţe biti protetska ili implantoprotetska. Implantat je aloplastiĉni biokompatibilni materijal koji se u kosti sidri najĉešće enosealno. Najĉešće se koriste titanski implantati oblika korijena zuba. Prednosti terapije su stimulacija kosti i kvalitetan povrat funkcije i estetike. U vidu implantoprotetske terapije, moţemo se odluĉiti za pokrovnu mobilnu protezu, fiksnu protezu ili most na implantatima. Za uspjeh je nuţno slijediti dijagnostiĉki algoritam, postaviti ispravnu indikaciju te kvalitetno isplanirati i provesti terapiju. Anamnezu i kliniĉki pregled nadopunjujemo radiološkom dijagnostikom (CBCT), fotografijama i gipsanim modelima. All-on-4 je metoda kojom se u jednom danu sanira potpuna bezubost. Atraktivna je pacijentima koji ne mogu duţe vrijeme biti bez zubi, kao i u dentalnom turizmu. Ipak, postoje odreĊena stanja u kojima se preporuĉuje izbjegavati ovaj tip terapije. Prihvatljiva koliĉina kosti je 5 mm širine i 10 mm visine kosti interkaninog podruĉja maksile i 5 mm širine i 8 mm visine kosti mandibule meĊu foramenovima mentale. Prednji se implantati postavljaju paralelno s aksijalnom osi, a straţnji su nagnuti pod kutom od maksimalno 45°. Maksimalan privjesak protetske suprastrukture je jedan ĉlan sa svake strane. Razlikujemo primarnu i sekundarnu stabilnost implantata. Primarna stabilnost za imedijatno opterećenje je minimalno 35 Ncm. U kirurško-protetskom protokolu nuţna je detekcija anatomskih struktura i nivelacija grebena. Za implantaciju se koriste standardizirane ili personalizirane vodilice, u operaciji sa ili bez odizanja reţnja, nakon ĉega se izraĊuju privremena i trajna protetska suprastruktura, u meĊusobnom razmaku od 3 do 6 mjeseci. Modifikacije tehnike ukljuĉuju V4-model, M4-model, bazalne i kratke implantate.Edentulism therapy can be prosthetic or implantoprosthetic. An implant is an alloplastic biocompatible material which is most commonly endosteal anchored. Titanium, root shaped implants are most commonly used. The benefits of implantoprosthetic therapy include bone stimulation and quality restoration of function and aesthetics. In implantoprosthetic therapy, we can opt for an implant supported mobile denture, fixed denture and implant bridge. For it to be successful, it is necessary to follow the diagnostic algorithm, set the appropriate indication and properly plan and perform the therapy. Anamnesis and clinical examination are complemented by radiological diagnostics (CBCT), photographs and plaster models. All-on-4 is a method of repairing complete edentulism in one sitting. It is attractive to patients who cannot be without teeth for a long time, as well as in dental tourism. However, there are certain conditions when it is recommended to avoid this type of therapy. Acceptable bone tissue size is 5 mm wide and 10 mm high intercanine area bone of the maxilla, and 5 mm wide and 8 mm high mandible bone among the foramina mentalia. The anterior implants are placed parallel to the axis and the posterior ones are angled at a maximum of 45°. The maximum prosthetic supra-structure cantilever is one member on each side. We distinguish between primary and secondary implant stability. The primary stability for the immediate load is a minimum of 35 Ncm. In the surgical prosthetic protocol, the detection of anatomical structures and ridge alignment is necessary. For implantation, standardized or personalized guides are used, with or without lobe surgery, after which temporary and permanent prosthetic supra-structures are made in the intervals of 3 to 6 months. Technique modifications include the V4-model, M4-model, basal and short implants