Prosthodontically driven implant therapy

Mogućnost nadomještanja nedostatnih zubi dentalnim implantatima iz korijena je promijenila oralnu rehabilitaciju te istovremeno unaprijedila dentalnu medicinu. U prošlosti su položaj, dubina i nagib dentalnih implantata određivani preostalim volumenom kosti. Težnja za predviđanjem i doživljajem protetskog rada, posebice u fiksnoj protetici, dovela je do razvoja novog koncepta zvanog protetski vođena implantoprotetska terapija. Koncept utvrđuje točan položaj dentalnog implantata koji je u skladu s planiranim završnim protetskim radom. Analiziranjem okluzalnog stanja određuje se idealan položaj implantata koji je usklađen s postojećom habitualnom okluzijom, statičkim i funkcionalnim odnosima. Reprodukcija položaja, dubine i nagiba kako je planirano predstavlja kliničaru najveći izazov. Pomoću kirurškog predloška prikupljene informacije o idealnom položaju implantata prenose se na operacijsko mjesto u usnoj šupljini. Uz konvencionalno postavljanje dentalnih implantata koje ne osigurava uvijek idealnu reprodukciju položaja implantata, postoji računalno vođeno postavljanje implantata. Ono zahtijeva primjenu trodimenzionalnog interaktivnog softvera. Softver omogućuje planiranje najboljeg mogućeg smještaja implantata s obzirom na budući protetski rad, anatomske i morfološke značajke kosti i mekih tkiva.The possibility of replacing insufficient teeth with dental implants has radically changed oral rehabilitation and simultaneously improved dental medicine. In the past, the position, depth, and inclination of dental implants was determined by the remaining bone volume. The desire to predict and perfect prosthetic work, especially in fixed prosthetics, has led to the development of a new concept called prosthetically guided implantology. The concept determines the exact position of the dental implant in accordance with the pre-planned prosthetic work. By analyzing the occlusal condition, the ideal position of the implant is determined, which is in line with the existing occlusion, static and functional relationships. Reproduction of position, depth and inclination as planned is the greatest challenge for the clinician. Using a surgical template, the collected information on the ideal position of the implant is transferred to the operative site in the oral cavity. In addition to the conventional dental implant placement, which does not always ensure the ideal reproduction of the implant position, there is a computer-guided implant placement. It requires the application of three-dimensional interactive software. The software allows for choosing the best possible placement of implants regarding future prosthetic work, anatomical and morphological features of bone and soft tissues