Step 1 - Diseño de Sonrisa y Plan de Cirugía

Nuestro Asistente de pacientes lo ayudará a coordinar una cita en la clínica más conveniente. El equipo de diseño de sonrisa tomará las fotografías necesarias para diseñar su sonrisa ideal.

Luego obtendremos un CBCT que nos permitirá realizar un análisis 3D completo de sus dientes y huesos. Junto con el Equipo de Diseño de Sonrisa, revisará, modificará y aprobará el Diseño de Sonrisa.

El equipo de dentistas multidisciplinarios analizará el caso desde todos los puntos de vista y determinará el mejor plan de tratamiento para lograr la sonrisa ideal. Su dentista le explicará todas las opciones de tratamiento recomendables y lo ayudará a decidir cuál es el más conveniente para usted.

Plan de tratamiento y aprobación de presupuesto.

Step 2 - Cirugía navegada o guiada y sonrisa provisional

El cirujano dental realizará cualquiera de estos 2 procedimientos.

  • CIRUGÍA GUIADA. Esto significa que utilizarán dispositivos para guiar la colocación de cada implante, asegurándose de que se coloquen exactamente en la posición que deben.
  • CIRUGÍA NAVEGADA. Es el equivalente a usar un GPS cuando estamos conduciendo. Esta es una nueva tecnología llamada conectar la planificación realizada en la computadora con la boca del paciente en tiempo real. Nos ayuda a tener mayor precisión en nuestra cirugía.

El especialista en estética colocará la sonrisa provisional. Hecho con materiales hermosos y naturales, durará hasta que los implantes estén listos para la prótesis final.

Step 3 - Sonrisa final, bonita y natural.

  • Su dentista revisará sus implantes y confirmará que todo está como se esperaba.
  • Colocación final de la prótesis
  • Ajuste y fotos de postratamiento.

Single Implants + 2 or 3 pieces

When we are missing a single tooth the best option is always a dental implant as we maintain the bone, we do not touch the teeth adjacent to the edentulous area and it is easier to clean than a bridge.

In areas where more than two pieces are missing, two or more implants may be used to replace more than three pieces. Depending on the area to be rehabilitated and the size of the implants, it will be necessary to place more or fewer implants.

Thus, in the anterior (incisor and canine) areas, two implants can be used to rehabilitate three or four teeth, but in the posterior (molar) zones, being the zone of maximum mastication force, a greater number of implants are preferable (For example three implants for four teeth or three implants for three teeth), always taking into account the available length and bone volume.

In areas where more than two pieces are missing, two or more implants can be used to replace more than three pieces.

Oral rehabilitation

They are implant-retained and implant-supported, they do not exert pressure on the gum. It is more comfortable for the patient, although in cases of large resorption it is sometimes valued to perform a removable structure to facilitate hygiene by the patient.

Reh. Metal – Porcelain

This treatment consists of the placement of 6 to 10 implants, both for the upper and lower arches (ALL ON SIX / ALL ON SIX PLUS). In this way, the definitive prosthesis, when possible, will be done in sections to reduce tensions and improve the distribution of forces. This prosthesis will be performed:

  • By system (CAD / CAM) with an internal structure of titanium or zirconium.
  • Made in three sections to avoid possible tensions.
  • Covered all by porcelain, which has the advantage of not dyeing over time, less wear of the prosthesis, greater aesthetics and greater biocompatibility (that is, soft tissues tolerate this material better than resin).
Reh. Metal – Resin structure

This treatment consists of the placement of at least 6 implants on the upper arch and at least 4 on the lower arch (ALL ON FOUR / ALL ON FOUR PLUS)


The prosthesis is made with an internal structure of titanium and with resin teeth. The advantage it has, is that it needs fewer implants. It is more indicated in the mandible than in the upper jaw. As it has pink gum, it is reserved for cases in which the gum is not shown when smiling.

Dentures

It consists of the placement of 2 implants in the jaw or 4 in the upper jaw that serves to retain the resin prosthesis to remove and put on. It is an implant-retained but mucosupported prosthesis, that is still resting on the gum.

Hybrid prosthesis on milled bar

It is also removable but always carries a minimum of 4 implants joined by a milled bar by CAD CAM on which a prosthesis that does not rest on the gum is inserted.

The duration of this treatment is approximately 4 months for the upper jaw and 3 months for the lower jaw. The patient will have teeth from the beginning of the treatment, if possible they will be fixed.

The treatment steps are divided into the following appointments:

    1. Placement of implants and temporary teeth.
    2. Approximately 10 days later the sutures are removed and the temporary teeth are checked.
    3. It is necessary to wait a period of osseointegration of approximately 2 months for the bottom and 4 for the top jaw. After that time, we check the implants and take prints to make a temporary fixed prosthesis. This prosthesis, on the one hand serves to make a progressive loading of the implants and, on the other, to define the aesthetics we want to achieve in the definitive prosthesis (size, shape of teeth and colour). In addition, it is preserved as a “replacement” prosthesis if in the future some repairs need to be done.
    4. The definitive prosthesis will begin to be developed when we are sure that everything is going well. The performance of this prosthesis entails at least 2 tests to verify fit and final aesthetics and one more appointment to place the teeth.

Note: The time to complete the treatment will depend on the patient and the aesthetic needs.

After 6 months of placing the final prosthesis we will carry out a free revision, in which we will check occlusion and we will perform a clean if necessary.

After one year it is recommended another visit to check gums and prostheses, where the mouth will be thoroughly cleaned and x-rays will be taken to control the stability of the bone around the implants. These maintenance visits, for all dental implant patients, should be performed every 6 months to ensure the stability of the treatment and the early detection of possible problems.

Implants for patients with bone loss

What are they? As we have said before, an implant is a prefabricated titanium root, which is placed in the place where there is absence of teeth. It replaces the natural root of the tooth. We consider short implants to those equal to or less than 8 mm.

When are they used? We consider short implants to be those equal to or less than 8mm. We place them in areas where there is a lack of bone. Its use is conditioned to the anatomy of the patient, when due to bone resorption, we cannot place implants of a regular size (10 mm or more). We can, therefore, avoid grafts and possible complications, mainly damage of sensitive anatomical structures (nerves, sinuses, etc. …).

Advantages:

  • Surgical technique of low morbidity 
  • Rapid bone healing as with regular-sized implants.
  • It reduces the time and cost of treatment by avoiding bone grafts.

These implants are longer than usually used in the mouth (about 45-55 mm versus 10-15 mm in conventional ones) and are placed exactly like conventional implants but anchored a little higher, in the Zygomatic bone. It is usually a treatment that is used in patients who have lost or will lose all the teeth of the upper jaw.

When is it advisable to use zygomatic implants?

  • Severe bone resorption of the maxilla.
  • In patients who have not had teeth for many years.
  • Patients who have suffered aggressive periodontal disease.
  • To prevent bone grafts from other donor sites.
  • When recovery and treatment time is important.

There are two types of treatments:

  1. Patient who still has some bone in the front of the maxillary bone: 4 implants are placed in the anterior maxillary area and 2 zygomatic implants in the posterior area.
  2. Patient suffering total resorption of the maxilla superior: 4 zygomatic implants in the posterior area.

This intervention is done with local anesthesia and conscious sedation, with an attending anesthesiologist. The patient is awake and relaxed. A temporary fixed prosthesis is always anchored on the newly placed implants within 24 hours of surgery.

Bone Graft

In some cases, the bone available for implant placement is insufficient, either because it has been a long time since the loss of the teeth or because previous infections in the area have destroyed the bone. In such cases we resort to guided bone regeneration. To do this we resort to xeno grafts with collagen membranes that act as a barrier to allow bone regeneration, or to autografts, taking bone from other areas of the mouth. In this way you can recover part of the lost bone to allow the placement of dental implants.

In these cases the time required for the treatment is extended by a further 6 months compared to the conventional treatment period.

CONTACT US IF YOU HAVE ANY OTHER DOUBTS

FAQ about dental implants

An implant is a prefabricated titanium root, which is placed on the site where there are no teeth. It replaces the natural tooth root.

  1. Dental scanner:

Full-size, three-dimensional image of the patient’s mouth. We measure the lengths, volumes and densities to be able to choose exactly the size of the implant without damaging any anatomical and/or nervous structure. It is essential for a good diagnosis. In Crooke & Laguna we have the latest generation radiological equipment so that the patient does not have to move to another center for these diagnostic tests.

  1. Intraoral and extraoral photographs to study the case in depth to be able to see the prosthetic space and measure the aesthetics that we must achieve.
  1. Model records: for the study of prosthetic space

It’s a simple technique and not painful. Placing 1 or 2 implants is a shorter and less irritating procedure than a filling. However, in the case of patients who are very anxious or who are going to have a more complex rehabilitation, it is possible to have several sedation treatments  so that the patient is totally relaxed during the process.

Usually, the process takes between 30 and 45 minutes, although it depends on the extension of the area to be treated.

By performing the proper maintenance, both at home and in the dental clinic, implants can last forever. However, if a periodontitis or “pyorrhoea” occurs in the teeth, the implants may be affected by peri-implantitis, which can cause the implant to be lost.

Yes, once the treatment is finished, the patient will be able to eat with complete normality.

Anyone can have implants with the exception of those patients who suffer from severe illnesses that lead to a weak immune system, or patients who have been treated for more than 3 years with bisphosphonates (mainly used in patients with menopausal osteoporosis or other diseases ). In these cases it is necessary to carry out further tests.

It can happen for different reasons that we can classify in 3 groups:

  • Factors related to the surgical technique: bad technique, quality of implant, bone cooling.
  • Factors related to the prosthesis: quality of material, fit, occlusion.
  • Factors related to the patient: systemic diseases (diabetes, immunosuppression …), tobacco, and poor hygiene.

It depends, for a single implant 4-6 visits is enough. When it is a full mouth rehabilitation it may require more visits to adjust the function and aesthetics of the mouth perfectly.

To make a fixed bridge, the adjacent teeth must be carved or lowered to the missing tooth area. This, in addition to an unnecessary loss of enamel, poses a risk of damaging the patient’s nerve (and consequently having to perform a root canal). In cases where a large number of dental pieces have been lost, we only have two alternatives: removable prosthesis or implants.

Here, the advantage of implants is clear; in addition to having fixed prosthesis, we get a better masticatory function and a better aesthetic. It is important to point out that when we place implants we favour the maintenance of the bone, however, when we use bridges or removable prostheses that bone gets thinner with time.

Case Studies

Tips when putting on dental implants

It is essential that the professional who places the dental implants is well trained in this field, since the correct three-dimensional placement of the implant is essential, as well as proper handling of the bone and gum surrounding the dental implants. In addition, it is important that the implant brand is supported by scientific studies, passes the relevant controls, and has a properly treated surface to favor implant integration.

If there are problems with gingivitis or periodontitis (pyorrhea), the relevant treatment must be carried out before implant surgery to avoid a transfer of bacteria from the teeth to the dental implants.

The prosthesis that supports the implant must fit perfectly over the implant head, without slots or spaces that favor the entry of bacteria. Likewise, it must be of metals compatible with the implant and with the gum and have a high polish to avoid contamination. Just as not all dressmakers sew the same, not all laboratory technicians reproduce the dental anatomy the same. This influences not only the aesthetics achieved, but also the chewing function and long-term success.

Every patient with dental implants should be checked every 6 months to check that soft tissues are well maintained, that there is no inflammation that can harm dental implants, and periodically check radiographs to check that bone levels are maintained, and if not, act as soon as possible with preventive measures. It is important to know that to clean the implants you need special instruments, Teflon or titanium, that do not scratch the surface of the implant.

If we have unitary dental implants it is easier, it is simply important that after brushing we use dental floss or interproximal brushes. In the case of rehabilitation, it is recommended to use a pressure water irrigator and special silk for bridges.