RU-2861535-C1 - METHOD FOR DENTAL IMPLANTATION OF UPPER JAW WITH PALATAL EXPOSURE OF IMPLANT THREADS IN BOUNDED AND FREE-END EDENTULOUS SPACES WITH LATERAL ATROPHY OF ALVEOLAR PROCESS

RU2861535C1RU 2861535 C1RU2861535 C1RU 2861535C1RU-2861535-C1

Abstract

FIELD: medicine. SUBSTANCE: invention relates to surgical dentistry, maxillofacial surgery, and can be used for replacing missing teeth in the form of bounded and free-end edentulous spaces with moderate atrophy of the alveolar process by installing dental implants with palatal exposure (buccal bone shield) with implants having a milled and anodised neck. Cone-beam computed tomography is performed. The thickness and height of the alveolar process are determined, and in accordance with the result obtained, the implant is selected by diameter and height, and the location for implant installation in the alveolar process is determined. An bone-mounted surgical template is made. Then, anaesthesia is administered, and an incision is made along the crest of the alveolar process with a buccal shift. The mucoperiosteal flap is reflected, providing access to the upper jaw. After that, the previously made bone-mounted navigation surgical template is applied, and beds for the implants are formed, while preserving the cortical plate of the coronal part of the alveolar process as a buccal shield. Then, dental implants with a milled and anodised neck are installed, leaving the threads of the implants on the palatal side uncovered by bone tissue. When a torque of more than 35 N/cm is reached, multi-unit abutments and healing caps are placed on the implants. The mucoperiosteal flap at the exit sites of the multi-unit abutments is sutured, and provisional prostheses are fixed. After that, digital impressions are taken for the manufacture of a provisional prosthetic structure. After 3-6 months, permanent prosthetic structures are manufactured and fixed. If necessary, for passive seating of the multi-unit abutment, a circular reduction of the cortical bone around the multi-unit abutment is performed. EFFECT: method, by installing dental implants with a milled and anodised neck in the alveolar process of the upper jaw with exposure of the threads on the palate side and creating a buccal bone shield in the area of missing teeth, makes it possible to increase the efficiency of implantation and subsequent prosthetics, shorten the duration of complex treatment, and minimise trauma during the operation. 2 cl, 7 dwg, 1 ex

Inventors

Ushnitskii Innokentii Dmitrievich
SEMENOV ALEKSANDR DMITRIEVICH
Unusian Onik Sarkisovich
Ivanov Andrian Vladimirovich

Dates

Publication Date: 20260505
Application Date: 20251016

Claims (2)

1. A method of dental implantation of the upper jaw with palatal exposure of the implant coils with included and terminal defects of the dentition and lateral atrophy of the alveolar process, which consists in the fact that a cone-beam computed tomography is carried out, the thickness and height of the alveolar process are determined and, in accordance with the result obtained, an implant is selected by diameter and height and the place of installation of the implant in the alveolar process is determined, an external surgical template is made, then anesthesia is carried out and an incision is made along the crest of the alveolar process with a vestibular displacement, the mucoperiosteal flap is peeled off, providing access to the upper jaw, after which a previously made external navigation surgical template is applied and a bed for the implants is formed, while leaving the cortical plate of the coronal part of the alveolar process as a vestibular shield, then dental implants are installed implants with a milled and anodized neck, while leaving the implant coils on the palatal side uncovered by bone tissue, upon reaching a torque of more than 35 N/cm, multi-unit superstructures and healing caps are installed on the implants, the mucoperiosteal flap at the site of the multi-unit exits is sutured and provisional structures are fixed, after which digital impressions are taken to manufacture a provisional orthopedic structure, after 3-6 months, permanent orthopedic structures are manufactured and fixed.
2. The method of dental implantation according to paragraph 1, characterized in that, if necessary, for passive seating of the multi-unit, a circular reduction of the cortical bone around the multi-unit is performed.

Description

The invention relates to the field of medicine, namely to surgical dentistry, maxillofacial surgery, and can be used to replace missing teeth in lateral atrophy of the alveolar process by installing dental implants with palatal exposure with implants with a milled and anodized neck in the area of the absence of several teeth in the form of included and terminal defects of the dental arches on the upper jaw. A known method of dental implantation is used in cases of significant horizontal resorption of the alveolar processes, which consists of resection of the ridge to a level of sufficient thickness of the alveolar processes (Paraskevich V.L. Dental implantology: Fundamentals of theory and practice. - 2nd ed. - M .: OOO "Medical information agency", 2006. - p. 259). It is performed by incision of the mucosa and periosteum, detachment of the mucoperiosteal flap and exposure of the crest of the alveolar process, grinding the ridge to a level where the thickness of the bone will allow implantation, using a Lindemann cutter or fissure bur, further preparation of the bone bed for the implant. The disadvantage of this method is its invasiveness, deterioration of aesthetic parameters at the orthopedic stage due to a decrease in the height of the bone and gums, as well as lengthening of the clinical crown, which leads to a narrowing of the indications for its use. A method of dental implantation is known (see patent No. 2416376 dated 20.04.2011), including detachment of the mucoperiosteal flap, installation of the implant, after installation of the implant, its packing with an alloimplant, covering the alloimplant with a film of biomaterial, suturing the wound and after 3-6 months installation of the supraradicular part of the implant, characterized in that with significant atrophy of the bone tissue of the alveolar process and the proximity of the mandibular canal or maxillary sinuses, respectively, a horizontal incision of the mucous membrane is made from the vestibular side slightly below the transitional fold and two vertical incisions through the crest of the alveolar process, the mucoperiosteal flap is peeled off and thrown back until the bone tissue is exposed, a pre-prepared surgical template is fixed, which determines the direction of drilling at the planned site, using Using burs, drills, and taps, bone beds are created whose depth does not reach the bottom of the maxillary sinus or the vascular-nerve bundle of the mandible by 2 mm, implants are inserted into the bone beds without completely immersing the intraosseous part of the implant into the bone tissue, decortication of the surface of the alveolar process and perforation of the bone plate are performed, sequentially placing on this area autoplasma enriched with platelets in the form of a gel, a superficially demineralized bone alloimplant in the form of a plate or bone block, in which holes are created using a surgical template, and a membrane for directed bone regeneration from preserved dura mater or amnion or tendon or demineralized bone tissue saturated with antimicrobial drugs that cause suppression of the growth of aerobic and anaerobic microflora. The disadvantages of this solution include the technical complexity and the need for bone substitutes and barrier membranes, which may lead to some inflammatory reactions after the procedure. Platelet-rich plasma (PRP) film does not possess the necessary mechanical and biological properties and does not last long, so it cannot serve as a barrier to infection. Another known method for reconstructing a damaged tooth socket wall is using a bone autograft taken from the maxillary tuberosity, followed by direct dental implantation and temporary restoration (Carlos Martine da Rosa DDS et al., International Journal of Periodontology and Restorative Dentistry, Moscow, 2014, pp. 59-68). The method involves extracting the tooth under local anesthesia as minimally as possible, curettage, and placing the implant in an optimal spatial position. A temporary crown is then fitted and optimized. Following this, under local anesthesia, an incision is made in the donor area (maxillary tuberosity) along the midline of the tuberosity crest to the distal surface of the last molar, a mucoperiosteal flap is created, and the bone crest is visualized. Using a 2 mm wide bone chisel, a bone graft is harvested and carefully placed into the defect, thus creating a normal ridge contour. The graft is positioned 2 mm below the gingival margin. The remaining space between the bone block and the implant is filled with cancellous bone chips. A temporary crown is then secured to the implant, and the wound is sutured. The second surgical site remaining after the graft is harvested is sutured closed. A disadvantage of this method is recession of the marginal gingiva and underlying bone tissue, especially in patients with a thin mucosal biotype and the absence of attached keratinized gingiva. Another disadvantage is the need for a second s