RU-2861640-C1 - METHOD FOR DENTAL IMPLANTATION

Abstract

FIELD: medicine; surgical dentistry. SUBSTANCE: invention can be used in dental implantation. Before surgery, a stereolithographic model of a blank for an individual gingival former is obtained using cone-beam computed tomography with measurements in the mesio-distal, vestibulo-oral and apico-coronal directions and dental software for working with 3D volumetric objects. Then this blank is printed on a 3D printer. During surgery, after implant placement, this blank is placed in the surgical area 4 mm coronally from the implant platform, a temporary abutment is fixed to the implant to the blank of the individual gingival former using a fluid dental composite material. The resulting structure is then removed from the implant and its shape is refined using the fluid dental composite material and then polished. After that, the finished individual gingival former is finally fixed to the implant. EFFECT: increasing the efficiency of implantological treatment, improving the implant emergence profile and the final aesthetic and biological treatment results due to directed healing of peri-implant soft tissues. 1 cl, 11 dwg, 1 ex

Inventors

• Maksyukov Dmitrij Stanislavovich
• Glushkov Daniil Sergeevich
• Maksyukov Stanislav Yurevich

Dates

Publication Date

20260506

Application Date

20250513

Claims (1)

1. A method of dental implantation, which consists in the fact that before the operation a stereolithographic model of the individual gingival cuff former blank is obtained using cone-beam computed tomography with measurements in the mesiodistal, vestibulo-oral and apical-coronal directions and dental programs for working with volumetric 3D objects, then this blank is printed on a 3D printer, during the operation after the installation of the implant, this blank is placed in the operating area 4 mm coronal to the implant platform, a temporary abutment is fixed to the individual gingival cuff former blank in the implant using a flowable dental composite material, then the resulting structure is removed from the implant, its shape is finalized using a flowable dental composite material and then polished, after which the finished individual gingival cuff former is finally fixed to the implant.

Description

The invention relates to medicine, in particular to surgical dentistry, and can be used in delayed and immediate dental implantation. For successful implant treatment, it is crucial to understand the importance of proper design and formation of the emergence profile of the permanent restoration (crown) on the implant. We can control tissue healing around the implant by adapting prosthetic elements such as gingival cuff formers (GCFs), temporary and permanent abutments (see Bertolini Mde M, Kempen J, Lourenco EJ, Telles Dde M. The use of CAD/CAM technology to fabricate a custom ceramic implant abutment: a clinical report. J Prosthet Dent. 2014; 111: 362-366). The use of such approaches allows us to plan the tissue healing process, making it more predictable and contributing to the achievement of better esthetic and functional results. To achieve the best possible match to the natural appearance, it is necessary to take into account the anatomy of the teeth and surrounding tissues as much as possible. The use of standard, prefabricated gingival formers can be an unpredictable method, as in most cases it leads to less satisfactory biological and esthetic results (see Ruales-Carrera E., Pauletto P., Apaza-Bedoya K., Volpato S.A. M., Ozcan M., Benfatti S.A. M. Peri-implant tissue management after immediate implant placement using a customized healing abutment. J Esthet Restor Dent. 2019; 31(6): 533-541. doi: 10.1111/jerd.l2512; see Perez A., Caiazzo A., Valente N., A„ Toti P., Alfonsi F., Barone A. Standard vs customized healing abutments with simultaneous bone grafting for tissue changes around immediate implants. 1-year outcomes from a randomized clinical trial. Clin Implant Dent Relat Res. 2020; 22(1): 42-53. doi: 10.111l/cid.12871. Epub 2019 Dec 3). A pressing issue in surgical dentistry today when performing dental implants is the maximum preservation or restoration of hard and soft tissue around the implant to achieve an aesthetic result. Prolonged absence of chewing pressure on the alveolar process of the maxilla and the alveolar part of the mandible leads to bone atrophy, which, in turn, complicates or even makes subsequent implant placement and prosthetic restorations impossible. The sooner endosseous dental implants are placed and orthopedic structures are fabricated to restore chewing function, the less significant the jaw bone atrophy will be. In the article "Peri-implant tissue management after immediate implant placement using a customized healing abutment" (see Edwin Ruales-Carrera, Patricia Pauletto, Karin Apaza-Bedoya, Claudia A M Volpato, Mutlu Ozcan, Cesar A M Benfatti. J Esthet Restor Dent. 2019 Nov; 31(6):533-541), the authors describe a simplified approach to using customized healing abutments (iCHAs) for immediate implant placement after tooth extraction in the anterior and posterior regions of the jaws to preserve soft tissue contours and reduce the number of clinical steps before placement of definitive restorations. According to them, this technique is effective for soft tissue healing around dental implants, providing a natural profile during implant-supported restorations and reducing the number of treatment steps. However, the method described by the authors excludes the use of computer technology, which increases the intraoperative time for the production of iFDM and does not take into account the collapse of soft tissues that occurs immediately after tooth extraction. In the work “Customized CAD/CAM healing abutment for delayed loaded implants” (see Alshhrani W. ML, Al Amri M. D. Customized CAD/CAM healing abutment for delayed loaded implants. Journal of Prosthetic Dentistry. 2016; 116(2): doi: 10.1016/j.prosdent.2016.01.0242016) the authors point out that when using conventional factory-made FDM for healing, the profile of the surrounding soft tissues may be unfavorable at the time of the orthopedic part of the implantological treatment, which requires additional and labor-intensive correction with the help of temporary restorations (crowns), therefore they present a technique for manufacturing iFDM for healing using computer modeling and computer-aided manufacturing (CAD-CAM) for an implant with delayed loading installed in the area of the missing first premolar of the upper jaw on the right. A surgical template was fabricated, which was used to take a final impression. The impression was digitized using a scanner, and the iFDM was developed digitally using computer software. According to the authors, this technique ensures guided implant placement and predicts optimal soft tissue contours, which improve the implant's appearance. However, the iFDM fabrication method described by the authors does not allow for implant placement without the aid of a surgical template and does not account for errors that occur during implant bed formation and placement, making the outcome of this treatment less predictable. A method for delayed dental implantation is known from patent sources, in wh