Historical
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Medical research at the service of your smile.
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It was in 1952 that hope was born following the discovery by a young Swedish researcher, Dr PI Branemark, of the ability of bone to naturally and spontaneously adhere to titanium.
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After thirteen years of in-depth multidisciplinary research, Dr Branemark applied this phenomenon, which he called “osteointegration”, to the dental field.
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His first patient, treated in 1965, received artificial dental roots, or "dental implants", to firmly support a dental prosthesis. For 41 years, until his death, these implants helped this patient to chew effectively and comfortably.
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The thousands of international multidisciplinary research carried out over fifty years on the Brånemark implant system from Nobel Biocare are the foundation of modern implantology. Following Branemark, other groups of researchers also made major contributions to modern implantology.
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Studied for more than fifty years, we now know that titanium is a perfectly bio-compatible material and therefore is now widely used in oral surgery.
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In the background: microscopic view of bone cells bonded to a titanium implant.
Techniques used in the laboratory
Several solutions are available to us to fix teeth on implants
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the sealed prosthesis
the screw-retained prosthesis
the Attached prosthesis
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The screw-retained prosthesis.
It is screwed either directly into the implant or into an intermediate element ("pillar") itself screwed into the implant.
Advantages
Easy and risk-free disassembly: this method of fixing was the majority for a long time at a time when unscrewing was much more frequent than today.
Connection by a machined abutment, precision of the adjustment,
Avoids the risks of sealing: no cement overhangs in the subgingiva, responsible for peri-implantitis.
Insertion, easy controls
Excellent esthetic results of the unitaries in the anterior sectors (if the access shaft is palatal or lingual)
Indicated in the presence of reduced prosthetic space
Disadvantages
Mechanical weakness of the screwing of the prosthetic element in the abutment: less resistance to screw fracture
If the access path is occlusal:
. questionable occlusal morphology;
. risk of interference when adjusting the occlusion, and fracture of the cosmetic element;
. unsightly appearance even if the well is masked by a composite, ceramic shards, wear of the screw head making it difficult or preventing its unscrewing ...
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The sealed prosthesis
The prosthesis is sealed on intermediate elements (“abutments”) which are screwed onto the implants.
Advantages
Aesthetic
Accuracy of connection-abutment adjustment
Respect for occlusal anatomy, easier occlusal balance
Anatomical emergence profile
Large diameter abutment-implant connection screw: resistance to fracture
Simple fabrication of temporary prosthetic elements
Possibility of correcting divergent implant axes
Prosthetic development identical to the prosthesis on natural teeth.
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Disadvantages
Difficult and risky removal: use cements that can be weakened with ultrasound (zinc oxyphosphates)
High risk of leaving excess cement in the subgingival area: their elimination must be complete otherwise there is a risk of peri-implantitis
Need to have sufficient available prosthetic height.
The attached prosthesis
or complete supra-implant adjunct prosthesis - Inamovo-removable or PACSI
Advantages
solve prosthesis mobility problems
find stable occlusal relationships
respond to loss of muscle mass
take skeletal changes into account.
easy cleaning.
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disadvantages
First psychological, it is always a "denture".
Stresses on ball or locator abutment implants, greater than on bar.
Most used implant brands in the laboratory
