MD595Z - Method for early placement of dental implants in a single surgical technique - Google Patents

Method for early placement of dental implants in a single surgical technique Download PDF

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MD595Z
MD595Z MDS20120103A MDS20120103A MD595Z MD 595 Z MD595 Z MD 595Z MD S20120103 A MDS20120103 A MD S20120103A MD S20120103 A MDS20120103 A MD S20120103A MD 595 Z MD595 Z MD 595Z
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implant
alveolus
gum
dental
absence
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MDS20120103A
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Romanian (ro)
Russian (ru)
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Валентин ТОПАЛО
Николае КЕЛЕ
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Валентин ТОПАЛО
Николае КЕЛЕ
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Abstract

The invention relates to dentistry, particularly to dental implantology and can be used for early placement of dental implants in a single surgical technique.According to the invention, the method is carried out in a single surgical technique, which consists in the fact that are extracted the affected teeth, in 4…8 weeks after complete healing of the gum is carried out the orthopantogram, then with a graduated dental cutter is penetrated without revolutions through the gum and alveolus contents, with dental cutters of different sizes is prepared the implant socket so that the diameter of the last cutter may be 1.0…1.5 mm smaller than the diameter of the implant, it is determined the depth of the socket, the determined size is compared with the orthopantogram data, based on the obtained data is chosen a screw-type implant, the implant, in case of absence of single rooted teeth, is placed in the center of the alveolus, in the absence of lower molars, is placed in the posterior jaw alveolus and in the absence of upper molars - in the palatal alveolus, the implant is placed by means of a dynamometric key with a force of 45…55 N/cm so that it may 2…3 mm tower above the gum, after which in the implant cavity with a syringe are introduced 0.1…0.3 ml of Levomekol ointment and is screwed a gum former, then during 5…7 days for prophylactic purpose is administered an anti-inflammatory therapy and is complied with the oral cavity antiseptic regimen.

Description

Invenţia se referă la stomatologie, în special la implantologia dentară şi poate fi utilizată pentru instalarea timpurie a implantelor dentare într-un timp chirurgical. The invention relates to dentistry, in particular to dental implantology and can be used for early installation of dental implants in a surgical time.

Este cunoscută instalarea implantelor dentare endoosoase într-un timp chirurgical, care prevede extragerea dinţilor afectaţi, peste 6…12 luni după extracţia dentară, după vindecarea definitivă a gingiei supraalveolare, se efectuează decolarea lambourilor mucoperiostale şi înlăturarea din alveolă a ţesutului de granulaţie, apoi se instalează implantul, iar în spaţiul dintre peretele alveolei şi implant se introduc grefe pentru fixarea implantului. Apoi lambourile mucoperiostale se suturează. După care timp de 5…7 zile se administrează profilactic o terapie antiinflamatorie şi se respectă un regim antiseptic al cavităţii bucale [1]. It is known that endosseous dental implants are installed during a surgical procedure, which involves the extraction of the affected teeth. After 6-12 months after tooth extraction, after the supraalveolar gum has completely healed, the mucoperiosteal flaps are lifted and the granulation tissue is removed from the alveolus. Then the implant is installed, and grafts are inserted into the space between the alveolus wall and the implant to fix the implant. Then the mucoperiosteal flaps are sutured. After that, for 5-7 days, an anti-inflammatory therapy is administered prophylactically and an antiseptic regimen of the oral cavity is observed [1].

Dezavantajele metodei menţionate constau în aceea că tratamentul protetic poate fi iniţiat nu mai devreme de 6…12 luni după extracţia dinţilor. În această perioadă de timp pacienţii au un disconfort funcţional şi estetic, fapt ce a impus efectuarea cercetărilor pentru a scurta acest termen, cu obţinerea unei rate înalte de succes. Totodată este traumatică (decolarea lambourilor mucoperiostale), deoarece se efectuează înlăturarea prin chiuretare a conţinutului alveolei aflate în fază de vindecare, ceea ce duce la o reabilitare mai târzie a pacienţilor. The disadvantages of the mentioned method are that prosthetic treatment can be initiated no earlier than 6…12 months after tooth extraction. During this period of time, patients experience functional and aesthetic discomfort, which has necessitated research to shorten this period, achieving a high success rate. At the same time, it is traumatic (detachment of mucoperiosteal flaps), because the contents of the healing alveolus are removed by curettage, which leads to a later rehabilitation of patients.

Problema pe care o rezolvă invenţia propusă constă în optimizarea reabilitării protetice a edentaţiilor prin elaborarea unei metode miniinvazive de instalare timpurie a implantelor dentare endoosoase pentru înlăturarea dezavantajelor menţionate, minimalizarea traumatizării pacientului şi evitarea complicaţiilor postoperatorii caracteristice metodelor cu prepararea lambourilor mucoperiostale şi totodată micşorarea timpului de reabilitare. The problem solved by the proposed invention consists in optimizing the prosthetic rehabilitation of edentulous teeth by developing a minimally invasive method for early installation of endosseous dental implants to eliminate the aforementioned disadvantages, minimize patient trauma and avoid postoperative complications characteristic of methods with mucoperiosteal flap preparation, while also reducing rehabilitation time.

Conform invenţiei revendicate, metoda se efectuează într-un timp chirurgical, care constă în aceea că se extrag dinţii afectaţi, peste 4…8 săptămâni după vindecarea completă a gingiei se efectuează ortopantograma, apoi cu freza dentară gradată se penetrează fără turaţii gingia şi conţinutul alveolei. Cu freze dentare de diferite dimensiuni se prepară locaşul implantului în aşa fel ca diametrul ultimei freze să fie cu 1,0…1,5 mm mai mic decât diametrul implantului. Se determină adâncimea locaşului, mărimea determinată se compară cu datele de pe ortopantogramă, în baza datelor obţinute se selectează un implant de tip şurub. Implantul, în cazul absenţei dinţilor monoradiculari, se inserează în centrul alveolei, în absenţa dinţilor molari inferiori se inserează în alveola posterioară a mandibulei şi în absenţa dinţilor molari superiori - în alveola palatină. Implantul se instalează cu ajutorul unei chei dinamometrice cu o forţă de 45…55 N/cm în aşa fel ca el să depăşească nivelul gingiei cu 2…3 mm, după care în cavitatea implantului cu o seringă se introduc 0,1…0,3 ml unguent Levomicol şi se înşurubează un conformator de gingie. Apoi timp de 5…7 zile în scop profilactic se administrează o terapie antiinflamatoare şi se respectă regimul antiseptic al cavităţii bucale. According to the claimed invention, the method is performed in a surgical time, which consists in extracting the affected teeth, after 4…8 weeks after the complete healing of the gums, an orthopantogram is performed, then with a graduated dental bur the gums and the contents of the alveolus are penetrated without revolutions. With dental burs of different sizes, the implant socket is prepared in such a way that the diameter of the last bur is 1.0…1.5 mm smaller than the diameter of the implant. The depth of the socket is determined, the determined size is compared with the data on the orthopantogram, based on the obtained data, a screw-type implant is selected. The implant, in the absence of monoradicular teeth, is inserted in the center of the alveolus, in the absence of lower molar teeth it is inserted in the posterior alveolus of the mandible and in the absence of upper molar teeth - in the palatine alveolus. The implant is installed using a torque wrench with a force of 45…55 N/cm so that it exceeds the gum level by 2…3 mm, after which 0.1…0.3 ml of Levomicol ointment is injected into the implant cavity with a syringe and a gum conformer is screwed in. Then, for 5…7 days, anti-inflammatory therapy is administered for prophylactic purposes and the antiseptic regimen of the oral cavity is observed.

Rezultatul invenţiei constă în optimizarea reabilitării protetice a edentaţiilor prin elaborarea unei metode miniinvazive de instalare timpurie a implantelor dentare endoosoase, minimalizarea traumatizării pacientului şi evitarea complicaţiilor postoperatorii, micşorarea timpului de reabilitare şi reducerea disconfortului funcţional şi estetic al pacientului. The result of the invention consists in optimizing the prosthetic rehabilitation of edentulous teeth by developing a minimally invasive method for early installation of endosseous dental implants, minimizing patient trauma and avoiding postoperative complications, shortening rehabilitation time and reducing the patient's functional and aesthetic discomfort.

Avantajele metodei propuse constau în aceea că gingia deasupra alveolei este vindecată, este redus riscul de infectare, este redusă perioada tratamentului, ceea ce reduce disconfortul funcţional şi estetic al pacientului. Prin instalarea timpurie a implantelor este posibilă o reabilitare implanto-protetică a pacienţilor mai devreme cu 4…8 luni. În dependenţă de timpul după extracţia dentară au fost propuse unele clasificări ale instalării implantelor. Wilson T. şi Weber H. Calssification of and therapy for areas of deficient bony housing prior to dental implant placement. Int. J. Periodontics Restorative Dent. 1993, vol. 13, p. 451-459 au utilizat termenii imediat, recent, amânat şi matur pentru a menţiona timpul plasării implantelor în relaţie cu vindecarea ţesuturilor moi, factor important în procedeele de ghidare a regenerării osului. Mayfield L. Immediate. Delayed and late submerged and transmucosal implants. In. Lindhe J. Proceedings of the 3rd European Workshop on Periodontology: Implant Dentistry.Berlin:Quintessenz, 1999, p. 520-534 a folosit termenii imediat, amânat şi târziu pentru a menţiona intervalul de timp de 0 săptămâni, 6..10 săptămâni şi ≥ 6 luni respectiv după extracţia dentară. Intervalul dintre 10 săptămâni şi 6 luni de către autor a fost omis. The advantages of the proposed method are that the gum above the alveolus is healed, the risk of infection is reduced, the treatment period is shortened, which reduces the functional and aesthetic discomfort of the patient. Early installation of implants makes it possible to perform implant-prosthetic rehabilitation of patients 4…8 months earlier. Depending on the time after tooth extraction, some classifications of implant placement have been proposed. Wilson T. and Weber H. Classification of and therapy for areas of deficient bony housing prior to dental implant placement. Int. J. Periodontics Restorative Dent. 1993, vol. 13, p. 451-459 used the terms immediate, recent, delayed and mature to mention the time of implant placement in relation to soft tissue healing, an important factor in procedures for guiding bone regeneration. Mayfield L. Immediate. Delayed and late submerged and transmucosal implants. In. Lindhe J. Proceedings of the 3rd European Workshop on Periodontology: Implant Dentistry. Berlin: Quintessenz, 1999, p. 520-534 used the terms immediate, delayed and late to refer to the time interval of 0 weeks, 6..10 weeks and ≥ 6 months respectively after tooth extraction. The interval between 10 weeks and 6 months was omitted by the author.

În majoritatea studiilor prin expresia „instalare imediată” se subînţelege că instalarea implantului are loc în acelaşi timp cu extracţia dentară. Schropp L., Kostopoulos L., Wenzel A. Bone healing folowing immediate versus delayed placement of titanium implants into extraction sockets: A prospective clinical study. Int. J. Oral Maxillofac Implants. 2003, vol. 182, p. 189-199, sub acest termen au în vedere instalarea implantelor în intervalul dintre 3 şi 15 zile după extracţia dintelui, iar Gomez-Roman G., Schulte W., d′Hoedt B. et al. The Frialit-2 implant system: Five-year clinical experience in single-tooth and immediately postextraction applications. Int. J. Oral Maxillofac Implants. 1997, vol. 12, p. 299-309 - între 0 şi 7 zile. Prin expresia „instalare amânată” (delayed placement) în multe studii implantele au fost instalate în perioada între 4 şi 8 săptămâni după extracţia dentară. În alte publicaţii acest termen este egal cu 8…14 săptămâni (Hammerle C., Lang N. Single-stage surgery combining transmucosal implant placement with guided bone regenartion and bioresorbable materials. Clin Oral Implants res. 2001, vol. 12, p. 9-18), 6 săptămâni - 6 luni (Zitzmann N., Naef R., Scharer P. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int. J. Oral Maxillofac Implants. 1997, vol. 12, p. 844-852), 1 săptămână - 9 luni (Gomez-Roman G., Schulte W., d′Hoedt B. et al. The Frialit-2 implant system: Five-year clinical experience in single-tooth and immediately postextraction applications. Int. J. Oral Maxillofac Implants. 1997, vol. 12, p. 299-309) după extracţie. In most studies, the expression “immediate installation” implies that the implant installation takes place at the same time as the tooth extraction. Schropp L., Kostopoulos L., Wenzel A. Bone healing following immediate versus delayed placement of titanium implants into extraction sockets: A prospective clinical study. Int. J. Oral Maxillofac Implants. 2003, vol. 182, p. 189-199, under this term they consider the installation of implants in the interval between 3 and 15 days after tooth extraction, and Gomez-Roman G., Schulte W., d′Hoedt B. et al. The Frialit-2 implant system: Five-year clinical experience in single-tooth and immediately postextraction applications. Int. J. Oral Maxillofac Implants. 1997, vol. 12, p. 299-309 - between 0 and 7 days. By the expression "delayed placement" in many studies, implants were installed between 4 and 8 weeks after tooth extraction. In other publications this term is equal to 8…14 weeks (Hammerle C., Lang N. Single-stage surgery combining transmucosal implant placement with guided bone regeneration and bioresorbable materials. Clin Oral Implants res. 2001, vol. 12, p. 9-18), 6 weeks - 6 months (Zitzmann N., Naef R., Scharer P. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int. J. Oral Maxillofac Implants. 1997, vol. 12, p. 844-852), 1 week - 9 months (Gomez-Roman G., Schulte W., d′Hoedt B. et al. The Frialit-2 implant system: Five-year clinical experience in single-tooth and immediately postextraction applications. Int. J. Oral Maxillofac Implants. 1997, vol. 12, p. 299-309) after extraction.

Pentru unificarea acestor termeni grupul de cercetători ştiinţifici „ITI” la a treia Conferinţă de Consensus în august 2003 (Gstaad, Elveţia) a definit termenii de instalare a implantelor după extracţia dentară. În baza acestor definiţii a fost evaluată vindecarea plăgii postextracţionale, specificată în următoarea lucrare: Hammerle C., Chen S., Wilson T. Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. Int. J. Oral Maxillofac Implants. 2004; 19(suppl): 26-28. Viabilitatea şi valoarea practică ale acestei definiţii au fost confirmate peste 4 ani, la a IV-a Conferinţă de Consensus, care a avut loc în 2007 (Ştudgard, Germania), Chen S., Beagle J., Jensen S. et al. Consensus Statements and Recommended Clinical Procedures Regarding Surgical Techniques. Int. J. Oral Maxillofac Implants. 2008; 24(suppl): 272-278. Conform acestei definiţii de clasificare, implantaţia după extracţia dentară poate fi de 4 tipuri: tipul 1 este considerată implantaţia efectuată imediat, la finele extracţiei dentare; tipul 2 - implantaţia timpurie efectuată după vindecarea definitivă a ţesuturilor moi cu „sigilarea biologică” a alveolei; tipul 3 - implantaţia timpurie după o substanţială vindecare osoasă a alveolei confirmată clinic şi radiografic şi tipul 4 este considerată implantaţia după vindecarea definitivă a alveolei cu modificările respective în sectorul edentat. De menţionat faptul că pentru toate variantele de instalare a implantelor este recomandată metoda în doi timpi chirurgicali cu decolarea lambourilor mucoperiostale. In order to unify these terms, the scientific research group “ITI” at the third Consensus Conference in August 2003 (Gstaad, Switzerland) defined the terms for implant placement after tooth extraction. Based on these definitions, post-extraction wound healing was evaluated, as specified in the following paper: Hammerle C., Chen S., Wilson T. Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. Int. J. Oral Maxillofac Implants. 2004; 19(suppl): 26-28. The viability and practical value of this definition were confirmed 4 years later, at the 4th Consensus Conference, which took place in 2007 (Studgard, Germany), Chen S., Beagle J., Jensen S. et al. Consensus Statements and Recommended Clinical Procedures Regarding Surgical Techniques. Int. J. Oral Maxillofac Implants. 2008; 24(suppl): 272-278. According to this classification definition, implantation after tooth extraction can be of 4 types: type 1 is considered implantation performed immediately, at the end of tooth extraction; type 2 - early implantation performed after definitive healing of soft tissues with "biological sealing" of the alveolus; type 3 - early implantation after substantial bone healing of the alveolus confirmed clinically and radiographically and type 4 is considered implantation after definitive healing of the alveolus with the respective changes in the edentulous sector. It should be noted that for all variants of implant installation, the two-stage surgical method with the lifting of mucoperiosteal flaps is recommended.

În studiu au fost incluşi 9 pacienţi (3 femei şi 6 bărbaţi, vârsta cuprinsă între 27 şi 49 ani) cu diverse forme de edentaţii parţiale, care s-au adresat pentru o reabilitare implanto-protetică. Pacienţii au fost examinaţi clinico-instrumental şi radiografic (ortopantomografia - OPG, radiografia retroalveolară). Criteriile de includere în studiu au fost: timpul parcurs după extracţia dentară - egal cu 4…8 săptămâni, alveola postextracţională în fază de vindecare - fără semne de inflamaţie. Criteriile de excludere: contraindicaţiile (generale şi locale) către inserarea implantelor. Pacienţii au fost informaţi despre caracterul studiului. Luând în consideraţie parametrii osului disponibil sunt selectate implantele după lungimea şi diametrul alveolei, cu condiţia că ele vor depăşi dimensiunile alveolei şi vor fi situate parţial în osul nativ perialveolar. Apoi cu freze dentare de diferite dimensiuni se prepară locaşul implantului în aşa fel ca diametrul ultimei freze să fie cu 1,0…1,5 mm mai mic decât diametrul implantului. Implantul, în cazul absenţei dinţilor monoradiculari, se inserează în centrul alveolei, în absenţa dinţilor molari inferiori se inserează în alveola posterioară a mandibulei şi în absenţa dinţilor molari superiori - în alveola palatină. Implantul se instalează cu ajutorul unei chei dinamometrice cu o forţă de 45…55 N/cm în aşa fel ca el să depăşească nivelul gingiei cu 2…3 mm. Acest procedeu fiind controlat „ad ocilus” prin miniplaga gingivală. În cavitatea implantului se introduc cu o seringă 0,1…0,3 ml de unguent Levomicol şi se înşurubează un conformator de gingie. Ulterior timp de 5…7 zile în scop profilactic se administrează o terapie antiinflamatoare şi se respectă regimul antiseptic al cavităţii bucale. The study included 9 patients (3 women and 6 men, aged between 27 and 49 years) with various forms of partial edentulism, who were referred for implant-prosthetic rehabilitation. The patients were examined clinically, instrumentally and radiographically (orthopaedic panoramic radiography - OPG, retroalveolar radiography). The inclusion criteria in the study were: the time elapsed after tooth extraction - equal to 4...8 weeks, the post-extraction alveolus in the healing phase - without signs of inflammation. Exclusion criteria: contraindications (general and local) to implant insertion. The patients were informed about the nature of the study. Taking into account the parameters of the available bone, the implants are selected according to the length and diameter of the alveolus, provided that they will exceed the dimensions of the alveolus and will be partially located in the native perialveolar bone. Then, with dental burs of different sizes, the implant site is prepared in such a way that the diameter of the last bur is 1.0…1.5 mm smaller than the diameter of the implant. The implant, in the absence of monoradicular teeth, is inserted into the center of the alveolus, in the absence of lower molar teeth it is inserted into the posterior alveolus of the mandible and in the absence of upper molar teeth - into the palatine alveolus. The implant is installed using a torque wrench with a force of 45…55 N/cm in such a way that it exceeds the gum level by 2…3 mm. This procedure is controlled “ad ocilus” through the gingival mini-wound. 0.1…0.3 ml of Levomicol ointment is introduced into the implant cavity with a syringe and a gum conformer is screwed in. Subsequently, for 5…7 days, anti-inflammatory therapy is administered for prophylactic purposes and the antiseptic regimen of the oral cavity is observed.

La pacienţii incluşi în studiu pe parcursul fazei de vindecare semne de inflamaţie ale ţesuturilor periimplantare nu au fost atestate. La examinare în termenii de osteointegrare manşeta periimplantară a fost reprezentată de gingia fixă cheratinizată. Analiza comparativă a radiogramelor a demonstrat că spaţiile periimplantare au devenit opace şi s-au contopit cu osul adiacent, ceea ce mărturiseşte faptul transformării matricei primare în os matur. In the patients included in the study during the healing phase, signs of inflammation of the peri-implant tissues were not attested. When examined in terms of osseointegration, the peri-implant cuff was represented by keratinized fixed gingiva. Comparative analysis of the radiographs demonstrated that the peri-implant spaces became opaque and merged with the adjacent bone, which testifies to the transformation of the primary matrix into mature bone.

Monitorizarea stabilităţii implantelor a demonstrat că în toate cazurile ele sunt stabile, având valori ale periotestului între 4 şi 7 ce au permis iniţierea tratamentului protetic. Aşadar, instalarea timpurie a implantelor conform metodei elaborate asigură osteointegrarea lor fără augmentare de materiale osteoplaste evitând a doua etapă chirurgicală, micşorând costul tratamentului şi timpul reabilitării pacienţilor cu 4…6 luni. Monitoring of implant stability demonstrated that in all cases they are stable, with periotest values between 4 and 7, which allowed the initiation of prosthetic treatment. Therefore, early installation of implants according to the developed method ensures their osseointegration without augmentation with osteoplastic materials, avoiding the second surgical stage, reducing the cost of treatment and the rehabilitation time of patients by 4…6 months.

1. Sanz Ig., Garcea-Cargallo M., Hererra D. et al. Surgical protocols foe earlyimplant placement in post-extraction sockets a systemic review. Clin Oral Implants Res. 2012, vol. 23, nr. 5, p. 67-79 1. Sanz Ig., Garcea-Cargallo M., Hererra D. et al. Surgical protocols for early implant placement in post-extraction sockets a systemic review. Clin Oral Implants Res. 2012, vol. 23, no. 5, p. 67-79

Claims (1)

Metodă de instalare timpurie a implantelor dentare într-un timp chirurgical, care constă în aceea că se extrag dinţii afectaţi, peste 4…8 săptămâni după vindecarea completă a gingiei se efectuează ortopantograma, apoi cu freza dentară gradată se penetrează fără turaţii gingia şi conţinutul alveolei, cu freze dentare de diferite dimensiuni se prepară locaşul implantului în aşa fel ca diametrul ultimei freze să fie cu 1,0…1,5 mm mai mic decât diametrul implantului, se determină adâncimea locaşului, mărimea determinată se compară cu datele de pe ortopantogramă, în baza datelor obţinute se selectează un implant de tip şurub, implantul, în cazul absenţei dinţilor monoradiculari, se inserează în centrul alveolei, în absenţa dinţilor molari inferiori se inserează în alveola posterioară a mandibulei şi în absenţa dinţilor molari superiori - în alveola palatină, implantul se instalează cu ajutorul unei chei dinamometrice cu o forţă de 45…55 N/cm în aşa fel ca el să depăşească nivelul gingiei cu 2…3 mm, după care în cavitatea implantului cu o seringă se introduc 0,1…0,3 ml unguent Levomicol şi se înşurubează un conformator de gingie, apoi timp de 5…7 zile în scop profilactic se administrează o terapie antiinflamatoare şi se respectă regimul antiseptic al cavităţii bucale.Method of early installation of dental implants in a surgical time, which consists in extracting the affected teeth, 4-8 weeks after the gum has completely healed, an orthopantogram is performed, then with a graduated dental bur the gum and the contents of the alveolus are penetrated without speed, with dental burs of different sizes the implant location is prepared in such a way that the diameter of the last bur is 1.0-1.5 mm smaller than the diameter of the implant, the depth of the location is determined, the determined size is compared with the data on the orthopantogram, based on the data obtained, a screw-type implant is selected, the implant, in the absence of monoradicular teeth, is inserted in the center of the alveolus, in the absence of lower molar teeth it is inserted in the posterior alveolus of the mandible and in the absence of upper molar teeth - in the palatine alveolus, the implant is installed using a torque wrench with a force of 45…55 N/cm so that it exceeds the gum level by 2…3 mm, after which 0.1…0.3 ml of Levomicol ointment is introduced into the implant cavity with a syringe and a gum conformer is screwed in, then for 5…7 days, anti-inflammatory therapy is administered for prophylactic purposes and the antiseptic regime of the oral cavity is observed.
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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
MD698Z (en) * 2013-05-03 2014-06-30 Валериу ФАЛА Combined method for fixation of bridge prostheses using implanted supports
MD697Z (en) * 2013-05-03 2014-06-30 Валериу ФАЛА Method for filling the partial edentulous areas adjacent to the bridge prosthesis
MD948Z (en) * 2015-04-02 2016-04-30 Валентин ТОПАЛО Method for directional simultaneous placement of second-stage dental implants

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