Case 2

UNIQUE TITANIUM

IMPLANT

DMi Implants

Clinical case: Wishes of the patient, restoring dentition by

fixed prosthetic designs. But when choosing a doctor for the

patient the main criterion was the low cost.

Panoramic

X-rays

of the

patient after

treatment

another clinic.

The implants were installed 7 months ago. In the mandible, constant pain in the

area 45 tooth. There is a bone resorption around all implants. In the 46 tooth

implant injured tooth root 45.

X-ray CT scan of the lower jaw - in area the 46 tooth

implant injured root of tooth 45.

Teeth 45,44,43, and 41, were extracted. Immediate implantation with immediate loading was performed. After 3 months, the patient received a permanent denture in the lower jaw. During this time the patient waiting

prosthesis on upper jaw from another clinic.

The patient returned back to the clinic with a

permanent fixed prosthesis on the upper jaw. The

patient can not chew food, the prosthesis is poorly

fixed, the aesthetics are unsightly, and more .....

After removal of the fixed bridge

of the upper jaw. Implants are

stable in the bone of the upper

jaw. The antagonists are

pronounced in the reverse bite.

X-ray CT scan of the upper jaw with implants installed (before treatment,) including a vertical sectional view.

X-ray CT scan of the front of the upper jaw with implants installed. There is bone resorption around the implant. The alveolar ridge

allows you to install the new implants.

1113 21 23

X-ray CT posterior maxilla to installed implants . There is bone resorption around the implant. The alveolar ridge does not allow

installation of new implants. It is necessary to increase the alveolar ridge bone (sinus lifting.)

151617 25 26 27

After a complete examination and analysis of the data, it was

proposed to remove all of the upper jaw implants, make

necessary bone grafting of the upper jaw, and the installation

of 10 new implants and prosthetics in the upper and lower

jaw.

All implants have bone resorption in excess of 3mm. It was decided to remove all implants of the upper jaw and to install new implants.

Regular two piece

implants

DMI implants are manufactured from titanium alloy Ti6Al4V-ELI material highly successful for fabrication of dental implants due to superior mechanical

properties.

Multi modular

three piece

implants

One piece implants

Criteria for selecting a dental implant.

1. The patient's wishes.2. The state of the jaw bones and soft tissues of the oral cavity.

3. Methods of dental implantation.4. Risk Factors.

5. Availability of examination methods and treatment.6. Availability of the necessary medical personnel,

equipment, tools and materials.

Criteria number 1:Getting a good ossteointegration of the implant to

create a support system for the restoration of teeth.

Implant+Prefix Perfect Unique Prima Solo Solo plus

Implant+Prefix Perfect Unique Prima

Criteria number 2:

Good primary fixation.

Implant+Prefix Perfect Unique Prima

Criteria number 3:

The maximum amount of the bone around the coronary part of

the implant for the prevention of bone resorption.

Implant+Prefix Perfect Unique Prima

Criteria number 4:

The possibility to replace one part of the implant in the future, in order

to increase the implant survival time .

Formation of bone implant bed and installation of 10 Unique implants using conventional methods. In the posterior maxilla - bone grafting (sinus

lift) with the installation of 4 implants. On the front 6 implants were installed abutments for a temporary prosthesis.

A panoramic X-ray immediately after the installation of new implants and bone grafting. The front 6 implants are set using

immediate loading.

X-ray CT scan of the maxilla 6 months after the installation of new implants and bone grafting.

1113 21 23

X-ray CT scan of the anterior maxilla 6 months after the installation of new Unique implants and bone

grafting(3DBone+Bone Apatite)..

17 16 15

X-ray CT posterior maxilla of 6 months after the installation of new implants and bone grafting (3DBone+Cerabond+Bone Apatite).

25 2726

There is no possibility to make aesthetic prosthetics.We need to think nonstandard in this case.

Washing the internal implant connection, installation and transfer control transfer sitting well on the implant. The use of hard individual impression tray. Rigid connection transfer to the implant, between the transfers and

implant and hard impression tray.

Modular Titanium Abutment / Transfer. The new system allows the use of one product as the implant transfer and the implant

abutment. It has a modular hex (2) and the abutment body (1) has a retention groove for the composite. A titanium screw (3)

connects the abutment and the modular hex . This system allows you to use to remove the exact impression method open tray and

manufacture of temporary prosthetic on the implants.

+ +21 3

12

3

Modular Titanium Abutment / Transfer. It has a modular hexagon (2) and an abutment body (1) has a retaining groove for the composite material. A titanium screw (3) is removed together with the modular socket head (2). This allows the elimination of passive impression from the

mouth. That ensures accurate impression.

Modular hexagon (2) is introduced into the body of the abutment \ transfer (1) which is inside the impression, and then a

titanium screw (3) fix the implant analog.

1 2 3

++

++

+

Standard titanium screw connectors (1) installed on the implants and are used in conjunction with a plastic sheath (2) and fixing screw (3) for the manufacture of

prosthetic designs with screw fixation.

12

3

Permanent prosthetic structure in the upper jaw (the lower part of the screw-retained crown and upper part of the cement-retained) on standard connectors "multi-unit" and mandibular crowns on implants with cement

fixation.

X-Ray control the correct sitting a permanent prosthetic structure in the upper jaw (the lower part of the screw-retained) on standard connectors "multi-unit"

Using sophisticated prosthesis on the upper jaw makes it possible to receive orthognathic ratio of dentition.

Permanent prosthetic structure in the upper jaw consists of a lower part(1) with a screw fixation and

the upper part(2) with cemented fixation.

1

2 11+2

View of the gypsum model of the permanent prosthetic constructions on the upper and lower jaw.

Implant set of titanium abutments (multi unit) on the lower part of a complex of a permanent prosthesis with screw fixation.

Setting a permanent prosthetic structure on the upper and lower jaw.

X-ray after the installation of a permanent prosthetic structure on the upper and lower jaw.

On an X-ray CT we see how far forward is the dental arch of the upper jaw for orthognathic jaw relations.

Before and after the treatment.

Before

Аfter

Аfter

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

The result of treatment (full restoration) satisfies the patient. On our scale of restoration of the mouth, we have achieved 13.

Restoration form.Restoration function. Full restoration.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Scale level dental restorations on implants (prof.Mushayev I.) from 1 to 15, where 15 is complete teeth in full dentition. From 1 to 5 only restore

function, without restoration anatomical shape of the teeth. From 6 to 10 only restore the anatomical shape of the teeth without restoration

function. From 11 to 14 restore anatomic form and function of the teeth.

2.Restoration

form.

1.Restoration function.

3. Full

restoration.

To obtain a correct final result must be:

B. Information and

opportunities:

A. The patient's

wishes:

1.Analysis of information from the patient.

2.Analysis of information from

the manufacture of materials.

3.Opportunity of the medical

personnel, equipment, tools and

materials.