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Following
many years of observations, one of the causes of unsuccessful implantodontics
has been further confirmed.
The
problem, however, has already been highlighted at times by scientific
publications such as the International Journal of Prosthodontics (volume
11, November-December 1998), Implantologia Orale (No. 2, April 1998),
Quintessenza Internazionale (year 15, January-February 1999), and by
volumes like Radiologia Implantologica by Antonio Pierazzini (Edizioni
Uses), and Implantologia e Implantoprotesi by Andrea Bianchi (Utet).
And yet the topic has never been fairly considered, in spite of its
importance.
The
reason for this sparse cognizance over a negative factor regarding one
of the various methodologies in implantodontics is due to the fact that
the procedure in question, used by most professionals, has been “wrongly”
assessed as the only valid and safe one.
This is not true. In fact, the very principle that made it be considered
such has been revealed with the passing of time to be its “Achilles
heel” (though also admitting that this method does have an undisputed
validity). It consists in deeply inserting, into the maxillary bone
or mandible deprived of teeth, some cylindrical or conical-shaped artificial
roots in titanium and leaving them for a few months until their complete
bony inclusion (osteo-integration).
The
stumps (or stump [abutment] if there is a single tooth to be implanted)
are screwed into the parts just appearing out from the bone (into which
the roots were inserted) and into the extracted sites along their axis.
The
tooth or teeth are then fixed onto the parts emerging from the gum.
It is found, however, that there is sometimes a re-absorption of bone
tissue in the zone of conjunction between the part inserted into the
bone and the part that stays outside the gum.
This
is due to a “peri-implantitis”, i.e. an inflammation and consequently
an infection that establishes itself in both the soft and hard tissues.
This
occurs (according to the relevant research) because, in the surface
interfaces of the stump spirals which are screwed in, and in those of
the part inserted into the bone, there are always some microscopic spaces
where some germs can enter because of bacterial plaque or something
else.
In time these germs cause the above mentioned peri-implantitis! It is
to be seen instead that with the traditional implants (screws-needles-blades,
etc.), this insidious and bothersome drawback is generally not manifested.
Because both the part that stays in the bone tissue and the part that
emerges from the gum, which acts as the abutment, are all one and therefore,
there not being any conjunctions, they do not offer germs even the minimum
space to get established and multiply.
The
supporters of so-called osteo-integrated implantodontics have not used
such implants. Indeed, many consider that an implant with an immediately
emerging stump, being subjected too soon to mastication, and tongue
and cheek movements, cannot be osteo-integrated given that the part
inserted into the bone would also derive mobility from these.
This hypothesis has not been found to be so certain. After all, in the
traditional implants (i.e. that are inserted in a single phase), there
is also a way of rendering them immediately stable, so that they do
osteo-integrate.
However,
the supporters of the two-phase method, who thought they had fine-tuned
a more secure method for the artificial root to osteointegrate perfectly,
have never taken this datum into serious consideration.
Instead,
the very theory that made it a winning one has not been found to be
as valid as supposed. There is nothing mathematical in medicine and
surgery.
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ABSTRACT
BIBLIOGRAFIA
