Chirurgické procedury a protetika pro monoimplantáty
The Surgical and Prosthetic Procedures related to the use of the Leone products for Monoimplants for O-ring overdenture described in the following pages are intended for Professionals experienced in dental implant techniques.
In case of lack of basic notions, we suggest to attend specific courses in order to reach a high level of knowledge and practice in the use of implants. The instructions for use of the products described below represent a sort of standard instructions that have to be adjusted to the individual needs and to the particular situations that may occur on the basis of the manual ability, the experience and diagnosis effected by the legally qualified medical operator. It is not ascribed to the manufacturer the duty of monitoring the procedures of use of the product. A correct and appropriate use of the instruments and products related to the LEONE Monoimplants for O-ring overdenture shall completely be reverted to the clinician. The surgical procedure hereunder described is merely indicative as any single treatment case is assigned to the experience of the operator. As every medical operator well knows, a correct procedure and a perfect manufacture of the prosthesis may sometimes be followed by not satisfactory results owing to particular situations not imputable to responsibility of the dental operator or the manufacturer.
The Leone Monoimplant for O-ring overdenture therapy is indicated in the treatment of the TOTAL LOWER EDENTULISM.
For contraindications and side effects read the instructions for use enclosed in the package of each product and available in our web site www.leone.it.
Before starting the surgical intervention, the patients have to be subjected to a series of exams; any single case has to be evaluated by the clinician.
It is the first approach to the patient and it represents a fundamental tool to recognize both risk factors and contraindications. Moreover, anamnesis allows for the evaluation of patient’s expectations, priorities, degree of compliance and motivation.
Anamnesis can help in evaluating the need for extra exams in addition to the routine ones (when the presence of pathologies that were not reported by the patient is suspected) and when particular situations drive to deem a complete medico-surgical exam necessary.
It consists of:
- inspection of the periodontal tissues, of the oral mucosa and of the teeth along with an initial evaluation of the occlusal relationships (skeletal Class, characteristics of the opposing arch and related potential problems, type of occlusion, interarch distance), of the presence of parafunctions, of the degree of oral hygiene, of the aesthetic conditions, of the morphology of the edentulous crest and the space available for the replacement of the prosthesis.
- palpation of the soft tissues and implant sites with a first evaluation of the bone morphology and thickness.
- a complete periodontal probing for the appraisal of the absence of both gengivitis and pockets.
PANORAMIC RADIOGRAPH: frequently, this radiograph enables to appraise bone height and the relationships between implant site and adjacent structures, such as mandibular canal, etc.
It is also possible to identify concavities and ossification defects due to previous tooth extractions.
INTRAORAL RADIOGRAPH: it is very helpful for the determination of the apico-coronal availability of bone.
LATERAL CEPHALOGRAM: it is useful for the determination of the mandibular symphysis.
COMPUTERIZED TOMOGRAPHY: it is advisable to remind that previous radiographic exams provide two-dimensional images which do not give information on bone thickness. In order to obtain this useful information a computerized tomography is necessary: it provides three-dimensional images, thus allowing for an accurate evaluation of bone morphology and, sometimes, bone density.
Instrumental or laboratory exams
When necessary, in cases where a pathology is suspected on the basis of anamnesis or clinical records.
The dimensions (implant length and transmucosal neck height) of the monoimplants to be seated are determined by the following factors:
- amount of bone available
- characteristics of the implant site
- thickness of the soft tissues in the areas involved.
Further and particular individual situations must be evaluated by the Dentist or the Dental Surgeon. Do not place monoimplants in the upper arch.
A template Cat. 156-2003-01 (page 50) is available that shows all Leone monoimplants GH3 in actual dimensions, with dimensions increased by 10% and increased by 25%, to match possible distortions created by the instrument for radiographic examinations (CT and panoramic radiograph). Superimpose the template to the radiograph in order to select the monoimplant in relation to the quantity of bone available.
To simplify the surgical operation, an instrument organizer Cat. 156-0017-00 (page 49) was conceived by LEONE to sterilize and hold the necessary instruments on the operating table. The organizer must be sterilized before use.
The sterilization must be performed as follows:
- wrap the organizer into a sterilization bag as requested by the manufacturer of the sterilizing machine.
- autoclave at 121° (250°F) for 20 minutes.
- remove the organizer from the autoclave and leave it cool inside the bag.
- leave the organizer inside the bag to preserve sterility
LEONE MONOIMPLANT PACKAGING
The monoimplant is supplied with the micro housing in a sealed envelope that also carries the relevant product information.
The packaging features a double protection to preserve the sterility of the implant subjected to a certified gamma x-ray process. A removable part of the label showing the information of the implant (see label symbols at page 125) is to be applied on the “Identity card” of the implant or on the clinical case sheet of the patient. A sterility indicator is present on the glass vial.
THE GLASS VIAL