YOUR TEETH ARE LOOSE OR LOST? REBUILD YOUR SMILE IN ONE WEEK
REPLACE YOUR DISEASED TEETH WITH PROTOCOLS FOR IMPLANT PLACEMENT WITH IMMEDIATE AESTHETICS
INTROdUCTION to Implantology with Immediate Loading:
Completely redo your smile under sedation in a few days
"YOU CAN'T SOLVE A PROBLEM WITH THE WAY OF THINKING THAT CREATED IT".
EVERYTHING you ever wanted to know
to remake your smile in a few days
discover the new paradigms and the world of MCI implant placement
THE LARGE BRIDGES ON MCI IMPLANTS FROM MOLAR TO MOLAR:
"ALL ON 10 / 8"
THE SMALL BRIDGES ON IMPLANTS IN MCI FROM PREMOLAR TO PREMOLAR:
"ALL ON 8 / 6"
Learn in the pages of the chapter “OUR WORLD: IMPLANTOLOGY WITH IMMEDIATE LOADING – ILL”
Everything you need to know to rebuild your mouth, in a few days, with one of the most modern permitted implant protocols:
- The placement of dental implants with an immediate load and aesthetic thanks to an implant-supported bridge of total reconstruction of your smile, as well as your masticatory function.
- A protocol for placing implants in a single surgical procedure, known as “one shot”;
- Aesthetic bridges for reconstruction of your teeth in less than a week.
Who is our “Gold Standard MCI” immediate loading dental implant protocol for?
The “Gold Standard MCI” is a total reconstruction of your mouth through the placement of a maximum number of dental implants, including in the posterior, upper and lower jaw sectors.
1/ Our “Gold Standard MCI” protocol for immediate loading of dental implants is designed for the most demanding patients who wish to have their dental arches reconstructed “ad integrum”, i.e. “a complete repair”.
Provided, however, that their clinical case is eligible for the indications of this protocol.
Unfortunately, it is often the case that the molars, i.e. the most posterior teeth of your dental arches, are extracted early. The consequence of these extractions is a melting of the alveolar bone. This is the bone that surrounds and holds the teeth. As the molars disappear, the bone around these teeth disappears with them.
In some favorable clinical cases, it is possible to place the implants in posterior areas:
- Either, directly and without prior pre-implant intervention, because the alveolar bone of the molars has not completely resorbed and allows the placement of implants directly;
- Either because bone grafts, in particular sinus grafts or “sinus lift” in the upper jaw, have made it possible to reconstruct the bone resorbed in the molars, especially the upper molars.
In these clinical cases, either already favorable or made favorable by pre-implant bone grafts, the placement of implants in the most posterior areas of the dental arch allows for a total reconstruction of your teeth, thanks to the installation of implant-supported bridges.
The benefits are immediate, after one week:
- An ideal restructuring of the mastication;
- A perfect setting of the bite, which is called “inter-maxillary occlusion”;
- A total restructuring of the smile and facial expression.
This occlusal wedge, at the most posterior level, protects the temporomandibular joints (TMJ). This is the joint between the lower jaw (called the mandible) and the skull, at the front of the ear canals.
2/ Our “Gold Standard MCI” protocol for immediate loading of dental implants is also designed for patients with a large build who cannot accommodate a limited number of implants.
There is a law of elementary physics that says that the pressure is equal to the force divided by the surface: P= F/S.
The stronger the patient is, the greater the chewing force.
Therefore, the number of implants should be increased as much as possible so that the pressure on each implant is minimized. Reduced pressure on each implant minimizes the risk of fracture or peri-implant bone resorption.
3/ This is precisely the example of the clinical case described in our film “Implants in MCI”:
The patient in this film is a very big, strong boy.
He was completely edentulous in the maxilla and diagnosed with terminal periodontitis in the mandible.
He was in extreme psychological distress because he had no solution until we took him in.
In the maxilla, we placed 10 implants using our “Gold Standard MCI” All on 10 protocol.
- The maxilla was previously reconstructed by two bilateral sub-sinus bone grafts, “sinus lift” type.
- We also performed two bone grafts in the maxilla for bone reconstruction of the alveolar ridge by osteosynthesis, associated with regenerative dentistry techniques. These grafts are located in the canines to compensate for the loss of substance following two infected cysts in the alveolar bone.
In the mandible, we placed 8 implants according to our “Gold Standard MCI” All on 8 protocol.
With two mini implants in the posterior mandibular molar regions, we were able to reconstruct molar masticatory function.
As a result:
- All maxillary posterior implants are screwed into this grafted bone in the maxilla.
- The two implant-supported bridges replace all of this patient’s natural teeth, molar to molar, with immediate loading or MCI.
- The high number of implants is necessary and sufficient in relation to the height/weight ratio of this patient of 1.90 m for 100 kg.
These two All on 10 and All on 8 techniques are made possible by a cascade of highly sophisticated pre-implant surgeries:
We call our protocol for complex case management the “Domino Surgeries MCI”. This concept of cascade oral surgeries is developed in the corresponding chapter.
Our “Gold Standard MCI” protocol for immediate loading of dental implants allows for an optimized result. It is one of the most satisfactory at present, both in terms of chewing and smile aesthetics.
With the placement of a large enough number of dental implants to support a fixed ceramic bridge prosthesis, this man has started a new life.
In
these chapters we will try to explain to you the essential prerequisites for the placement of implants in the posterior sectors of the jaw.
Some people are in a desperate dental situation!
In particular, due to extreme bone resorption, implants cannot be placed. This contraindication to implant placement therefore makes implant procedures in MCI very difficult.
To remove these contraindications, the implant surgeon is obliged to perform a series of surgical interventions, called “pre-implant bone grafts”.
In order to reconstruct the jawbone and compensate for the loss of bone substance, which is a consequence of the physiological and automatic resorption of the bone, immediately following dental extractions, a succession of bone grafts is scheduled.
These bone reconstructions are the prerequisite for the placement of dental implants and the attachment of a complete implant-supported bridge in immediate esthetic loading.
We call this cascade of surgical interventions in our protocols “Domino Surgeries MCI”. This topic will be developed in the corresponding chapter.
In the event that it is not possible to program a “Domino Surgeries MCI” protocol to place implants in the posterior sectors, our backup protocol “DAMAGE CONTROL MCI” takes over.
Our protocol for emergency rescue of patients in distress, the “Damage Control MCI”, replaces the first-line protocol, the “Gold Standard MCI”:
- Or, because the patient decides that the partial, but sufficient, reconstruction of the “Damage Control MCI” is suitable for him and he wants to dispense with other surgical procedures, due to lack of time, desire or money;
- Either, because his teeth have already fallen out or are about to fall out in the very near future, he wishes above all to find a solution to avoid being toothless and therefore de-socialized.
The “Damage Control MCI” protocol is developed in the corresponding chapter.
First principle: Who is our “Domino Surgeries MCI” protocol intended for, and in particular, intra-sinus bone grafts or Sinus Lift?
We have seen that the protocol for placing dental implants in the “Gold Standard MCI” is a total reconstruction of your mouth, thanks to the placement of a maximum number of dental implants, including in the posterior sectors of the jaws.
However, your clinical case must be eligible for the indications of this protocol.
Unfortunately, it is often the case that the molars, i.e. the most posterior teeth of your dental arches, are extracted early. The consequence of these extractions is a melting of the alveolar bone, i.e. the bone that surrounds and holds the teeth. As the molars disappear, the bone around these teeth disappears with them.
In these unfavorable clinical cases, it is not possible to place the implants in the posterior sectors, because the alveolar bone of the molars has completely resorbed and does not allow the placement of the implants.
In order to solve this problem and to make the placement of implants possible, bone grafts will have to be performed. In particular, sinus lift grafts in the upper jaw are used to reconstruct the volume of resorbed alveolar bone.
Second principle: The filling of the sinus base or “sinus lift” is a prerequisite in the protocol for placing dental implants in immediate loading. In particular, for the realization of a “Gold Standard MCI”.
This compensation of the resorption of the posterior sub-sinus molar bone in the maxilla is not the only contraindication to the placement of dental implants!
In some very unfavorable clinical cases, where the maxillae are severely atrophied, bone resorption also affects the premolar area behind the canines and even the anterior area of the smile teeth.
In these very difficult cases, even the “Damage Control MCI” is not enough to solve the problems.
The implementation of the “Domino Surgeries MCI” protocol is essential for these distressing situations.
These cases and their variants are described in the chapters on MCI implant-supported bridges in the maxilla and mandible.
When the“Domino Surgeries MCI”protocol is indicated , a cascade of reconstructive bone grafts is envisaged and planned.
The “Domino” effect leads, from surgery to pre-implant surgery, to the reconstruction of the bone bases and the placement of dental implants with immediate loading by a complete implant-supported bridge.
Once the posterior bone volume of the maxilla has been reconstructed, we can consider carrying out our protocol for placing dental implants in Immediate Loading, known as “Gold Standard MCI”.
Third principle: The “Domino” effect of pre-implant surgeries leads in fine to the reconstruction of the bone bases: this is precisely the example of the clinical case described in our film “The sinus lift”.
In this extremely difficult clinical case due to almost total resorption of the posterior part of the maxilla with strong pneumatization of the sinuses, the two sides of the upper maxilla were reconstructed by two bilateral sub-sinus bone grafts, called “Sinus Lift”, prior to implant placement.
The result of this clinical case is totally satisfactory since we have completely reconstructed both dental arches of this patient.
In this case, it is a variant of the “Gold Standard MCI” because we did not place 10 implants in the maxilla and 8 in the mandible, but 8 implants in the maxilla and 8 in the mandible.
Indeed, the size of this little lady did not allow to pose more!
- In the maxilla, we placed 8 implants using our “Gold Standard MCI” All on 8 protocol.
- In the mandible, we placed 8 implants according to our “Gold Standard MCI” All on 8 protocol.
As stated in the article on the “Gold Standard MCI”, the patient’s size and strength must be taken into account: an implant treatment for a large man weighing 100 kg is not the same as for a small woman weighing 50 kg.
The principle of demonstration by image:
In our film “The Sinus Lift”: the patient is a frail and charming lady, diagnosed with a terminal periodontitis bi maxillary. She was bound to be totally toothless soon.
The medical desertification of his region of residence and the complicity of his clinical case for general practitioners deprived him of a perennial solution. Without a technical solution to avoid a “denture”, she was in medical wandering, until we took her in charge.
The ICM was completely impossible to perform without performing both bilateral Sinus Lifts.
Unfortunately, she did not have enough bone volume, even with mini implants, to place the necessary implants in the posterior maxillary region.
In the maxilla: We were obliged to reconstruct the sub-sinus bone volume that was resorbed following the dental extractions.
This surgery of bone grafting between the sinus and the residual bone of the jawbone is called a sinus filling or sinus lift.
In the mandible: With the placement of mini implants, we were able to place dental implants beyond the area of the inferior alveolar nerve exit, to be as posterior as possible and replace the molars.
Clinical outcome:
On the control radiograph at the end of the treatment, it can be seen that, on each side, the 3 posterior implants out of the 4 placed are completely screwed into the grafted bone.
With this increased number of implants, we were able to attach two implant-supported bridges, high and low, with molars that restore almost all of our patient’s occlusal and masticatory function.
With two mini implants in the posterior mandibular molar regions, we were able to reconstruct molar masticatory function.
As a result:
- All maxillary posterior implants are screwed into this grafted bone in the maxilla: this is the result of the “Domino Surgeries MCI”.
- The two implant-supported bridges replace all of this patient’s natural teeth, molar to molar, with immediate loading or MCI: this is the result of the “Gold Standard MCI”.
- The high but optimized number of implants is in keeping with the size/weight ratio of this 1.69 m, 55 kg patient.
In conclusion: These two techniques “All on 8” in the maxilla and “All on 8” in the mandible are made possible by a cascade of the most sophisticated pre-implant surgeries: it is this protocol that we have named “Domino surgeries MCI”.
Our “Gold Standard MCI ” protocol for immediate loading of dental implants delivers a highly optimized result, which is highly satisfying in terms of both mastication and smile aesthetics.
Thanks to the placement of a sufficient number of dental implants to support a fixed ceramic bridge prosthesis, this woman has started a new life.
Smile designer presents its catalog of mci protocols: OUR solutions for every edentulous situation.
our solutions in mci to stabilize the patient physically, socially and emotionally
IN THIS CHAPTER WE PRESENT OUR CATALOG OF SOLUTIONS FOR REPLACING ALL TEETH WITH DENTAL IMPLANTS IN IMMEDIATE LOADING.
The problem with placing implants in immediate loading and replacing all the teeth in the arch with an implant-supported bridge in immediate loading is the amount of implantable bone volume that is totally or partially available, especially in the posterior sectors of the maxilla.
In clinical cases of terminal periodontitis (loosening of the teeth) or extensive periapical cysts (endodontic cysts at the tips of the dental roots), it is common for the bone volume of the maxillae to be completely atrophied.
This situation is particularly frequent in the posterior sectors of the jaws and especially in the upper jaw:
In these critical situations, the available bone volume is not sufficient to place dental implants to replace the posterior premolar and/or molar teeth.
There are also clinical cases that present this same type of bone resorption in the anterior sector:
In this case, if there is no bone resorption in the posterior sectors, it is relatively easy to attach an implant-supported bridge that replaces the posterior teeth and serves as a support for reconstructing the anterior sector.
On the other hand, if the anterior and posterior sectors are both totally atrophied, it will be very difficult to place implants:
Either, the solution of the filling of bilateral sinuses will be retained and we find ourselves in the previous situation. Either, it will not be possible to perform these procedures and in this case the placement of zygomatic implants will be the only solution, replacing a complete removable prosthesis.
Pre-implant grafts must be performed to reconstruct this lost bone volume.
These techniques are known and well catalogued. There is no problem implementing them. All these techniques are described in all the chapters of our website.
But these interventions take time to heal!
The patient must agree to spend time on the operation and add the healing time to it. This means four months of bone healing plus possibly four months of osseointegration of the implants, in cases of surgical cascade. In some favorable cases, these two healing times are confused.
If the patient is in a clinical situation that does not jeopardize his or her anterior teeth, there is no problem taking the time to perform these cascades of pre-implant surgeries to reconstruct the posterior sectors.
These “Sinus lift” techniques, for example, are described in our chapter on conventional “one shot” implantology under general anesthesia.
However, the situation is totally different when the indication for an extraction with immediate loading is given, since by definition the patient’s clinical situation is one of peril, which can be almost immediate.
Thus, by nature, this clinical situation implies that the anterior sector is condemned as much as the posterior sectors.
The most favorable clinical cases for immediate loading are treated in our first two
solutions:
– Solution 1 ” Gold Standard MCI ” : click here
– Solution2 ” Gold Damage Control MCI “: click here
In these clinical cases, the patient has a favorable volume of maxillary bone structure. We are able to completely reconstruct the patient in a single surgical procedure and the placement of an implant-supported prosthesis a few days later.
Of course, this first version of the bridge screwed onto the dental implants with a resilient cosmetic is not definitive, but it is comfortable enough to be kept for the 6 to 12 months of healing time, while waiting for the installation of the implant-supported bridge with a definitive ceramic cosmetic.
But there are even more serious clinical situations, where the patient is in a critical situation such that his anterior teeth as well as his posterior teeth are all “falling out”, in an almost immediate future, projecting him into a catastrophic personal and professional situation.
And if, to make matters worse, the posterior (or even anterior) bone resorption is very advanced, the placement of the implants is compromised!
There are also situations where the teeth are already lost.
The people most at risk of edentulism are those with stomatophobia. If they are unable to find a solution to manage this phobia, they may find themselves wandering for too long, where the psychological suffering of the disgrace is added to the physical suffering of the mutilation.
These dramatic circumstances lead to a succession of “lost opportunities” at the same time professional, social, emotional, family that not only concern the dark period corresponding to the loss of its aesthetic aspect, but also its future.
Because everything that has not been done and everything that could not be done, as a result of the disgrace due to the loss of teeth, will lead to disastrous consequences sometimes for several years, or even all his life.
In some of the most tragic cases, this will determine a personal and/or professional failure of the patient who will not have been able to pursue an education, or a professional career, or a marriage. The deadly consequences are as endless as they are disastrous.
Our result: your brand-new smile in a single implant placement procedure and the delivery of two resilient implant-supported bridges with composite cosmetics, in Immediate Cosmetic Loading a few days later.
See details of the protocol and clinical cases in the corresponding chapters.
Warning: Even if we show satisfactory clinical results in our presentation pictures, they can never be a promise of similar success in your own clinical situation. Each person is different and each clinical case is unique.
Our result: your brand-new smile in a single implant placement procedure and the delivery of two resilient implant-supported bridges with composite cosmetics, in Immediate Cosmetic Loading a few days later.
See details of the protocol and clinical cases in the corresponding chapters.
Disclaimer: Even though we show satisfactory clinical results in our presentation photos, they can in no way be promises of similar success in your own clinical situation. Each person is different and each clinical case is unique.
Our solutions for managing stomatophy and clinical cases of complex edentulism with high bone resorption.
In reality we have not invented anything! We have simply transposed and adapted all the techniques that apply in medicine and general medical surgery to dentistry and in particular to oral implantology.
The solution to the problem of stomatophobia is very simple: use medical techniques.
Simply use the anesthesia techniques that prevail in the medical world for any surgical procedure.
Patients are sedated with techniques performed by our anesthesiologists such as intravenous sedation which are described in the chapter that you can consult by clicking here.
Or, it is enough to use the techniques of anesthesia with a hospitalization in clinic and interventions carried out under general anesthesia. The description of this protocol is in the chapter that you can consult by clicking here.
The solution to the problem of managing complex edentulous clinical cases with high bone resorption is also very simple: it is the application of pre-implant oral surgery techniques, boosted by the new paradigms of regenerative dentistry.
We have therefore set up an intermediate solution that can immediately solve most of the problems of these people in a situation of infectious peril, psychological and de-socialization, without closing any therapeutic door, necessary to optimize their clinical situation in the future.
This is our solution 3: “Damage Control MCI”: click here.
This solution 3 “Damage control MCI” comes to the rescue of the first two in cases of greater bone resorption:
Solution 1:“Gold Standard MCI can be performed when the resorption that all implants can be placed atfirst sight or that pre-implant grafting surgeries can be done beforehand, without urgency or stress, to restore all sectors of the dental arch ad integrum.
Solution 2: “Gold Damage Control MCI” can be used when boneresorption is moderate and almost all implants can be placed at first sight to restore the posterior sectors ad integrum .
The trick of posterior molar extensions allows to avoid preimplant grafting surgeries.
Solution 3: Damage Control MCI is used when the other two solutions are not possible because boneresorption is high or very high. Not all implants can be placed at first and pre-implant grafting surgeries cannot be done beforehand.
The emergency and stress management commands to restore the physical integrity of the patient.
Following the conduct of our protocol number 3 “Damage Control MCI”, we will find ourselves in two situations:
In the first, most favorable scenario, the Damage Control MCI completely fulfilled its mission of saving the patient and virtually restoring the dental arch.
Because our protocol is an extremely powerful therapy, we are usually able to place enough implants in the anterior and both lateral sectors to completely restore the dental arch. This solution restores the anterior sector ad integrum and the posterior sectors virtually ad integrum . Provided that two posterior extensions are created at the posterior ends of the implant-supported bridge in immediate loading, to replace the first molars.
In this case the number three solution, “Damage Control MCI”, has fulfilled its rescue mission and the patient can choose to remain in this situation since he will have 12 necessary and sufficient teeth from right first molar to left first molar.
He has reconstructed the posterior sectors of the dental arches, even partially, his masticatory function and his smile aesthetics.
In the second case, the “Damage Control MCI” has completely fulfilled its first mission of saving the patient BUT too partially fulfilled the mission of reconstructing the posterior dental arch and mastication.
Because our protocol is an extremely powerful therapy, it immediately restored people to health. In fact, we are able to place enough implants in the anterior sector to reconstruct the aesthetics of the teeth of the smile in order to prevent the patient from becoming unsocialized.
But in the case where the two lateral sectors have a very resorbed alveolar bone ridge, it is difficult to place implants in its posterior areas and thus to completely restore the dental arch and mastication.
On the other hand, two posterior extensions can be created at the posterior ends of the implant-supported bridge in immediate loading, to replace the premolars.
But as we have seen above, this premolar and molar wedging is insufficient for an efficient mastication and a good health of the temporomandibular joints.
Clinical optimization of the posterior sectors, following the rescue of the anterior sectors and the beginning of the lateral sectors thanks to the “Damage Control”:
Once this initial rescue has been achieved thanks to the “Damage Control MCI”, we are able to reconstruct the posterior sectors over time to add implants in these areas and increase the reconstruction of the jaws until an “ad integrum” result of the “Gold Standard MCI” or “Gold Damage Control MCI” type is achieved.
This means a complete reconstruction of all the dental arches, of the masticatory function, and of the aesthetics of the smile.
At this level of reflection, our protocols for jaw reconstruction described in our solution number four “DOMINO SURGERIES MCI” takes all its interest:
There are even more catastrophic clinical situations in which the posterior maxillary sectors are almost completely resorbed.
In these situations, it is not even possible to place implants in the premolar areas, but only in the anterior sector of the smile in the best of cases, with the canines from right to left as the implantable limit.
Our “Domino Surgeries” solution is designed to implement a first phase of rescue in this extreme clinical situation: we manage to replace the area of the smile teeth with very small posterior extensions at the level of the first premolars with dental implants and a rescue implant-supported bridge.
Following this first phase of immediate implant placement, performed in relative urgency to restore the anterior sector and put the patient back into a positive social dynamic, a whole series of pre-implant surgeries follows in cascade, which, little by little, thanks to a domino effect, reconstruct all the posterior sectors of the maxilla. In particular, the upper jaw is most often the most atrophied.
These cascaded salvage dental arch reconstruction protocols are described in the chapter “Domino surgeries”.
This is our solution 4 “Domino Surgeries MCI”, click here to learn more.
The ultimate solution for zygomatic implants
There is an ultimate stage of total and terminal atrophy of the maxillae.
In this case, it is very difficult to use the previous protocols and return to a clinical situation that is implantable in a conventional way.
However, there is an alternative to braces which is in these cases the placement of zygomatic implants with an immediate loading of a temporary denture that will be replaced 6 months later by a permanent denture.
This is a high-risk solution because it involves the basal bone of the maxilla and the foot of the cheekbone (zygomatic). In case of hazards, this is the area that will be affected.
This surgical protocol is reserved for very experienced operators, generally maxillofacial doctors, and only in a hospitalized situation in a clinic.
This is our solution 6: “zygomatic“.
Smile Designer, in these cases, can refer you to specialized maxillofacial practices.
What are the advantages and constraints of the placement of dental implants in aesthetic and immediate loading
The placement of dental implants for immediate esthetic loading is one of the most modern and successful approaches to thede novo replacement of severely dilapidated dental arches .
dental arches.
The placement of dental implants in Aesthetic and Immediate Load: it is a single surgical procedure, most often in an operating room under general anesthesia. She allows us to place an implant-supported prosthesis that replaces all the teeth of the smile and often the chewing teeth in less than a week.
This implant-supported prosthesis replaces most of the teeth, including those of the smile:
It is a aestheticbridge prototype that replacesall or part of your teeth that are condemned or already missing.
The placement of dental implants with immediate loading and aesthetic treatment
is currently one of the protocols that allows us to hope for an aesthetic result optimized. IIt combines implants, bone grafts, regenerative dentistry (PRF) and 3D digital technologies (radiology and CAD/CAM).
Protocols explained in videos:
one of our MCI implant surgeries
one of our sub-sinus bone graft surgeries - sinus lift -
Please note that these videos are of surgical procedures. They may offend the sensibilities of some people.
THE FILM OF THE INSTALLATION OF "IMPLANTS IN AESTHETIC AND IMMEDIATE LOADING".
SURGERY FOR THE PLACEMENT OF IMPLANTS IN "MCI":
THE RIGOROUS METHOD OF IMPLANT PLACEMENT IN BI-MAXILLARY MCI
UNDER GENERAL ANESTHESIA
THE FILM OF A SINUS LIFT PROCEDURE WITH THE CONTRIBUTION OF REGENERATIVE DENTISTRY: THE "PRF
Sinus lift" surgery.
the prerequisite for the placement of implants in MCI
UNDER GENERAL ANESTHESIA
YOU ARE UNIQUE!
CLINICAL CASES OF SMILE RECONSTRUCTION WITH OUR MCI IMPLANT SOLUTIONS
WE ANSWER YOUR QUESTIONS
on implantology with immediate AESTHETICS AND LOADING
The dentist answers your most frequently asked questions.
If your question is not mentioned, please make an appointment for a teleconsultation and an accurate answer.
No. This does not exist. The dentist must choose from his or her panel of techniques those that are closest to the needs and desires of the patient.
It is up to the implantologist to propose implant solutions to manage the patient’s total edentulism, but it is up to the patient to choose THE solution that best suits him or her.
It is important to understand that each protocol has indications and contraindications, advantages and disadvantages.
At no point in these popularization chapters should it be understood that all clinical cases can be treated in the same, universal way.
The demand of dentists in the modern protocols proposed to them is as much a restoration of function, as of anatomy and aesthetics.
It is, of course, also the patients’.
But even more concerning them, their demands are a complete erasing of their mutilations, their physical and moral sufferings, the restoration of their spirit and their life that has been turned upside down.
For this reason, modern dentistry is increasingly using restorative dental techniques with implants and immediate loading, or ILI.
However, the choice of technique is essentially based on the patient’s initial anatomical conditions, biological criteria and financial condition.
In view of these requirements, the availability of professionals in the patients’ comfort zone and the required skills are necessary. The scarcity of professionals makes these things difficult.
However, thanks to information on the internet and social networks and ubiquitous direct communication in video appointments, patients are increasingly travelling and looking for their practitioners where they find their criteria of choice.
This is where modern digital imaging comes into its own.
3D radiology and modern 3D photography allows us to make a “digital copy” of the patient and to dematerialize it.
2D and 3D radiological files, scans, photos and biological data can be sent from any point in the world to another.
Thus a patient can be diagnosed remotely via the internet and receive information.
- The primary aim is to optimize the aesthetics of the gingiva (soft tissue) that will heal around implant-supported prosthetic reconstructions such as full bridges in composite or ceramic. Thanks to the early aesthetic maturation of the gingival scalloping around the platforms screwed into the dental implants, the aesthetic contours of the dental prosthesis are thus much better managed and the overall appearance is very natural.
- The second interest is to optimize bone healing around the implants: just as osteosynthesis pins immobilize the bones in the event of a bone fracture in a limb.
- The third advantage is that this protocol eliminates the need for the patient to wear tedious removable temporary prostheses (dentures). Moreover, wearing a removable prosthesis while the implants are under the gum may mobilize the implants and ruin the healing by osseointegration. Remaining edentulous for the time of osseointegration is the safest option to heal properly. But the patients are associalized. Thanks to the loading techniques, immediately after the placement of the dental implants following the dental extractions on the entire arch, this problem of asocialization is avoided without disturbing the healing process and even by promoting it.
By default, our pioneering MCI protocol is to perform the following procedures simultaneously in a single surgery, known as a “one-shot”:
- Extract all remaining teeth during surgery;
- Place dental implants immediately to replace them;
- Place an allogeneic bone graft to fill the bone gaps between the dental implants and the walls of the dental sockets after dental extractions. Also to “over-graft” the oral bone walls and to anticipate post-extraction bone resorption: this point is fundamental to restructure the aesthetics of the gingival scalloping around the ceramic prosthetic crowns on implants;
- Load the bone grafts with iPRF (Plasma Rich Fibrin). The contribution of PRF in its injectable form in the bone graft allows a contribution of cellular growth factors determining in the conduct of the MCI protocol. The healing factors contained in autologous blood concentrates promote angiogenesis and the formation of a neo-vascularization in both the jawbone (hard tissue) and the gingiva (soft tissue);
- Cover the bone grafts with aPRF (Plasma Rich Fibrin), in order to optimize bone and gum healing;
- Suture the woundswith aPRF membranes so as not to create gingival tension by pulling the flaps;
- Make an impression to record the positioning of the implants placed;
- Fabricate the resilient composite implant-supported bridge within 2 to 3 days and screw it onto the implants for immobilization.
The primary endpoint is the measurement of the available implantable bone volume on initial radiological examination using the 3D scanner.
It is this criterion that will determine whether enough dental implants can be placed to support the weight of mastication on a fixed implant-supported prosthesis.
In a very schematic way, we will define in the chapter “the world of MCI” several groups of solutions to restore the dental arches by a fixed implant-supported dental prosthesis. In particular for the more or less atrophic maxilla .
Of course, each case is different.
Only a careful study of the clinical case, the needs, the desires and the level of requirements of the patients can lead to a choice of treatment plan.
