Article
Cover
RJDS Journal Cover Page

RGUHS Nat. J. Pub. Heal. Sci Vol No: 16 Issue No: 3   pISSN: 

Article Submission Guidelines

Dear Authors,
We invite you to watch this comprehensive video guide on the process of submitting your article online. This video will provide you with step-by-step instructions to ensure a smooth and successful submission.
Thank you for your attention and cooperation.

Case Report
Naveen Edavan Puliya Cheriyath*,1, Nadeem Abdul Rahman2, Angitha K3, Nikhita Narayanan4, Deepthi V5,

1Dr. Naveen E P C, Senior Lecturer, Department of Prosthodontics, Kannur Dental College, Kerala, India

2Department of Prosthodontics, Kannur Dental College, Kerala, India

3Department of Prosthodontics, Kannur Dental College, Kerala, India

4Department of Prosthodontics, Kannur Dental College, Kerala, India

5Department of Prosthodontics, Kannur Dental College, Kerala, India

*Corresponding Author:

Dr. Naveen E P C, Senior Lecturer, Department of Prosthodontics, Kannur Dental College, Kerala, India, Email: dreamsmiledent@gmail.com
Received Date: 2023-11-22,
Accepted Date: 2024-02-19,
Published Date: 2024-09-30
Year: 2024, Volume: 16, Issue: 3, Page no. 54-56, DOI: 10.26463/rjds.16_3_2
Views: 231, Downloads: 13
Licensing Information:
CC BY NC 4.0 ICON
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0.
Abstract

The purpose of this article was to report a case of rehabilitating a patient involved in a road traffic accident using 10 single piece basal implants, which were functionally loaded with a mandibular cement-retained fixed partial denture. Great outcomes were achieved with immediate loading implants. They can be inserted both into the healed bone and also the extraction sockets. Their implantation in bone of poor quality is made possible owing to their structural features. This makes basal implants the best choice over conventional implants in accident cases where the bone is irregular and has multiple defects. In cases where alternative treatment plans involve uncertain augmentations, basal implants should always be the first choice. The basal implantology technique resolves all the problem related to traditional (crestal) implantology.

<p>The purpose of this article was to report a case of rehabilitating a patient involved in a road traffic accident using 10 single piece basal implants, which were functionally loaded with a mandibular cement-retained fixed partial denture. Great outcomes were achieved with immediate loading implants. They can be inserted both into the healed bone and also the extraction sockets. Their implantation in bone of poor quality is made possible owing to their structural features. This makes basal implants the best choice over conventional implants in accident cases where the bone is irregular and has multiple defects. In cases where alternative treatment plans involve uncertain augmentations, basal implants should always be the first choice. The basal implantology technique resolves all the problem related to traditional (crestal) implantology.</p>
Keywords
Basal implant, Immediate loading, Implantology, Cement retained
Downloads
  • 1
    FullTextPDF
Article
Introduction

Dental implants are now the preferred method of rehabilitation over traditional fixed partial dentures (FPDs) and removable partial dentures (RPDs). However, the main disadvantage of conventional implants is the delay in loading, which typically involves waiting a minimum of 4-6 months after placement. This is one of the reasons for implants not being a popular option for rehabilitation. Introduction of basal implants and its design developments have made immediate loading possible, making it a popular choice.1 More aggressive threads of basal implants have made placement possible even in cases of trauma where bone is compromised and success of conventional implants is in doubt.2

Conventional Crestal Implantology

When an implant is placed into the jaw bone from the crestal alveoli and has vertical primary load-transmitting surfaces, it is referred to as a crestal-type implant in crestal implantology. The alveolar bone, which is used by conventional implants, is lost following tooth extraction and diminishes over the course of a person's life as function declines. As the front section of the jaw typically provides sufficient vertical bone, it is customary to place screws which are at least 10 - 13 mm long in this area. Crestal implants are not advised for patients with very limited available vertical bone.

Basal Implantology

Modern implantology systems, such as basal implantology or bicortical implantology, use the basal cortical section to hold dental implants in place. The retention of these exceptional and cutting-edge implants is made possible owing to the design.3 The term "orthopedic implant" is also used to distinguish basal implants from the more common phrase "dental implant", as basal implantology involves the use of orthopedic surgery guidelines. The limitation of basal implants is that it is not indicated in single tooth replacement and requires a greater number of implants to be placed for rehabilitation.4

Case Report

A 35-year-old male patient reported to the Department of Prosthodontics, Crown and Bridge, with multiple missing teeth in mandibular arch which were extracted following an accident one year ago. On examination, only second molars and impacted third molars were present in the mandibular arch (Figure 1). Areas of irregular healing following trauma were noted on the ridge. Patient desired rehabilitation with fixed implant prosthesis with minimum time for the completion of procedure. Considering the time factor and the age of patient, implant placement followed by immediate loading was decided as a suitable treatment choice. Since immediate loading was required, basal implant was the best choice available. Pre-operative orthopantomogram (OPG) was advised. The patient underwent standard blood investigations including clotting time and bleeding time, and the findings were deemed to be within normal limits. The local anesthesia was achieved with infiltration technique using lignocaine 2% to ensure the responsiveness of the mandibular nerve. Then, utilizing a flapless rapid method, ten basal implants were inserted which was single piece (Figure 2).

Polyvinyl siloxane material was used to record impressions and Aluwax was used to record tentative jaw relations. An OPG was made to verify their positions and angulations (Figure 3). Definitive jaw relation records were made on the second day following the successful completion of the metal try-in procedure and the metal framework trial within the patient's mouth. On the third day, a cement-retained porcelain-fused to metal (PFM) FPD was functionally loaded onto every implant, resulting in a bilateral balanced occlusion. Final smile evaluation was done (Figure 4).

Discussion

Since basal implants are positioned in the cortical bone which provides a greater primary stability, immediate loading is feasible and results are more predictable. As soon as feasible, the metal framework should be splinted to prevent further deterioration of the peri-implant bone structures due to the 72-hour bone remodeling process.

The masticatory forces that are generated in the bone surrounding the implants are also distributed to other cortical locations by the splinting. Traumatology is familiar with this process and its guiding principles.5 Using handgrip equipment, ten implants were inserted using a flapless technique into the mandibular jaw. It is possible to introduce the aggressively threaded, smooth surface basal implants into contaminated sockets.6 Without corticalization, excellent primary stability may be attained along the vertical surfaces of implants. They can therefore be utilized for both immediate loading and placement.7 In this instance, the entire process was completed in five days.

Basal implants support single and multi-unit restorations in the upper and lower jaws. They can be placed both in extraction socket as well as in the healed bone. Their structural characteristics enable their implantation in a bone with insufficient height and width. In cases where alternative treatment plans involve uncertain augmentations, basal implants should always be the first choice. The method of basal implantology provides solutions for any issue related to traditional (crestal) implantology. This shortens the time required for the treatment completion.

Conflict of Interest

Nil

Supporting File
References
  1. Creugers NH, Kreulen CM, Snoek PA, et al. A systematic review of single-tooth restorations supported by implants. J Dent 2000;28:209-17.
  2. Yadav RS, Sangur R, Mahajan T, et al. An alternative to conventional dental implants: Basal implants. Rama Univ J Dent Sci 2015;2:22-8.
  3. Kopp S, Kopp W. Comparison of immediate vs. delayed basal implants. J Maxillofac Oral Surg 2008;7:116-22.
  4. Narang S, Narang A, Jain K, et al. Multiple immediate implants placement with immediate loading. J Indian Soc Periodontol 2014;18:648-50.
  5. Chang TL, Raoumanas ED, Klokkevold PR, et al. Biomechanics, treatment planning and prosthetic considerations. In: Carranza's Clinical Periodontology. 10th ed. St. Louis: Saunders Elsevier; 2006. p. 1167-81.
  6. Heim D, Capo JT. Forearm, Shaft. In: AO Principles of Fracture Management. Vol. 2. Stuttgart, New York: Thieme-Verlag; 2007. p. 643-56.
  7. Shah S, Ihde A, Ihde S, et al. The usage of the distal maxillary bone and the sphenoid bone for dental implant anchorage. CMF Implant Dir 2013;8:3-12.
HealthMinds Logo
RGUHS Logo

© 2024 HealthMinds Consulting Pvt. Ltd. This copyright specifically applies to the website design, unless otherwise stated.

We use and utilize cookies and other similar technologies necessary to understand, optimize, and improve visitor's experience in our site. By continuing to use our site you agree to our Cookies, Privacy and Terms of Use Policies.