Interview

IMPLANTOLOGY WITH IMMEDIATE LOAD

In the past, implant placements used to be done by following long surgical procedures.
New technology has revolutionised this situation, allowing patients to have beautiful and natural teeth immediately after implant placement.
We've had the chance to talk to Dr. Giovanni Bona, a dentist who currently uses this methodology.

Dr. Bona, what is an implant with immediate load?
It is a technique whereby the patient can straight away have function and aesthetic rehabilitation with fixed teeth immediately after the implant is installed. It can also be associated with the extraction of damaged teeth and immediate implant placement, reducing waiting times to zero.

Which sort of patients and problems is this technique effective for?
Certainly all those patients who have serious periodontal issues as well as issues of dental mobility who cannot treat their teeth with traditional therapy. In addition, for those people who, for business or personal reasons, would not want to have a tooth missing or cannot stand the idea of having a temporary mobile prosthesis. The ideal patients are those who need to replace all the teeth of one or both arches as, theoretically, a fixed prosthesis is much more stable.

Is the surgery painful? Does it hurt during or after surgery?
The surgery is performed with local anesthetic, using higher doses than the ones used for cavity and root canal treatments. Furthermore, in our surgeries we have adopted aware sedations, performed by a doctor anesthetist, which prevent the patient from falling into a state of agitation that is typical of those people who undergo surgery. Subsequently, post-extraction and post-surgery pain can be treated with the use of simple pain killers which are directly prescribed to you by your dentist.

What is the procedure like?
The treatment consists of a fixed number of sessions:
• the first visit is a checkup during which you will be given a diagnosis, panoramic x-rays and photos will be taken and a CAT scan will be prescribed
• during the second session, your teeth and damaged residues will be removed, your implant inserted and the doctor will take a dental impression of your teeth to model your final prosthesis. Implants are inserted in the frontal part of the jaw, which are usually characterised by a better bone quantity and quality
• the day after surgery the patient returns to the clinic to collect a temporary prosthesis - which is fixed as it is screwed on the previously placed implants
• after three months, when the osseointegration is completed, the temporary prosthesis is replaced with a resin or ceramic permanent one.

Dr. Bona, what are the advantages of this technique compared to traditional implantology?
1. The patient can have complete and functional set of teeth straight away.
2. Minimal treatment and rehabilitation times (fixed teeth, at the latest, 36 hours after surgery).
3. Less expensive for the patient: in all cases, a maximum of 6 implants are positioned, which is more than enough to sustain the chewing load.
4. There is less need to undergo difficult and expensive pre-implant surgery (such as sinus lifts, bone grafting, etc.), owing to the fact that the implants are positioned in areas where bone is present, and tilted in such a way as to avoid "delicate" anatomical structures such as the lower alveolar nerve and the upper maxillary sinus.

Should the patient take some precautions? Are there side effects related to implants with immediate load?
The only precaution the patient must take is to avoid chewing hard food for at least one month whilst adopting a soft food diet. The patient must also follow therapies and advice usually prescribed by the dentist in cases of minor dental surgery as well as teeth extraction - i.e. don't drink hot beverages, don't smoke, etc
As for the side effects, they are dependent on the patient's general health. Therefore, it is at the dentist discretion to carry out further checkups should the patient show exhibit complications.
Furthermore, this type of surgery is unadvised in the case of insufficient jaw. However, we would like to highlight the fact that thanks to the technique of inclined implants, we can actually resolve a number of problems which in the past used to require bone reconstruction.

What are the costs involved for an entire tooth arch rehabilitation?
We can provide a rough cost estimate on the basis of a simple dental panoramic x-ray which the patient can send to our e-mail address giovannibona@tin.it, or by phoning one of our surgeries to arrange a free appointment. For further inquiries and information, you can consult our website www.gbona.com, where you will be able to see images of a number of cases treated with the immediate load method.