IMPLANTOPROTETSKA REHABILITACIJA U ESTETSKOJ ZONI

professional thesis

• Title (english): IMPLANTOPROSTHETIC REHABILITATION IN THE AESTHETIC ZONE
• Author: Joško Grgurević
• Mentor: Ketij Mehulić (mentor)
• Committee member: Andreja Carek (predsjednik povjerenstva)
• Committee member: Ketij Mehulić (član povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Fixed Prosthodontics); Zagreb
• Defense date and country: 2019-10-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry

Abstract

Implantoprotetika je disciplina dentalne medicine koju karakterizira izvanredan razvoj
materijala i tehnika rada. Svrha je ovoga rada sistematično prikazati znanstvenu podlogu i
suvremene koncepte implantoprotetske rehabilitacije u estetskoj zoni.
Prilikom implantoprotetske rehabilitacije u estetskoj zoni treba voditi računa o 10 ključnih
parametara: klinički pregled i procjena estetskog rizika, planiranje terapije na tomogramu,
atraumatska ekstrakcija zuba, ugradnja implantata u 3D ispravnom položaju, upotreba uskih
implantata, nadomještanje kosti u bukalnom procijepu, podebljavanje bukalnih mekih tkiva,
modeliranje izlaznog profila, uzimanje otiska i konačni protetski rad.
Postoje četiri vremenska modaliteta ugradnje implantata nakon vađenja zuba: imedijatna, rana
nakon cijeljenja mekog tkiva, rana nakon djelomičnog cijeljenja koštanog tkiva i kasna. Iako
je imedijatna ugradnja implantata jednako uspješna kao i rana i kasna, te smanjuje broj
operativnih zahvata i čuva kost i meko tkivo, odluka o vremenu ugradnje mora biti utemeljena
na biološkim parametrima, prvenstveno biotipu i stanju bukalne kosti i gingive.
Debljina i cjelovitost bukalne kosti izuzetno su bitne jer tanki biotip i oštećenja kosti dovode
do nepredvidljivosti estetskog rezultata, a biotip sluznice je vjerojatno najvažniji čimbenik u
planiranju implantoprotetske rehabilitacije u estetskoj zoni jer o njemu ovisi količina resorpcije
kosti i dugoročne recesije gingive.
Precizna 3D ugradnja implantata i obavezna augmentacija bukalnog procijepa u dvije zone
preduvjeti su za postizanje dugoročno predvidljivog estetskog rezultata, a vrijeme izrade
individualiziranog provizorija ovisno je o biotipu gingive.
Socket shield tehnika potencijalno može prevenirati mnoge probleme koji se javljaju kod
implantacije u estetskoj zoni, ali su potrebna dodatna istraživanja kako bi se utvrdila dugoročna
održivost postignutih rezultata.

Abstract (english)

Implantoprosthetics is a discipline of dental medicine characterized by remarkable
development of materials and techniques. The purpose of this paper is to systematically present
the scientific background and contemporary concepts of implantoprosthetic rehabilitation in
the aesthetic zone.
When performing implant-prosthetic rehabilitation in the aesthetic zone, 10 keys should be
considered: clinical examination and aesthetic risk assessment, CBCT planning, atraumatic
tooth extraction, implant placement in the 3D correct position, use of narrow implants, buccal
gap bone augmentation, buccal soft tissue augmentation, emergence profile management,
impression technique and final prosthetic restoration.
There are four implant placement options after tooth extraction: immediate, early after soft
tissue healing, early after partial bone healing, and late. Although immediate implant placement
is as successful as early and late, and reduces the number of surgeries and preserves bone and
soft tissue, the timing of implantation must be based on biological parameters, primarily the
biotype and condition of the buccal bone and gingiva.
The thickness and integrity of the buccal bone are extremely important because thin biotype
and damaged bone lead to an unpredictable aesthetic result. Soft tissue biotype is probably the
most important factor in the planning of implant-prosthetic rehabilitation in the aesthetic zone
as it defines the amount of bone resorption and long-term gingival recession.
Precise 3D implant placement and compulsory dual zone buccal gap grafting are prerequisites
for achieving a long-term predictable aesthetic result, and the time of individualized provisional
fabrication depends on the gingival biotype.
The socket shield technique can potentially prevent many of the problems that arise with
implantation in the aesthetic zone, but additional research is needed to determine the long-term
viability of the results achieved.

• Keywords: implantati; estetska zona; rehabilitacija
• Keywords (english): dental implants; aesthetic zone; rehabilitation
• Language: croatian
• URN:NBN: urn:nbn:hr:127:959221
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra dentalne medicine (sveučilišni/a magistar/magistra dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-02-04 11:32:40