Kirurške komplikacije implantološke terapije

master's thesis

• Title (english): Surgical complications in implant therapy
• Author: Darijan Tubikanec
• Mentor: Ivan Zajc (mentor)
• Committee member: Ivan Zajc (predsjednik povjerenstva)
• Committee member: Davor Brajdić (član povjerenstva)
• Committee member: Berislav Perić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2016-09-27, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

Kada govorimo o komplikacijama u implantologiji, podjela se temelji na tri
glavna dijela koncipirana tako da se jedan nadovezuje na drugi meĎusobno se
nadopunjavajući.
Prvi dio govori o postupcima koje je potrebno provesti radi smanjenja rizika
nastanka komplikacija. Svaki zahvat bi trebao započeti anamnezom iz koje
doznajemo postoje kontraindikacije koje bi ugrozile zahvat, nakon čega slijedi izrada
plana. Kod pacijenata kod kojih postoje ograničenja u vidu nedostatka kosti provode
se postupci augmentacije kosti. Najčešći razlog za augmentaciju u gornjoj čeljusti su
nisko spušteni recesusi maksilarnih sinusa prilikom čega se izvodi podizanje dna
sinusa, dok se kod atrofične donje čeljusti radi augmentacija grebena. Suvremena
implantologija sve više koristi CBCT koji se smatra zlatnim standardom.
Intraoperativne se komplikacije kod neiskusnog kliničara dogaĎaju iz razloga
nepoštivanja anatomskih ograničenja koje se ovisno o čeljusti nalaze u gotovo svim
smjerovima. Mezio-distalno granicu čine postojeći zubi ili implantati, buko
lingvalno kortikalne ploče dok apikalno nosna šupljina i maksilarni sinus u gornjoj,
odnosno mandibularni kanal u donjoj čeljusti.
Nakon implantacije uvijek dolazi do gubitka visine marginalne kosti što je
fiziološka pojava ukoliko ostane u okviru dimenzija do 0.2 mm godišnje. Postoji
nekoliko tehnika očuvanja visine kosti, od kojih su neke manje, a neke više uspješne.
Gubitak implantata se može dogoditi rano čemu uzrok može biti traumatsko
postupanje prilikom izrade ležišta implantata, prerano protetsko opterećenje, rad u
nesterilnim uvjetima i ostali razlozi koji dovode do izostanka oseointegracije. Kasni
gubitak implantata je najčešće uzrokovan periimplantitisom, neadekvatnim protetskim
rješenjima gdje je implantat preopterećen, a može doći i do loma implantata u kosti.

Abstract (english)

When it comes to complications in implant dentistry, classification is based
on three main parts designed so that each one of them connects to the other two and
are mutually intertwined.
The first part refers to procedures which need to be taken with the purpose of
reducing the risks of making complications. Each operation should start with
anamnesis which shows whether there are contraindications which may endanger
surgical operation, and are followed by plan making. Patients with restrictions such
as lack of bone marrow undergo the procedures of bone augmentation. The most
common reason for augmentation in the upper jaw are low recesus of maxillar
sinuses when sinus lift is needed, while in atrophic lower jaw the augmentation of
ridge is done. Modern implant dentistry uses CBCT, which is seen as gold standard.
Intraoperational complications of an inexperienced doctor happen because of
not having enough respect of anatomic restrictions which can be found in all
directions depending on the jaw. The existing teeth or implants make the meziodistal
border, cortical plates buccolingual while apically nasal cavity and maxillary sinus in
the upper and mandibular canal in lower jaw.
After the implantation there is always a loss of marginal bone height which is considered a physiological
feature if it remains within the frame of dimensions which make 0.2 mm per year. There are several techiques of
keeping the bone height of which some are less and some more successful. The loss of implants can occur
early when it is caused by traumatic treatment while making the implant bed, when the prosthetic burden
happens too soon, when work is done in nonsterile conditions and there are other reasons which lead to lack
of osseointegration. Later loss of implants is most commonly caused by periimplatitis and inadequate
prosthetic solutions when the implant is overburdened and also, the implant can break in the bone.

• Keywords: zubni implantati; donošenje odluka; kliničko
• Keywords (english): dental implants; clinical decision-making
• Language: croatian
• URN:NBN: urn:nbn:hr:127:343469
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-11-22 12:15:15