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Implant dentistry
Implant dentistry is a part of dental medicine combining knowledge and skills from a few areas of general and dental medicine, chiefly anatomy, oral surgery, parodontology and dental prosthetics.

In modern implant dentistry the possibilities are limitless and the insertion of implants is almost always possible provided that a suitable and high-quality implant system, the right, safe and predictable technique of augmentation and the best surgical techniques are used. All this ensures an almost painless and completely safe procedure and a short recovery period for the patient.

Whether it is an insertion of a single implant or an implantation work on both toothless jaws, it is important to use a state-of-the-art implant system, diagnosis methods, instruments and equipment, and the best bone augmentation and gum sewing materials.

In Dental clinic Tomislav Flegar, D.M.D., for implant and bone augmentationprocedures we use top-rated and state-of-the-art PRGF - Endoret® biotechnology which produces the best and the most natural material for bone augmentation from the patient's blood plasma.


Dental implants are bolts which are inserted into the patient's jaw. They are made of titanium, while their surface is treated witha variety of methods, from bombarding the surface with ions of various gasses up to calcium ions, all for better accretion of implant with the surrounding bone. Modern implants, made by renowned producers, the only ones we use, have differently shaped parts enhancing excellent accretion with the surrounding bone i.e. SUCCESSFUL IMPLANTATION. Each implant has its own serial number and declaration, which are given to the patient after the implantation. Sometimes implant procedures need adding of a part of a bone i.e. AUGMENTATION. An implant can be placed almost always, with the right choice of augmentation techniquei.e. the best and the safest for the patient. We use all known augmentation techniques, including using the patient's plasma with retained factors and growth hormones, as the most natural and the best material possible. A computer programme for planning implant procedures, first-class implant, knowledge, responsible approach and the use of all implantation and augmentation techniques and protocols, the use of the state-of-the-art biotechnology and its scientific background described in over 150 scientific articles, modern equipment, twenty years of work experience, constant education of dentists and close collaboration with the Biotechnology Institute are what we consider to be the precondition for a successful outcome in even the most complex cases. Since dental implants supplement natural tooth root, they are a state-of-the-art solution for replacing a single tooth or a completely toothless jaw.

Teeth in one day ("All on four, All on six")

It is a system based on four to six implants in either upper or lower jawbone which, by the use of special abutments and cylinders, a so called 'hybrid bridge' is fixed onto in the same day or at the most within 36 hours after the placing of the implants. This system allows avoiding anatomic structures which could otherwise be an impediment in implant placement, or to be more precise it allows the placing of implants without big surgeries of sinus lift or bone augmentation.

On the day of the surgery the patient arrives at the clinic in the morning, where he/she is given local anaesthesia and sometimes also conscious sedation, which helps to endure the few hours of surgery more easily. After the patient is given anaesthesia, the implants are placed. While placing the implants their stability is of primary importance since they need to be able to sustain pressure immediately after they are placed. Later on special abutments are placed, allowing the optimal transmission of forces on the freshly placed implants as well as fixing the hybrid dental bridge with screws. Afterwards gum is sewed-up and the patient's dental impression is made. Throughout the day the patient visits the clinic several times for the various stages of prosthetic work on the prototype of the hybrid dental bridge fixed by screws, a temporary prosthesis meant to be worn for 3 – 6 months before a permanent dental bridge is fixed with screws onto the implants. The screw hole is then filledwith dental composite, leaving its location completely unnoticeable and fully integrated in the whole of the prosthetic work.

When it comes to the permanent bridge, more attention is given to aesthetics and the already osseointegrated implants' ability to sustain full pressure. It is particularly convenient for the patient that while the permanent one is being made they are able to wear the temporary bridge in their mouth, which is removed and placed back at every check-up, allowing them to function normally.

The permanent work can be made in metal-ceramic, zirconia-ceramic or acrylic, and by the use of CAD-CAM technology while using the same materials.

The advantages of this kind of dental work are numerous, while for patients the main advantage is that the toothless jaw is supplied with fixed teeth in a single day, avoiding the waiting period of 3-6 months as in 'classical' implant placement.

In conclusion, it is the state of the art technically highly sophisticated procedure which allows high-end aesthetical and functional results in a short time-span of around twelve hours. Highly sophisticated procedures such as CBCT scans, computer programmes for planning the procedure, making the model to help with the implant placement, modern equipment, reliable implant placement systems, application of all experience-based knowledge and techniques, as well as partnership with an educated dental technician, all make an augmentation with permanent prosthetics and excellent functional and aesthetical results a reality.

Immediate implant placement and loading

Sometimes immediate tooth removal and implant placement is possible. This significantly shortens the waiting period between tooth removal and possible implant placement at the same location, which substantially shortens the duration of the whole therapy. For this, certain conditions have to be met, such as atraumatic tooth extraction to preserve the bone, inflammation-free location with enough 'healthy' bone, as well as positive anatomical situation.

Modern methods in diagnostics, such as CBCT scans and computer programmes for planning the implant placement, making the model to help with the implant placement; modern equipment and technology, including PRGF - Endoret® biotechnology; permanent education and vast experience – all these are our strengths in these kinds of procedures, leading to predictable and satisfactory end result.

Furthermore, sometimes it is possible to load implant which has just been placed. This kind of procedures are usually done in the aesthetic part of the oral cavity, when it is completely unacceptable for the patient to remain toothless all throughout the period of implant accretion. In those cases special abutments are used to provide extraordinary aesthetic results immediately after the implant placement, as well as correct force transfer on the freshly placed implant, in order to insure the success of implant-prosthetic therapy.

Dental implant placement procedure

Dental implant is a titanium bolt which is placed into the jaw bone by a simple and completely painless procedure. It is a state-of-the-art procedure for replacing a single tooth or a completely toothless jaw.

In Dental clinic Tomislav Flegar, D.M.D., we use BTI (Biotechnology Institute, web address: bt-biotechnologyinstitute.com) implants, the placement of which is a bit different than the placement of all other implants. In the procedure we use microsurgical technique and material made of the patient's blood plasma, with retained factors and growth hormones, which further enhances the accretion of implant with the surrounding bone.

The procedure of implant placement and making a prosthetic tooth replacement is done in several phases:

1. Dental check-up and referring to CBCT scan – the dentist listens to the patient’s wishes, motives, capabilities and expectations. General physical condition of the patient is also discussed and the patient is introduced to the implant placing procedure. CBCT scan is highly important in planning implant therapy since it is the only kind of scan allowing a three-dimensional image, which is necessary for competent top-quality therapy plan.

2. CBCT scan analysis, therapy plan and professional quote – CBCT scan is opened in a special computer programme which enables us to see all anatomy structures, the height and width of the bones, and most importantly it measures the density i.e. quality of the bones. Once the therapy plan is made, a professional quote is added up.

3. Implant placement – first the patient’s blood is taken in the clinic, followed by local anaesthesia at the implant placement location. When the anaesthetic takes action a small cut is made in the patient’s gums in order to reach the bone. The bone is then biologically drilled with specially designed instruments, at low speed and without flushing so that a completely biologically preserved bone is left at the preparation location. The location is then flushed with the patient’s blood plasma, as is the surface of implant, which is then placed in the bone, and afterwards gums are sewed up with microscopic needle and thread.

4. Abutment placement – after the accretion of the implant with the surrounding bone and when the gums are shaped, a titanium or zirconia abutment is placed on the implant, onto which a dental crown is placed.

Most common misconceptions about dental implant placement

My doctor told me that it is impossible to place an implant into my jaw and that I need a prosthesis/dental bridge! During my work experience I have placed many implants. In only few cases it was impossible to place an implant because of the narrow horizontal space between teeth. In all other cases, the implant placement was successful. Sometimes it takes various pre-implant procedures to enable the placement of implants. For the best-quality work in implant dentistry it is necessary to know, learn and use all surgical techniques for bone augmentation, maxillary sinus floor augmentation, bone blocks extraction, using fibrin and other kinds of membranes, while using the best and state-of-the-art technology, methods and procedures, which will all enable a successful implant placement in almost any patient.

If I get a dental implant, I won’t be able to go to MRI (magnetic resonance imaging)! Implants are made of titanium, which, apart from being extremely solid and light, is also non-magnetic. Because of all these performances, all endoprostheses (materials which are implanted into the body), as well as dental implants, are made of titanium. Furthermore, all prosthetic superstructure replacing a lost tooth is also made of non-magnetic metals.

My blood pressure is high and I have diabetes so I can’t get a dental implant! High blood pressure is not a contradiction to implant placement, and neither is controlled diabetes. Only few systemic illnesses can be considered contradictions to dental implants.

Will my body ‘accept’ or ‘reject’ the implant? Dental implants are made of metal, titanium, which is immunologically inert, which means that the reaction from the body is not needed for the implant to ‘take hold’. Osseointegration i.e. the accretion of Implant with the surrounding bone, depends on the processes of new bone creation and the degradation of the existing one, while the immune reaction of the body makes no difference in this case. By using the patient’s blood plasma, rich in growth factors, the process of implant accretion is significantly enhanced, with the success rate as high as 99%.

I’ve read that dental implants don’t last long! Thedurability of a dental implant depends on various factors. Skill, knowledge and experience of the doctor performing the operation, the implant made by a top-quality producer with years of scientific research, the performance of implant placement, manufacture of prosthetic superstructure according to the professional rules, the patient’s oral hygiene and regular check-ups, all together guarantee the long-lasting of dental implant.

Concept "ON THE EDGE"
New concept in implant dentistry

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