A dental implant is the first step to replace the missing tooth through the placement of a Crown supported by the internal part of the titanium core of the fixture. The options for the dental implants placement vary from a single tooth to a full mouth restoration with removable or fixed dentures. the tooth can be replaced inmediatelly meaning that the extraction, implant placement and a crown are placed the same day. Also extraction of all remaining teeth on the lower jaw are ideally to place 4 or 5 implants and build a so called Hybrid fixed denture in three or four days. The idea of a so called all on 4 is real and can be done with excellent results. We also use all on 5 wich from costs is almost the same compared with the all on 4. On the upper maxilla we use and recommend all on 6 for a hybrid fixed denture. On the other hand for a fixed upper bridge, 8 fixtures should be placed to achieve a distribution of biomechanicall forces through the dental arch in the jaw. The ideal solution for a full mouth restoration is always to receive individual implants supported crowns, then a bridge, then hybrid fixed denture, then an overdenture and finally a removable denture. To decide what of the options are doable we make a simulation of the future position of the teeth by using a computed tomography over a software to build with the use of a 3D printer a surgical guide. From here we decide if a sinus lift graft should be made, or if a simple bone graft with or before the dental implants are placed are needed to achieve one of the options depending on the bone atrophy. If no graft is needed implants are placed and prosthesis are build fixed or removable depending on the need of waiting for osseointegration of titanium from the implants to the bone to form a intimate bond wich will ensure a long-term success for the dental implants and the restorations.
Dr. Jairo Vargas