Implantologia dentale e Split crest

Espansione ossea per l’inserimento di impianti dentali


Per l’inserimento di impianti dentali è fondamentale che il paziente presenti sufficiente materia ossea nella mascella.
Tuttavia, la caduta dei denti o la loro perdita dovuta a un trauma, una parodontite profonda o una carie mal curata, provoca sempre un importante riassorbimento osseo che, a sua volta, modifica il profilo delle creste mascellari.
Questa atrofia ossea è poi un problema che si presenta quando il paziente desidera avvalersi di una protesi fissa su impianti dentali. Occorre, dunque, praticare un intervento di rigenerazione ossea pre-protesica per inserire impianti di calibro e lunghezza adeguati al carico masticatorio da sopportare.

dentista a bari, split crest, impianti dentali
Foto 1
dentista a bari, split crest, impianti dentali
Foto 2

Tale rigenerazione consiste in una espansione controllata dell’osso mascellare ottenibile tramite una tecnica denominata split crest. Essa consiste nel separare chirurgicamente le zone corticali -vestibolare e palatina- dell’osso mascellare con spostamento in avanti della vestibolare. Si tratta in pratica di una frattura ossea controllata. Nello spazio ottenuto vengono inseriti impianti dentali endossei con innesto di tessuto osseo omologo (proprio del paziente), eterologo e collagene.

Nel caso presentato osserviamo l’agenesia dentale di 12, ovvero l’assenza congenita di un incisivo superiore destro. In questo caso la misurazione dello spessore osseo è di circa 3 mm in direzione vestibolo-palatale (foto 1 e 2).

dentista a bari, split crest, impianti dentali
Foto 3

Abbiamo praticato l’intervento di espansione ossea controllata split crest con cauto inserimento di espansori manuali conici a vite Ostwill di calibro crescente, ottenendo una espansione ossea di circa 3 mm (foto 3).
In tale breccia ottenuta viene immesso tessuto collagene e osso eterolologo e inserito un impianto in titanio con superficie a rugosità controllata NANO-TITAN di ultima generazione, per ridurre il tempo per la sua completa osteointegrazione, ovvero l’assorbimento definitivo dell’impianto dentale da parte dell’osso. (foto 4).

Successivamente sarà eseguito, a fine trattamento ortodontico, un intervento di chirurgia parodontale, detto roll flap, a lembo bilaminare con innesto muco gengivale prelevato dal palato per la ricostruzione dell’architettura gengivale intorno all’impianto dentale.

dentista a bari, split crest, implantologia dentale
Foto 4

 

Prof. Vito Tomasicchio, 
Dentista a Bari e Corato: Centro dentistico Tomasicchio

Torna all’indice degli articoli.

Articolo in Breve
Split Crest per l'Inserimento degli Impianti Dentali
Titolo
Split Crest per l'Inserimento degli Impianti Dentali
Riassunto
Split crest: espansione ossea per l’inserimento di impianti dentali, a cosa serve e in cosa consiste questa tecnica chirurgica.
Autore

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