Implant placement most of the times is a challenge faced by implantologists. These challenges can be very poor bone support due to extractions, gum disease, poor finances and/or extreme expectations from patients.
Our implantologists at The Dental Specialists have faced these issues right from the beginning. Conventional implants needed huge finances, bone augmentation or sinus lifts. It’s not an easy task, both for the implantologist and the patient.
Serving thousands of patients since 15 years, whenever conventional system was tried, there was a huge financial burden on the patients, not to mention the physical trauma and strain of sinus lifts, bone grafts, membranes, that increase the costs and make them even more painful, and very technique sensitive procedures requiring great skills and experience from the implantologist concerned.
Moreover, the waiting periods are very long, frustrating both patient and doctors alike. Our team felt there is an immediate need for an implant procedure that is necessary for our dear patients.
The good news is that all these traits are available in TTPHIL Implantology. Its a combination of Surgical principles of Basal Implants for high primary stability and Immediate Loading and Prosthetic principles of conventional screw retained technology which is very important for retrievability and high esthetic considerations
TTPHIL implants are also known as Bicortical or 2 Piece Cortical Implants. Our team utilizes the best of implant companies manufactured from Germany and Israel which have been approved by FDA , CDESCO. Orthopaedic specialists l, Father of Implantology Dr. Branemark is also an orthopedcian introduced basal Bicortical Implantology that spread to dentistry. The invention of osseointegration by Dr. Branemark in the rabbit is also Bicortical Basal Implantology. TTPHIL IMPLANTOLOGY ( TALL- TILTED- PINHOLE – IMMEDIATE LOADING PROTOCOL) can be done for every case: Ideal Good Bone cases, Atrophied No Bone cases, Single tooth, Multiple teeth , Full arch , Full mouth Rehabilitation, both in Maxilla Upper Jaw as well as Mandible in the lower Jaw. Maxillary and mandibular posteriors in resorbed ridge cases pose a great challenge because of the anatomical limiting structures like Maxillary Sinus and Inferior Alveolar Nerve will not allow us to place the implants straight axial conventional way, which requires major bone grafting, sinus grafting and augmentation procedures. TTPHIL IMPLANTOLOGY makes it possible by placing the implants in the tilted way bypassing the major anatomical limiting structures and engaging the basal cortical bone , thereby achieving predictable primary stability which allows us to IMMEDIATE LOAD THE IMPLANTS. Immediate loading or delayed loading depends on the primary stability achieved. The decision will be taken by your implantologist. Bicortical Stabilization doesnt mean we can always load Immediately because many other factors need to be considered. Its not the implant system which is forcing us to load the implants, it depends on the knowledge experience of the implantologist, which is allowing us to take a decission for your benefit.
Why TTPHIL implants?
Basal bone is the highly dense bone in the jaws. It’s less prone to infections. This is the bone area that provides the best support to the implants. Basal bone is very much strong and highly mineralized compared to crestal alveolar bone. Crestal alveolar bone has less strength and less load bearing capacity. The conventional implants are always placed in the less strong crestal bone. But the basal bicortical TTPHIL implants are always placed in the much stronger basal bone.
ADVANTAGES OF TTPHIL IMPLANTS
1.INDICATIONS:Basal implants are used generally in poor bone quantity and quality bone engaging basal cortical bone.
Conventional cannot be used in poor bone quantity and quality.
TTPHIL Implants can be used for both poor and adequate ideal bone quantity and quality bones because we engage both basal cirtucal as well as alveolar bone.
2.MECHANISM:Basal implants stabilize by Osseofixation.
Conventional implants stabilize by osseointegration
TTPHIL Implants stabilize by both Osseofixation and Osseointegration. We have added advantages of osseoexpansion, densification and Osseocondensation because we use minimal invasive single drill concept. Hence Immediate loading is possible.
3.IMPLANT PROCEDURE: Basal implants are forced to be loaded in 72 hours because the bone develops or starts osteoclastic activity which is a natural process in any healthy human being. Basal implants are supposed to be loaded immediately if not loaded in 3 days may fail because they are just osseofixated to basal cirtical bone and no osseodensification. Because basal implants are single piece implants the implantologists do not have a choice to load late. It is the implant system which is forcing to load and not your doctor. So your doctor has to force you to get the teeth immediately. Because of the extractions and surgical procedures the gum shrinks over a period of time which creates space between the teeth and the gingiva which creates space for food lodgement leading to halitosis and infections. Sometimes there are chances the teeth break etc because of the laboratory errors, since the teeth and the dentures are fixed with cement your doctor is also helpless. So you are helpless! Now few companies have come with screw retained basal implants which is somewhat better option than cement retained singke piece basal implants.
Conventional implants take 3 to 4 months to take loads. They believe in bone building concepts. Here quantity of bone is built not quality of bone. Here we need to wait for 3 months to 12 months to build the new bone.
TTPHIL implants can be loaded between 2 days to 14 days depending on case to case. You are not forced to load the implants. The doctor is the decision maker and not the implant system. In case your doctor feels there is no stability of the implant , to avoid risk you can wait to avoid failures.
4.ARMAMENTARIUM: TTPHIL and Basal implants have a very simple kit. In both these techniques flapless procedures are done.
Conventional implants have complex kits consisting of surgical kit, sinus lift kit, ridge split kit, planning kit etc
Basal implants are cheaper compared to conventional implants because the abutment comes with the implant. Milling of the implants takes less time with any kind of basic milling machines. Basal Implants have abutments and implants connected. It’s easy to fabricate and machine these implants. These implants are not approved by FDA. Conventional and TTPHIL 2 PIECE CORTICAL implants are affordable. Maybe a little expensive than basal but safer than basal implants. Safer means your implant doctor takes the decision whether to load or not to load not the imolant system which is forcing to load. 2 piece implants have screw retained prosthetic solutions. Basal implants have only cement retained solutions ( Some companies have come with retrievability solutions because of the retrievability problems. These screw retained basal implants are somewhat better than cement retained basal. Anything can happen any time in medical field. Laboratory error, surgical errors, esthetic errors bite errors, patient compliance many more, so safe to go for retrievable solutions) which need to be cut when a problem or complication occurs. Basal on a long term is very expensive. No doctor tries to touch your case. You need to go back to the same doctor again to get it repaired.
Basal implants are cheaper. But 10 to 12 implants have to be placed to restore 6 teeth in each quadrant only till 1st molar. Is it worth spending so much. Basal implanys are thin having very less Bone Implant Contact , so more implants are suggested to you. Now you calculate which is cheaper???
On the other hand Conventional or TTPHIL IMPLANTS use 6 implants to restore all the teeth till 2nd molars giving maximum chewing efficiency to you. The decision is taken by your implantologist based on your xrays and clinical findings. Immediate loading or delayed loading will be taken by your dentist after placement of the implants only based on the stability achieved.
6.PROSTHETIC PROCEDURE: In basal system, prosthesis has to be delivered in 72 hours so it’s an advantage and disadvantage simultaneously. Offering accurate and perfect prosthesis with perfect bite snd esthetics and function in such a short time is a challenge. There will be lot of gaps between prosthesis and your gums over a period of time when the gums shrink. It makes it difficult to clean, speak and esthetics are compromised.
In TTPHIL and conventional system, prosthetics can be digitalized reducing the number of appointments. We use retruevable solutions. No trauma of cutting the metal bridges
7.SURFACE OF IMPLANTS: Basal implants have smooth and conventional implants have rough surface. Rough surfaces have increased risk of infections. Hence recently conventional implants are coming with antibiotic coated rough surfaces that fight infections. TTPHIL implants have both advantages of Basal and Conventional Implants. TTPHIL Implants are rough to improve BIC (Bone Implant Contact) and are placed way below the bone ( SUBCRESTALLY) to prevent chance of infections. TTPHIL IMPLANTOLOGY uses longer antibacterial gold anodized abutments which prevent risk of infections. TTPHIL have advantages of both Conventional and basal!
8.MAINTENANCE: TTPHIL, Basal and Conventional implants need maintenance visits, and prostheses too need regular evaluation.
9.PATIENT SELECTION: Smokers and periodontitis patients can get the basal and TTPHIL and conventional implants done. But they cannot get conventional implants done if bone grafting has to be done. It takes more healing time. TTPHIL implants takes the osseofixation, densification and osseointegration as advantage.
10.ADDITIONAL SURGERY: TTPHIL and Basal implants don’t need any additional surgery or augmentation. Conventional implants almost always need additional painful traumatic surgeries.
Basal implants have lot of prosthetic disadvantages and Conventional implants have lot of surgical disadvantages. TTPHIL IMPLANTOLOGY takes the advantages of both Basal and conventional implantology and overcomes the disadvantages of both Basal and Conventional implants.
When all the above comparisons indicate that TTPHIL basal cortical implants are much better compared to the conventional implants and basal implants then why get conventional implants? Why don’t we simply use TTPHIL implants in all cases?
The answer is not simple. The physiology and biochemistry of the jaws differ from person to person. Depending on a lot of factors, your implantologist will decide which one would be best for you. Usually conventional implants can be done by many general dentists too. But TTPHIL implants need specially skilled and experienced experts in the field. That is what exactly our implantologists do at The Dental Specialists. 15 years of laborious research has given birth to an innovation called TTPHIL that’s creating a revolution in Implantology. In this technique designed by Dr Venkat Ratna Nag, the implants gather all the basic necessities like osseointegration, Osseofixation and osseocondensation for the best stability. Tall Tilted, Pin hole Immediate loading is the technique that’s bringing wonderful results with excellent prosthetic work and beautiful aesthetics. Utilizing two piece implant system is bringing out amazing results as the technique uses the surgical advantage of single piece system and prosthetic advantage of two piece system. Screw retained prostheses would enable the dentist to evaluate effectively periodically. Cement retained system is not retrievable. Screw retained system is retrievable and very comfortable to manipulate and follow up. These implants are longer implants which have better surface area over the conventional implants which are very short. That’s the reason why these conventional implants cannot be loaded immediately.