TITANIUM SUBPERIOSTEAL ONE PHASE-TWO PHASE SECOND PART

SECOND PART

TITANIUM SUBPERIOSTEAL CUSTOM MADE ONE PHASE IS A PREDICTABLE GRAFTELSS SOLUTION FOR THE SEVERE ATROPHIC MAXILLA AND MANDIBLE

THE SYSTEMATIC USE OF STEREOLITHOGRAPHY FOR SUBPERIOSTEAL IMPLANTS : 15 YEARS EXPERIENCE CLINICAL CASES PROCEDURE AND TECHNIQUE

ENRICO BELOTTI M.D. / D.D.S

ENRICO BELOTTI M.D. / D.D.S EDUCATION 1977 SCIENTIFIC HIGH SCHOOL BRESCIA (ITALY) ( 5 YEARS) 1983 DEGREE IN MEDICINE AND SURGER WITH HONORS BRESCIA UNIVERSITY ( 6 YEARS) 1988 SPECIALIZATION IN INTERNAL MEDICINE BRESCIA UNIVERSITY ( 5 YEARS) 1992 POST-GRADUATE ORAL IMPLANTOLOGY AND ORAL SURGERY NEW YORK ( 1 YEAR) 20013 MASTER'S DEGREE IN AESTHETIC SURGERY PERUGIA (ITALY) (2 YEAR)

EXPERIENCE MORE THAN 100 CONFERENCES , TUTORING AND TEACHING OF CUSTOM MADE SUBPERIOSTEAL TECHNIQUE IN 30 YEARS OF PROFESSION ACADEMIC YEAR 2012/2013 POST DOCTORAL TUTOR " MASTER SECONDO LIVELLO DI IMPLANTOLOGIA E PROTESI DENTARIA UNIVERSITY NOSTRA SIGNORA DEL BUON CONSIGLIO TIRANA -ALBANIA E. BELOTTI M.D / D.D.S HAS BEEN FAVORITE SURGEON STUDENT OF C.M.WEISS D.D.S AND PROF L.LINKOW D.D.S ( FATHER OF MODERN IMPLANTOLOGY) MORE THAN 10,000 SURGICAL OPERATION IN LOCAL, CONSCIOUS SEDATION AND GENERAL ANESTHESIA , FOR NEOFORMATIONS OF SOFT AND HARD TISSUE , INCLUDED,DYSODONTIASIS, DENTAL IMPLANTS , GRAFTS AND PERIODONTAL SURGERY. 800 SURGICAL INTERVENTIONS OF FULL-ARCH SUBPERIOSTEAL/ PARTIAL SUBPERIOSTEAL CUSTOM MADE IMPLANTS DESIGNED FOR ADVANCED BONE ATROPHIES COLLABORATION FOR PROJECTS AND PATENTS -ENDO-ORAL WELDER COMEPRE (1994) -TITANIUM CASTING OF SUBPERIOSTEAL DEVICES (VITTONI AURODENTAL BRESCIA ITALY) SINCE 2000 -THE SYSTEMATIC USE OF STEREOLITHOGRAPHY FOR SUBPERIOSTEAL IMPLANT WITH BIO-ENGINEER DAVOLIO (SINCE 2004)

IN SOME CASES, DUE TO PROLONGED PERIODS OF EDENTULISM, REHABILITATION OF THE EXTREMELY ATROPHIC EDENTULOUS MAXILLA IS COMPROMISED, AS THE ALVEOLAR BONE VOLUME IS OFTEN INADEQUATE. PATIENTS WITH ADVANCED OR SEVERELY RESORBED ALVEOLAR CRESTS PRESENT A DAUNTING SITUATION REGARDING BONE HARVESTING AND DENTAL REHABILITATION. DURING THE LAST 3 DECADES, SEVERAL SURGICAL PROCEDURES HAVE BEEN DEVELOPED TO INCREASE LOCAL BONE VOLUME IN DEFICIENT ANATOMICAL REGIONS, INCLUDING COMPOSITES GRAFTS , LE FORTE 1 OSTEOTOMY WITH INTERPOSITIONAL BONE GRAFTS, GRAFTING OF THE MAXILLARY SINUS WITH AUTOGENOUS BONE AND/OR BONE SUBSTITUTE,,VASCULARIZED GRAFTS ,ZIGOMATIC IMPLANTS WITH INTRA-SINUS OR EXTRA-MAXILLARY APPROACHES AND TILTED PTERYGOID IMPLANTS

LEFORT 1 AND INTERPOSITIONAL GRAFT EVEN IF PREDICTABLE HAVE NOT RECEIVED AN ADEQUATE ACCEPTANCE FROM PATIENTS AND HAVE INDICATIONS IN SERIOUS ONCOLOGICAL AND POST-TRAUMATIC BONE LOSSES THE PROCEDURES HAVE NOT A FAVORABLE RISK- BENEFIT RATIO COMPOSITES GRAFTS PROCEDURE IS NOT PREDICTABLE IN THE LONG TERM

ZIGOMATIC IMPLANTS WITH INTRASINUS OR EXTRA-MAXILLARY APPROACHES NEEDS A PROPER SELECTION; PREEXISTING SINUS PATHOLOGIES MUST BE CORRECTED (F.E.S.S.) THE APPROACHES ARE INDICATED IN EMI-MAXILLECTOMY; POSSIBLE SERIOUS COMPLICATIONS SUCH AS PENETRATION INTO THE PTERYGOPALATINE FOSSA AND INFRATEMPORAL FOSSA. CUTANEOUS FISTULA AND THE ASEPTIC NECROSIS OF THE ZYGOMATIC BONE, WILL NOT LEGALLY JUSTIFY THE THERAPEUTIC CONDUCT OF NOT EXPERTS OPERATORS WITHOUT ADEGUATE TRAINING AND NOT ADEGUATE SCIENTIFIC KNOWLEDGE BEFORE THE SURGICAL PROCEDURE;A HEIGHT LOWER THAN 15 MM OF THE ZIGOMATIC BONE CAN REDUCE THE BIOMECHANICAL RESISTANCE TO THE LOAD AND THERE ARE NOT SUFFICENT CLINICAL DATA FOR EXTRA-MAXILLARY APPROACHES THE SUBPERIOSTEAL SYSTEM HAS NOT LOCAL AND SYSTEMIC CONTRAINDICATIONS; MORBIDITY AND CO-MORBIDITY WHICH CAUSES THE FAILURES OF MODERN TECHNIQUES DO NOT INFLUENCE THE PROGNOSIS OF THE IMPLANT

FROM A MULSTISLICE C.T. GET THE 3D RECONSTRUCTION OF THE ARCH ( UPPER/LOWER ); THE STL FILE GENERATES A LITOGRAPHIC MODEL UPON WHICH THE TITANIUM CUSTOM MADE DEVICE IS PRODUCED IN A SINGLE OPERATING TIME , PATIENT CAN LEAVE THE OFFICE WITH A TEMPORARY PROSTHESIS LOADED IMMEDIATELY 30 YEARS OF EXPERIENCE TAUGHT ME THAT THE ONLY COMPLICATIONS CONCERN THE SOFT TISSUES

IT IS ENOUGH TO DO A MULTISLICE C.T. IN A RADIOLOGICAL CENTER ACCORDING TO OUR INDICATIONS TO BE UNDERTAKEN TO THE PROCEDURE FOR MORE INFORMATION, SEND MAIL TO INFO@ENRICOBELOTTI.COM OR TO CALL +39 030 7400212 DENTAL OFFICE THE INTERVENTION CAN BE DONE IN OUR CLINICS IN CONSCIOUS SEDATION IN BRESCIA OR MILAN ITALY

SUBPERIOSTEAL IMPLANT

ENRICO BELOTTI M.D.

ENRICO BELOTTI

info @ enricobelotti.com

PROCEDURA CHIRURGICA ( Prima Fase ) Spina nasale anterosuperiore Esplorazione del tessuto molle riduzione accentuata del fornice Sedi Biostatiche

Versante Palatino

PROCEDURA CHIRURGICA ( Prima Fase )

Evitare incisioni profonde di rilascio

PROCEDURA CHIRURGICA ( Prima Fase ) Impianti a carico immediato effettuati in una seduta precedente (saldatura provvisoria)

PROCEDURA CHIRURGICA ( Prima Fase )

ENRICO BELOTTI M.D.

PROCEDURA CHIRURGICA ( Prima Fase )

Fascio interincisivo

Processo zigomatico

ENRICO BELOTTI M.D.

PROCEDURA CHIRURGICA ( Seconda Fase )

Minina incisione di scarico

Barre lontane dalla fenestrazione

Barra Palatina Fenestrata

ENRICO BELOTTI M.D.

PROCEDURA CHIRURGICA ( Seconda Fase ) Miglior controllo con sutura a punti staccati

Errore : piccola esposizione

ENRICO BELOTTI M.D.

La tensione della sutura può provocare una lieve ischemia dei tessuti molli

OPT POSTOPERATORIE

LOWER SUBPERIOSTEAL IMPLANT STEP BY STEP

SOTTOPERIOSTEO INFERIORE STEP BY STEP 1) ISOLARE IL FORAME MENTONIERO

ENRICO BELOTTI M.D.

SOTTOPERIOSTEO INFERIORE STEP BY STEP 2) REPERIRE LA LINEA OBLIQUA ESTERNA E PROCEDERE IN SENSO DISTALE AL TRIGONO SULLA BRANCA MONTANTE

SOTTOPERIOSTEO INFERIORE STEP BY STEP 3) APPLICARE L’IMPIANTO

ENRICO BELOTTI M.D.

SOTTOPERIOSTEO INFERIORE STEP BY STEP

ENRICO BELOTTI M.D.

SOTTOPERIOSTEO INFERIORE STEP BY STEP

ENRICO BELOTTI M.D.

4) SUTURARE SENZA TENSIONE

SOTTOPERIOSTEO INFERIORE STEP BY STEP Branca Montante

Free space

Linea obliqua esterna Forame mentoniero

SOTTOPERIOSTEO INFERIORE STEP BY STEP

Fossa sottomandibolare

Inserzioni muscolari miloioidee ( limite inferiore linguale )

SOTTOPERIOSTEO INFERIORE STEP BY STEP OPT POSTOPERATORIA

ENRICO BELOTTI M.D.

ASPETTO DEI TESSUTI DOPO LA RIMOZIONE DELLA PROTESI A 6 ANNI

Monconi del sottoperiosteo

REINTERVENTO CON APPROCCIO SOTTOPERIOSTALE

Staffa ideata da MAPOLLONI -Trento (Italy)

Reintervento con modalitĂ sottoperiostale

PRIMO TEMPO OPERATORIO

ENRICO BELOTTI M.D.

SECONDO TEMPO OPERATORIO Barra palatina fenestrata

Saldatura delle viti a carico immediato

ENRICO BELOTTI M.D.

Precisione ottimale del dispositivo

SECONDO TEMPO OPERATORIO DIMISSIONE DEL PAZIENTE CON IL PROVVISORIO NELLA STESSA GIORNATA

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.

ENRICO BELOTTI M.D.