Implantoprosthesis

Implant rehabilitation has become a standard, quite widespread procedure in dentistry. This implant boom is all the more surprising for someone like me who is advanced enough in years to remember the primeval period when handcrafted, rather rudimental metallic devices were what was available, in Italy, too.

Implant placement is not an end unto itself. What the patient requests in substitution of his missing teeth is a prosthesis that can integrate them both functionally and esthetically. Application of a prosthesis, which can vary greatly depending on all the different individual conditions, completely obeys the precepts of traditional prosthetics, even in the case of implant support.

A prosthesis supported by intraosseous implants is different from a traditional prosthesis for another characteristic, too: the relationship between implant and bone is not, in fact, an even minimally articulated one, as is the relationship between the alveolus and root of the natural tooth. The direct contact between the metal and bone is rigid, ankylotic. There is no micro-yielding of the periodontal ligament nor any positional mini-adaptations allowed by the handling of the alveolar bone and the radicular cement. Because of this there is absolute need to respect the prosthetic procedures in order to have a harmonious restoration of the occlusion that is subject to significant functional stress, not only axial but also transversal and torsional.

This interdependence between the two designs is the raison d’être of this work, which is the condensation of a strongly consolidated activity, carried out under the guide of Prof. Preti together with his two precious collaborators Profs. Bassi and Schierano. We should also mention the authoritative contributions by several student-colleagues who participated in the productive research activity and clinical application that have received so much recognition and awards, especially internationally.

To properly complete this exposition of the specific problems of dental prosthetic rehabilitation, a chapter has been dedicated to Periodontology and therefore entrusted to Prof. Aimetti and his collaborators. The periodontist’s participation with the implant team is important, as we can easily imagine, for correct maintenance of the prosthetic implant over time. The rules of hygiene are in fact essential, particularly at the neck of the teeth where the barrier to the septic environment of the oral cavity is given by the juxtaposition of the gums to the metal. Longevity of most implants, as well as experimental findings (the referred statistics, especially international ones, have success rates we could define as overwhelming) have disproved worries about this being a possible entry way for infection. Moreover, the periodontist’s participation, as well as that of an endodontist, starts from the very beginning with the planning of the intervention, when deciding whether the compromised teeth can be saved or not, when they may still be responsive to treatment.

The rich array of images and photographic documentation that completes and illustrates the text testifies to the great experience of the Authors, who have been able so effectively and descriptively to condense the knowledge collected and developed in thirty years of prolific clinical and research activity.

Remo Modica

Professor Emeritus, University of Turin, Italy