Une prise en charge chirurgicale spécialisée pour remplacer une ou plusieurs dents manquantes, avec une planification précise et des solutions adaptées aux cas simples comme complexes.
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Les réhabilitations implantaires complexes nécessitent une planification précise, une évaluation du volume osseux, de l’état parodontal et des contraintes prothétiques.
Au cabinet 47VH à Nice, ces situations sont prises en charge dans un cadre spécialisé en implantologie, parodontologie et chirurgie orale, avec une approche adaptée aux cas de greffe osseuse, de sinus lift, d’édentement étendu ou de reprise après échec implantaire.
La perte complète des dents ou la présence d’une dentition à mauvais pronostic peut altérer la fonction masticatoire, l’élocution et l’équilibre occlusal.
La réhabilitation implantaire complète constitue aujourd’hui une solution fiable pour remplacer l’ensemble des dents par une reconstruction fixe sur implants.
The practitioner places several dental implants in the jawbone to support a full fixed implant-supported prosthesis. This reconstruction replaces all teeth with a stable and functional restoration.
Dans de nombreuses situations cliniques, le praticien peut réaliser la reconstruction implantaire en une seule séance chirurgicale, incluant l’extraction des dents compromises, la pose des implants, une éventuelle greffe osseuse et la mise en place d’une prothèse provisoire immédiate (MCI).
At the 47VH implant clinic in Nice, this full implant rehabilitation can, in certain clinical situations, be performed in a single surgical session.
A dental implant is an artificial titanium root inserted into the jawbone to replace a missing tooth. When all the teeth in an arch need to be replaced, several implants can support a full implant-supported prosthesis.
This reconstruction makes it possible to restore a fixed dentition supported by implants and to reestablish functional occlusal balance.
Unlike conventional removable dentures, implant-supported restorations generally offer:
Full mouth implant rehabilitation requires careful planning to ensure the implant-prosthetic and biological stability of the treatment.
The practitioner may consider full implant rehabilitation when all the teeth in an arch can no longer be preserved or when conventional prosthetic solutions are no longer able to restore stable chewing function.
In these situations, the dental surgeon analyzes the clinical condition, the periodontal status, the available bone volume, and the biomechanical constraints before determining whether full implant reconstruction represents the most appropriate therapeutic option.
Several clinical situations may lead to proposing this type of treatment.
Complete tooth loss refers to the absence of all teeth on a jaw. This situation can lead to a significant reduction in chewing ability as well as instability of removable dentures.
In this context, full implant rehabilitation allows stabilization of a fixed prosthesis supported by several dental implants. This approach aims to restore more effective chewing function and improve the stability of the prosthetic reconstruction.
Before considering this treatment, the practitioner analyzes the available bone volume and the condition of the tissues to determine the feasibility of implant reconstruction.
In some situations, the remaining teeth show significant damage: extensive caries, dental fractures, bone loss related to advanced periodontitis, or multiple restorations that have become unstable.
When preserving the teeth can no longer ensure long-term function, the practitioner may consider extracting the compromised teeth followed by full implant reconstruction.
This therapeutic strategy then makes it possible to restore a stable fixed dentition supported by implants, following precise surgical and prosthetic planning.
Some patients experience repeated failures of prosthetic treatments, particularly when several successive restorations become unstable or non-functional.
In these situations, full implant rehabilitation may represent a therapeutic alternative that allows reconstruction of the dental arch on more stable biological foundations.
The practitioner then performs a thorough clinical and radiological assessment to evaluate the possibility of placing several implants intended to support a full prosthetic reconstruction.
Full implant reconstruction is frequently performed in the context of complex implantology cases. Long-standing tooth loss, periodontal diseases, or progressive bone resorption can reduce the available bone volume and complicate implant placement.
Before any procedure, the practitioner performs a thorough clinical assessment combined with three-dimensional imaging (CBCT). This evaluation allows precise analysis of bone volume, the position of anatomical structures, and biomechanical constraints.
When the available bone is insufficient to ensure optimal implant stability, various surgical techniques can be used to reconstruct bone support suitable for implant placement.
At the 47VH clinic in Nice, these complex situations are managed through precise surgical planning in order to optimize implant stability.
After a tooth extraction, the alveolar bone gradually resorbs in the absence of functional stimulation. This resorption can reduce the height or thickness of the bone and make implant placement more complex.
The practitioner then evaluates several parameters:
When bone volume is insufficient, the surgeon may consider bone reconstruction techniques in order to create a favorable environment for implant placement.
Bone grafting allows the increase of bone volume in areas where the bone is insufficient. The practitioner uses bone substitute biomaterials or bone grafts to reconstruct the missing bone volume.
This bone reconstruction can be performed:
The objective is to restore bone volume compatible with implant stability and the long-term durability of the prosthetic reconstruction.
In the posterior maxilla, the proximity of the maxillary sinuses may limit the bone height available for dental implant placement.
Sinus floor elevation, also known as a sinus lift, involves repositioning the sinus membrane to create space for the formation of new bone volume.
The practitioner can then place a graft material in this space to promote bone regeneration.
This technique makes it possible to restore sufficient bone height for implant placement in the posterior regions of the maxilla.
In certain clinical situations, the practitioner can perform full implant rehabilitation during a single surgical session. This approach makes it possible to combine several therapeutic steps in order to reduce the number of procedures and quickly restore functional dentition.
When anatomical and biological conditions allow, the treatment may include the extraction of compromised teeth, placement of dental implants, and insertion of an immediate provisional prosthesis.
This therapeutic strategy relies on careful planning and the achievement of sufficient primary implant stability. The practitioner therefore performs a precise evaluation of the clinical situation before proposing this type of treatment.
This approach is regularly used at the 47VH implant clinic in Nice when biological and mechanical conditions allow.
In situations where the remaining teeth present significant damage — extensive caries, fractures, or mobility related to advanced periodontitis — preserving them no longer ensures long-term function.
The practitioner then proceeds with the extraction of the compromised teeth. This step allows the elimination of infectious foci and prepares the surgical site for implant reconstruction.
The extraction is performed with particular attention to preserving bone volume and the surrounding tissues.
After the extractions, the practitioner places several dental implants into the jawbone according to the previously established treatment plan.
The three-dimensional planning performed using CBCT imaging makes it possible to determine:
This step aims to achieve sufficient primary stability to allow placement of a provisional prosthetic reconstruction.
When the implants demonstrate sufficient stability, the practitioner may place an immediate provisional prosthesis, also referred to as immediate loading.
This prosthesis allows the patient to have a provisional fixed dentition immediately after the surgical procedure.
During the healing phase, this provisional restoration maintains function and aesthetics while protecting the implants during the osseointegration period.
After the bone healing phase, the practitioner provides the final implant-supported prosthesis, designed to meet the patient’s functional and aesthetic requirements.
In the context of full implant rehabilitation, the practitioner distributes several implants within the dental arch to support the fixed prosthesis.
The approaches known as All-on-4 or All-on-6 are based on the placement of four to six implants strategically positioned in the jawbone to support a full fixed prosthesis.
These implants serve as support for a full implant-supported prosthesis.
The practitioner determines the implant configuration based on:
Each indication is subject to individualized planning.
The success of full implant reconstruction relies on precise surgical planning.
The practitioner performs a detailed clinical examination and complements this assessment with three-dimensional imaging (CBCT).
This imaging allows evaluation of:
La planification tridimensionnelle permet d’optimiser la stabilité primaire des implants et de sécuriser l’intervention chirurgicale.
The duration of full implant rehabilitation varies depending on the initial clinical situation.
In many cases, the practitioner can perform tooth extractions, implant placement, and placement of a provisional prosthesis during the same surgical day.
A healing phase known as osseointegration then allows the bone to bond durably with the surface of the titanium implants. This biological phase generally lasts several months.
After this healing period, the practitioner places the final implant-supported prosthesis.
The dental surgeon performs implant surgery under local anesthesia.
After the procedure, postoperative effects are generally mild. Slight swelling or localized sensitivity may occur for a few days.
The practitioner systematically provides postoperative instructions in order to optimize healing and prevent complications.
Un suivi clinique régulier permet ensuite de contrôler l’intégration des implants et la stabilité de la reconstruction prothétique.
Full implant rehabilitation cases require precise planning and a surgical approach tailored to each patient.
The examples below illustrate different implant-prosthetic reconstruction configurations performed at the 47VH clinic in Nice.
Ceramic implant bridge on implants
Bridge céramique sur implants avec et sans fausse gencive
Références bibliographiques
- Maló P. et al. — “All-on-4” immediate-function concept for completely edentulous maxillae: a clinical report on the medium (3 years) and long-term (5 years) outcomes. Clin Implant Dent Relat Res, 2012. PubMed PMID 22008153
- Papaspyridakos P. et al. — A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants, 2012. PubMed PMID 22299086
- Gallucci G.O. et al. — Consensus statements and clinical recommendations for implant loading protocols. Int J Oral Maxillofac Implants, 2014. PubMed PMID 24660204
- Jensen S.S., Terheyden H. — Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. Int J Oral Maxillofac Implants, 2009. PubMed PMID 19885447
- Yin X., Li J., Chen T., Mouraret S., Dhamdhere G., Brunski J.B., Zou S., Helms J.A. — Rescuing failed oral implants via WNT activation. J Clin Periodontol, 2016. PubMed PMID 26718012
Can all teeth be replaced with dental implants?
Le praticien insère plusieurs implants dentaires dans l’os de la mâchoire afin de soutenir une prothèse complète fixe. Cette solution permet de restaurer une dentition stable et fonctionnelle lorsque l’ensemble des dents doit être remplacé.
Une planification clinique et radiologique précise permet de déterminer le nombre d’implants nécessaires et la faisabilité du traitement.
How many implants are needed to replace a full dental arch?
Ces implants sont positionnés stratégiquement dans l’os de la mâchoire afin de soutenir une prothèse complète fixe. Les protocoles connus sous les appellations All-on-4 ou All-on-6 reposent sur cette répartition implantaire.
Le nombre exact d’implants dépend du volume osseux disponible, de la répartition des contraintes biomécaniques et du projet prothétique.
Can implants be placed on the same day as extractions?
Cette approche consiste à réaliser l’extraction des dents compromises puis à insérer les implants au cours de la même intervention chirurgicale. Lorsque la stabilité primaire des implants est suffisante, une prothèse provisoire peut également être mise en place immédiatement.
However, the feasibility of this technique depends on several biological and anatomical criteria that are evaluated during the consultation.
How long does full implant rehabilitation take?
Dans de nombreux cas, les extractions dentaires, la pose des implants et la mise en place d’une prothèse provisoire peuvent être réalisées au cours d’une seule séance chirurgicale.
Une phase de cicatrisation appelée ostéointégration permet ensuite à l’os de se fixer durablement aux implants. Cette phase biologique dure généralement plusieurs mois avant la réalisation de la prothèse définitive.
Is full implant rehabilitation painful?
L’intervention est réalisée sous anesthésie locale, ce qui rend le geste indolore pendant la chirurgie. Après l’intervention, les suites opératoires restent le plus souvent modérées et comparables à celles d’extractions dentaires multiples.
Slight swelling or localized sensitivity may occur for a few days. Post-operative instructions are systematically provided to promote optimal healing.
Who can benefit from full implant rehabilitation?
Le praticien évalue plusieurs paramètres avant de proposer ce traitement, notamment l’état général du patient, la qualité et le volume osseux disponibles ainsi que l’état des tissus parodontaux.
A specialized consultation combined with three-dimensional imaging allows determination of the feasibility and the most appropriate implant treatment strategy.