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Uporaba dentalnih implantata sve je popularnija terapijska metoda nadoknađivanja izgubljene jedne ili više žvačnih jedinica, kao i sanacije cijeloga bezubog grebena. Položaj ugradnje dentalnog implantata važan je čimbenik za dugoročni uspjeh implantoprotetičke terapije. Položaj implantata ima najznačajniji utjecaj na stvaranje biološke širine i resorpciju alveolarne kosti. Položaj dentalnih implantata ovisi o više čimenika, najvažniji su dizajn implantata i biološka svojstva mjesta ugradnje. Dizajn implantata značajan za mjesto ugradnje određuje polirani vrat implantata i postojanost mikropukotine. Biološka svojstva važna prilikom ugradnje implantata, o kojima ovisi položaj ugradnje implantata, jesu debljina mekog tkiva iznad alveolarnog grebena te debljina same kosti u koju se implantat ugrađuje. Položaj ugradnje implantata dijeli se na postavljanje u razini tkiva (transmukozni implantat) te u razini kosti pri kojemu postoji podjela na: epikrestalno, suprakrestalno i subkrestalno postavljanje. Ako je implantat pravilno postavljen, neće doći do resorpcije kosti, a zdravlje mekih tkiva bit će postojano, što osigurava dugotrajnost terapije. U radu su prikazana dva klinička slučaja. Riječ je o pacijentima kojima je bila indicirana ekstrakcija zuba te implantoprotetička terapija. Svi su implantati postavljeni subkrestalno. The use of dental implants is an increasingly popular therapeutic method of replacing one or more lost masticatory units as well as repairing the entire toothless ridge. The position of dental implant placement is an important factor for the long term success of implant prosthetic therapy. The most significant impact the position of the implant has is on the creation of the biologic width and the resorption of the alveolar bone. The position of dental implants depends on several factors, the most important being the design of the implant and the biological properties of the installation site. The design of the implant significant for the installation site determines the polished neck of the implant and the stability of the microgap. The biological properties which are important during implant installation and which the implant position depends on are the thickness of the soft tissue above the alveolar ridge and the thickness of the bone itself in which the implant is placed. There are two types of implant placement position at the tissue level (transmucosal implant), and at the bone level, at which implants can be placed epicrestally, supracrestally, and subcrestally. If the implant is placed correctly, bone resorption does not occur, and the health of the soft tissues remains stable, ensuring long term therapy. This paper presents two clinical cases. The patients were indicated for tooth extraction and implant prosthetic therapy. All implants were placed subcrestally.

Dentalna implantoprotetika interdisciplinarna je grana dentalne medicine koja spaja segmente oralne kirurgije, paradontologije i stomatološke protetike. Predstavlja kvalitetan oblik terapije time što omogućava nadoknadu jednoga izgubljenog zuba ili više njih. Vrhunski planiran kiruški dio terapije preduvjet je za uspješnu izradu protetskog nadomjestka, kojim je omogućena estetska i funkcijska rekonstrukcija orofacijalnog sustava narušenog gubitkom zuba. Implantoprotetički nadomjestci sastoje se od oseointegriranog implantata, implantatne suprastrukture te mobilnog ili fiksnog protetičkog rada. U današnje doba rijetko korištene jednodijelne implantate zbog velikih nedostataka zamijenili su dvodijelni sustavi, odnosno sustavi s odvojivom suprastrukturom koja se na oseointegrirani dio implantata pričvršćuje vertikalnim vijkom. Na tržištu su dostupne suprastrukture različitih materijala i oblika koje mogu biti ravne ili različito angulirane te individualne ili konfekcijske. Osim dobre oseointegracije implantata bitan čimbenik za dugotrajnost implantoprotetske terapije jest mehanička stabilnost spoja implantata i suprastrukture. U početku koristili su se vanjski spojevi koje su zbog boljih svojstava zamijenili unutarnji spojevi s antirotacijskom zaštitom. Kod unutarnjih spojeva proizvođači često rabe Morseov konus (cold weld), koji omogućuje izvanrednu mehaničku stabilnost i smanjuje mikropukotinu te komplikacije vezane uz nju. Jednako se tako kod unutarnjih spojeva rabi koncept platform switchinga, time se smanjuje resorpcija kosti te posljedično poboljšava estetika i funkcija takvih radova. Na tržištu postoji čitav niz proizvođača koji nude različite sustave dentalnih implantata i suprastruktura te različite načine vezivanja. Neki sustavi međusobnu su kompatibilni što redstavlja bolju optimizaciju samog sustava i veću dostupnost dijelova. Korištenjem provjerenih implantoloških sustava izbjegavaju se biološke i tehničke komplikacije te je moguće predvidljivije planiranje terapije. Dental implant prosthetics is an interdisciplinary branch of dental medicine that combines segments of oral surgery, periodontology and dental prosthetics. It represents a quality form of therapy as it enables the replacement of one or more missing teeth. Top quality planning in the surgical segment of the therapy is a prerequisite for a successful construction of a prosthetic replacement, which enables aesthetic and functional reconstruction of orofacial system disrupted upon the loss of a tooth. Implant prosthetics replacements comprise of an osseointegrirated dental implant, implant suprastructure and mobile or fixed prosthetic replacement. One-piece implants, which are currently seldom used because of substantial disadvantages, have been replaced with two-piece systems or systems with detachable suprastructure that is fixed with a vertical screw to the osseointegrated part of the dental implant. Suprastructures of different materials and shapes are currently available on the market. They may be straight or differently angulated, as well as individual or standard. In addition to good implant osseointegration, an important factor for the long-term impact of implant prosthetic therapy is mechanical stability of the connection of the implant and suprastructure. External connections were used initially, yet they were replaced by nternal connections with anti-rotation protection because of their superior features. Internal connections are frequently used by manufacturers with conical Morse taper (cold weld), which provides extraordinary mechanical stability and decreases micro gaps and complications normally associated with them. Similarly, the concept of platform switching is used with internal connections, which reduces bone resorption and consequently improves both the aesthetics and function of such replacements. A large number of manufacturers are currently operating on the market, providing a wide range of dental implant systems and suprastructures, as well as different methods of connection. Some systems are mutually compatible, which implies a more effective optimisation of the system and a greater availability of the components. iological and technical complications are avoided upon use of verified implant systems, which enables a more predictable treatment planning.

Implantoprotetika kompleksna je grana, koja predstavlja oblik terapije kod nedostatka zubi. Vrhunski obavljen kirurški dio terapije preduvjet je za izradu uspješnog protetskog nadomjestka, koji će pacijentu omogućiti normalno žvačnu funkciju i dobru estetiku. Dobra oseointegracija stvara stabilnost implantata i omogućava mu funkcionalno trajnost, ali da bi ostala stabilna situacija mekog i tvrdog tkiva bitan čimbenik je i protetska platforma. Jednodijelni implantološki sustavi imaju ograničenja zbog određenog smjera implantata, kojeg ne možemo korigirati implantantnom nadogradnjom. Na tržištu su se pojavili dvodijelni sustavi, koji rješavaju probleme koso položenih implantata i omogućavaju bolje manipuliranje mekog tkiva i time postizanja bolje estetike. Pojavom dvodijelnih implantoloških sustava razvijala se i protetska platforma na implantatima. Kroz povijest došlo je do različitih ideja i njihovih modifikacija. Trajnost implantoprotetske terapije ovisi o mehaničkoj stabilnosti spoja implantata i nadogradnje, koji je uvjetovan oblikom i vrstom protetske platforme. U početku koristili su se vanjski spojevi implantata i nadogradnje, ali su brzo zamijenjeni s unutarnjim spojevima u kombinaciji s različitim antirotacijskim elementima. Kod unutarnjih spojeva često se koristi Morseov konus, koji smanjuje mikropukotinu i probleme vezane uz to. Uvođenjem koncepta promjena platforme poboljšala se estetika takvih radova, što je posljedica pozitivnog utjecaja užeg promjera nadogradnje na koštana i meka tkiva. Korištenjem provjerenih implantoloških sustava izbjegavaju se tehničke i biološke komplikacije te je moguće predvidljivije planiranje terapije zbog čega su pacijenti zadovoljniji krajnjim rezultatom. Implant prosthetics is a complex branch of dentistry which treats the loss of teeth. A well-performed surgical part of the therapy is a prerequisite for the successful making of a prosthetic which is aesthetically acceptable and enables a normal chewing function. Good osseointegration creates the stability of the implant and enables the duration of its functionality. However, in order for the implants to be functional for a long time and to have a stable situation of terms of soft and hard tissue, an important is also the prosthetic platform. One-piece implant systems are limited due to the particular direction of the implant which cannot be adjusted through the upgrade of the implant. Two-piece implant systems are now available: they solve the problem of implants being placed askew and enable better manipulation of soft tissue which then enables better aesthetics. The emergence of two-piece implant systems enabled the further development of prosthetic platforms on implants. Many ideas and modifications were introduced over time. The durability of implant prosthetics therapy depends on the mechanical stability of the bond between the implant and the upgrade which is defined by the type and shape of the prosthetic platform. External bonds between implants and upgrades were used, but they were quickly replaced with internal bonds combined with various anti-rotational elements. The Morse taper is often used in the making of internal bonds because its use decreases the possibility of micro-ruptures and problems connected to them. The concept of platform switching improved the aesthetics outcome of the procedure; this fact is a consequence of the positive influence of upgrades on both the soft and the hard tissue. The use of verified implant systems diminishes the possibility of technical and biological complications and enables predictive therapy planning, which are factors that contribute to the overall satisfaction of the patients.