What is the surgical technique of dental implantology for atrophic patients of the Galileus Cerclage Sinus® and what is it for?

Chapter 1: Challenges in Dental Implantology – Lack of Bone in the Posterior Zones of the Upper Jaw

Introduction: Dental implantology is a constantly evolving field, but challenges faced by surgical practitioners have always been present. One of the most significant difficulties is the lack of bone in the posterior zones of the upper jaw. In this chapter, we will explore the causes of this issue and how the lack of bone can impact dental functionality and aesthetics.

Causes of Bone Lack: The loss of teeth, especially in the posterior molar area, can lead to accelerated bone resorption. This phenomenon is caused by the lack of direct stimulation of bone cells during chewing. Without this stimulation, bone cells cease to regenerate new bone, leading to resorption in areas without stimulation.

Consequences on Functionality: Efficient chewing requires a solid bone foundation, especially in the posterior zones of the upper jaw. The lack of bone in these areas can compromise the ability to chew effectively and influence dental occlusion. This can lead to digestion problems and additional stress on other parts of the masticatory system.

Impact on Dental Aesthetics: The posterior zones of the upper jaw are crucial for the aesthetics of a smile. The lack of bone in these areas can make it challenging to create stable and aesthetically pleasing dental prosthetics. The prosthesis may lack sufficient support, compromising the natural appearance of the smile.

Traditional Approaches: In the past, the lack of bone in the posterior zones of the upper jaw was a challenging issue to address. Traditional approaches often required complex procedures, such as autologous bone grafts or maxillary sinus lifts, with prolonged healing times and additional risks.

The Galileus Cerclage Sinus® Revolution: A significant breakthrough has come with the Galileus Cerclage Sinus® technique developed by Prof. Roberto Conte. This innovative technique addresses the lack of bone in the posterior zones of the upper jaw efficiently and safely. Using a personalized and minimally invasive approach, Galileus Cerclage Sinus® offers a comprehensive solution for implant rehabilitation.

Conclusions: The lack of bone in the posterior zones of the upper jaw is a common challenge in dental implantology. However, thanks to innovative approaches like Galileus Cerclage Sinus®, patients can effectively confront this challenge, restoring not only functionality but also the aesthetics of their smile. This revolutionary technique represents a step forward in the field of implantology, providing lasting and satisfying results.

Chapter 2: Why Bone Resorption Occurs in the Posterior Zones of the Upper Jaw

Introduction: Understanding bone resorption in the posterior zones of the upper jaw is essential for addressing the challenges of dental implantology. In this chapter, we will examine the reasons behind this phenomenon and how it affects the bone structures of the maxillary region.

Bone Resorption Process: Bone resorption is a physiological response to the lack of mechanical stimulation in areas where teeth are lost. When teeth, especially the posterior molars, are lost or extracted, the chewing forces that normally stimulate bone production are interrupted. As a result, bone cells, called osteoblasts, cease to generate new bone tissue.

Role of Osteoblasts: Osteoblasts are responsible for forming new bone. During chewing, forces applied to the teeth stimulate osteoblasts to produce bone around the tooth roots. With the loss of teeth, osteoblasts no longer receive this stimulation, and the bone formation process is halted.

Consequences of Lack of Stimulation: In the posterior zones of the upper jaw, the lack of stimulation from chewing can lead to rapid bone resorption. This process is accelerated compared to other areas of the jaw, as the chewing force is more intense in the posterior molars.

Implications on Functionality: Bone resorption compromises the stability of dental prosthetics and can affect chewing functionality. The lack of bone support in the posterior zones can make it challenging to create stable prosthetics and may result in uneven force distribution during chewing.

Aesthetic Issues: In addition to functional impacts, bone resorption can cause aesthetic problems. The lack of bone can make it difficult to securely anchor dental prosthetics, compromising the natural appearance of the smile. This can affect the patient’s confidence and quality of life.

Traditional Approaches and Limitations: Traditional solutions for bone resorption in the posterior zones of the upper jaw often involve complex procedures such as bone grafts or maxillary sinus lifts. However, these approaches have limitations, including prolonged healing times and additional risks.

The Breakthrough with Galileus Cerclage Sinus®: Galileus Cerclage Sinus®, developed by Prof. Roberto Conte, represents an innovation in treating bone resorption. This personalized technique targets the lack of bone in the posterior zones of the upper jaw, offering a comprehensive and lasting solution.

Conclusions: Understanding the bone resorption process in the posterior zones of the upper jaw is crucial for developing effective approaches in dental implantology. Galileus Cerclage Sinus® emerges as an advanced solution that revolutionizes how we tackle this challenge, providing lasting results and improving the quality of life for patients.

Capitolo 3: Galileus Cerclage Sinus® – An Innovative Response to Bone Resorption, Including Extensive Maxillary Sinus Lifts

Introduzione: In the previous chapter, we examined the challenges related to bone resorption in the posterior zones of the upper jaw. In this chapter, we will explore Galileus Cerclage Sinus® as an innovative response to this issue, including extensive maxillary sinus lifts.

Galileus Cerclage Sinus®: An Introduction: Galileus Cerclage Sinus® is an advanced surgical technique developed by Prof. Roberto Conte. This personalized methodology focuses on bone regeneration in the posterior zones of the maxilla, addressing bone resorption in a targeted manner.

Approach to Bone Regeneration: Galileus Cerclage Sinus® not only addresses bone resorption but also provides an effective solution for extensive maxillary sinus lifts. This technique aims to restore lost bone, providing a solid foundation for the placement of dental implants.

Surgical Process: During the surgical process of Galileus Cerclage Sinus®, a personalized approach based on a detailed assessment is employed. The technique involves autologous bone grafting and the application of customized bone-circlets to stabilize the maxillary sinus area.

Elimination of the Need for Extensive Maxillary Sinus Lifts: One distinctive feature of this technique is its ability to eliminate the need for extensive maxillary sinus lifts. The targeted approach and customization of procedures allow addressing challenges related to bone resorption without resorting to invasive interventions.

Benefits of Galileus Cerclage Sinus®:

Effective Stabilization: Customized bone-circlets play a key role in stabilizing the maxillary sinus area, ensuring a solid foundation for dental implants. Minimization of Recovery Times: The procedure aims to reduce recovery times through an efficient and personalized surgical strategy. Elimination of the Need for Extensive Maxillary Sinus Lifts: Galileus Cerclage Sinus® provides a solution without the need for extensive maxillary sinus lifts, simplifying the surgical process.

Comparison with Traditional Approaches: Compared to traditional approaches that may require extensive maxillary sinus lifts, Galileus Cerclage Sinus® offers a more efficient alternative, reducing risks and improving the overall patient experience.

Conclusions: Galileus Cerclage Sinus® stands as an innovative and advanced response to bone resorption in the posterior zones of the maxilla, including the challenge of extensive maxillary sinus lifts. This personalized technique distinguishes itself for its effectiveness in bone regeneration and providing a solid foundation for dental implants, representing a significant step forward in the field of dental implantology.

Chapter 4: Comparison between Galileus Cerclage Sinus® and Other Implant Techniques

Introduction: In the previous chapter, we examined Galileus Cerclage Sinus® as an innovative response to bone resorption in the posterior zones of the upper jaw, including extensive maxillary sinus lifts. In this chapter, we will compare Galileus Cerclage Sinus® with other common implant techniques to provide a comprehensive perspective on treatment choices.

All-on-4, All-on-6, and Quad Zygomatic Implants: An Overview: Before delving into Galileus Cerclage Sinus®, let’s take a look at traditional implant techniques such as All-on-4, All-on-6, and Quad Zygomatic Implants. These methodologies are often used to address tooth loss and bone resorption.

Implant Placement:

All-on-4 and All-on-6: Primarily focus on the front part of the maxilla, using a limited number of implants. Quad Zygomatic Implants: Involve implants anchored in the zygomatic bones, avoiding the posterior zones of the atrophic maxilla.

Galileus Cerclage Sinus®: Involves the placement of two implants, one in the pterygoid region and the other in the nasal region, providing a solid anchorage in the posterior sections of the atrophic upper maxilla.

Posterior Chewing:

All-on-4 and All-on-6: Chewing in the posterior zones might be limited, as the emphasis is on the front part of the dental arch. Quad Zygomatic Implants: Similarly, chewing in the posterior zones might be compromised.

Galileus Cerclage Sinus®: Distinguishes itself by providing direct support for chewing even in the posterior zones through strategic implant placement.

Implant Insertion Design:

All-on-4 and All-on-6: Focus on reducing the number of necessary implants, primarily targeting the front regions. Quad Zygomatic Implants: The design is based on anchoring in the zygomatic bones to avoid the posterior sections.

Galileus Cerclage Sinus®: The design is specifically targeted at the posterior zones of the upper maxilla, addressing bone atrophies in these areas.

Dental Prosthetics:

All-on-4, All-on-6, and Quad Zygomatic Implants: Various prosthetic options with possible false gum, depending on the case.

Galileus Cerclage Sinus®: Offers a fixed circular ceramic prosthesis without false gum, crafted individually to fit the patient.

Conclusions: The comparison between Galileus Cerclage Sinus® and traditional implant techniques highlights key distinctions in design, implant placement, and functional outcomes. Galileus Cerclage Sinus® stands out for offering a comprehensive solution, targeting the posterior zones of the maxilla, with significant benefits in terms of stability and chewing. The choice between techniques will depend on the specific needs of the patient and the severity of bone atrophy in different regions of the maxilla.

Chapter 4 – A: Placement of Dental Implants in the Galileus Cerclage Sinus® Technique

Introduction: In the context of the innovative Galileus Cerclage Sinus® technique, the precise placement of dental implants plays a crucial role in creating a solid foundation for fixed dental prosthetics and overcoming challenges associated with the lack of bone in the posterior areas of the upper jaw.

Placement of Pterygoid Implants:

Pelatine Pterygoid Bone (Section 18/28): Pterygoid implants, 19/21 mm long, are positioned in the pelatine pterygoid bone, specifically in section 18/28. This placement is crucial to leverage the robustness of the pelatine pterygoid bone, characterized by strength and hardness.

21 mm Variant for Cortical Layers of the Sphenoid: In its longer version, 21 mm, the pterygoid implant is designed to reach the cortical layers of the sphenoid, a particularly resistant bone. This approach aims to achieve robust anchorage by screwing the apex of the implant with a force exceeding 100 newtons, ensuring the stability needed to support fixed dental prosthetics for an extended period, estimated between 20 and 30 years.

Placement of Nasal Implant: On the opposite side, towards the frontal area and premaxilla, the nasal implant is inserted, measuring 18/19 mm in length. This implant is positioned in section 15/25, following a transversal arrangement towards the nasal spine. This placement figuratively encircles the maxillary sinuses, creating two strategic resistance pillars to support fixed dental prosthetics in atrophic but crucial areas for oral health and chewing in the coming decades.

Basal Bones: Basal cortical bones, classified as category D1, are characterized by their hardness and resistance, with the peculiarity of not significantly resorbing over time. These bones include the zygoma, canine, and pterygoid region, serving as fundamental resistance pillars when alveolar bones wear down.

Conclusions: The targeted placement of implants in the Galileus Cerclage Sinus® technique exploits the characteristics of basal cortical bones, ensuring a robust and strategic anchorage. Pterygoid implants, with their 21 mm variant, and the nasal implant are carefully positioned to provide a durable and reliable solution for long-term chewing and oral health.

Chapter 5: Advantages of the Galileus Cerclage Sinus® Prosthesis – Aesthetics and Functionality

Introduction: In the context of dental implantology, the choice of a prosthesis plays a fundamental role in determining not only aesthetics but also functionality and the longevity of the implant solution. We will explore the distinctive advantages offered by the Galileus Cerclage Sinus® prosthesis, focusing on its impeccable aesthetics and advanced functionality that characterize this innovative solution.

• Impeccable Aesthetics: The Galileus Cerclage Sinus® prosthesis stands out for its attention to aesthetics, providing a solution that not only restores functionality but also the natural appearance of teeth. Patients can enjoy a harmonious and well-proportioned smile, significantly contributing to increased confidence and psychological well-being.
• Advanced Chewing Functionality: The strategic placement of implants, especially pterygoid and nasal implants, allows for a balanced distribution of forces during chewing. This contributes to advanced chewing functionality, enabling patients to enjoy a wide range of foods with confidence and comfort. The stability of implants, firmly anchored in basal cortical bones, ensures a reliable bite force.
• Customized Design: Each Galileus Cerclage Sinus® prosthesis is tailor-made to fit the specific needs of each patient. This customization considers not only the aesthetic aspect but also the unique anatomical characteristics of the patient. The result is a prosthesis that seamlessly integrates with the facial structure and provides optimal comfort.
• High-Quality Materials: The prosthesis is made with high-quality materials, ensuring durability over time. The strength and longevity of the materials used contribute to maintaining the stability and integrity of the prosthesis over the years, offering a long-term solution for patients.
• Improvement in Quality of Life: Thanks to the combination of advanced aesthetics and functionality, the Galileus Cerclage Sinus® prosthesis leads to a significant improvement in the quality of life for patients. The ability to fully enjoy meals, reduce self-consciousness related to the appearance of teeth, and maintain optimal oral health are all benefits contributing to overall well-being.

Conclusions: The Galileus Cerclage Sinus® prosthesis distinguishes itself by offering not only superior aesthetic results but also advanced chewing functionality. These advantages, combined with customized design and the use of high-quality materials, make this solution a comprehensive option for patients seeking durable and satisfying implant rehabilitation.

Chapter 6: Implant Distribution and Functional Benefits of Galileus Cerclage Sinus®

Introduction: The strategic distribution of implants in the Galileus Cerclage Sinus® technique plays a fundamental role in providing significant functional benefits, contributing to the stability of fixed dental prostheses and enhancing chewing efficiency. In this chapter, we will explore the arrangement of implants and the functional benefits offered by this innovative implant methodology.

Placement of Pterygoid Implants: Pterygoid implants, measuring 19/21 mm in length, are precisely positioned in the pterygoid process of the sphenoid bone, specifically in section 18/28. This strategic placement aims to leverage the strength and resilience of this area, providing a secure anchorage for fixed dental prostheses. The 21 mm variant, reaching the cortical plates of the sphenoid bone, offers even more stable support.

Placement of Nasal Implant: The implant framework is completed with the insertion of the nasal implant, measuring 18/19 mm in length, in section 15/25. This implant is transversely positioned towards the nasal spine, figuratively surrounding the maxillary sinuses. This arrangement creates two fundamental pillars of resistance to support fixed dental prostheses in atrophic areas, ensuring stability and functionality.

Functional Benefits of Implant Distribution:

Balanced Chewing Support: The distribution of pterygoid and nasal implants allows for balanced chewing support, replicating the natural distribution of forces during chewing. This contributes to improved chewing efficiency.

Minimization of Stress on Implants: The presence of multiple strategically distributed implants helps minimize stress on each implant, reducing the risk of overload and increasing the overall durability of the implant structure.

Stability of Fixed Dental Prostheses: The accurate arrangement of implants, supported by the robustness of basal cortical bones, provides fundamental stability for fixed dental prostheses. This results in efficient chewing and lasting comfort.

Long-Term Benefits: The combination of pterygoid and nasal implants, positioned in key areas for strength and stability, offers long-term functional benefits, ensuring a solid foundation for oral health.

Conclusions: The strategic distribution of implants in Galileus Cerclage Sinus® is designed to maximize functional benefits, ensuring balanced chewing, stability of fixed dental prostheses, and long-term resilience. This innovative approach significantly contributes to the clinical success and well-being of patients undergoing this advanced implant methodology.

Chapter 7: Choosing the Type of Prosthesis in Galileus Cerclage Sinus®

Introduction: Galileus Cerclage Sinus®, with its innovative implant technique, offers various options for choosing the type of prosthesis. In this chapter, we will explore the different possibilities available, allowing patients to customize the prosthetic solution based on their aesthetic and functional needs.

Prosthesis Options:

Fixed Ceramic Prosthesis Without False Gums: Description: This option provides a fixed ceramic prosthesis without false gums, custom-made without aesthetic compromises. The absence of false gums provides natural aesthetics and a comfortable sensation. Advantages: Maximum aesthetic naturalness, uncompromised comfort, and ease of cleaning.

Composite Definitive Prosthesis on 12 Front Teeth with False Gums: Description: A solution involving a definitive composite prosthesis on 12 primarily front teeth, with the addition of false gums to cover any aesthetic imperfections. Advantages: Covering potential aesthetic flaws while maintaining complete chewing function.

Criteria for Choice:

Personal Aesthetics: The choice between a ceramic prosthesis without false gums and a composite one with false gums will depend on the patient’s personal aesthetic preferences. Priority may be given to a more natural appearance or the correction of visual defects.

Comfort and Maintenance Ease: Patients seeking ease of cleaning and maintenance may prefer a prosthesis without false gums, while those wishing to cover potential aesthetic flaws might opt for the option with false gums.

Final Considerations: The choice of the type of prosthesis in Galileus Cerclage Sinus® is a personalized process that takes into account the patient’s aesthetic preferences and functional needs. Striking a balance between natural aesthetics, comfort, and ease of maintenance will contribute to lasting satisfaction with the results achieved through this advanced implant methodology.

Chapter 8: Crucial Questions to Ask Before an Implant Procedure

Introduction: The decision to undergo an implant procedure is significant and requires a thorough understanding of the process. In this chapter, we will explore some crucial questions that patients should ask before undergoing an implant procedure with the Galileus Cerclage Sinus® technique.

• What Prosthetic Options Are Available to Me?Rationale: Understanding prosthetic options allows the patient to customize the solution based on their aesthetic and functional preferences.
• What Are the Specific Risks and Benefits of the Galileus Cerclage Sinus® Technique? Rationale: Knowing the specific risks and benefits of the technique enables the patient to make an informed decision based on an understanding of potential challenges and advantages.
• What Is the Surgeon’s Experience and Training Regarding Galileus Cerclage Sinus®? Rationale: The surgeon’s competence in the technique is crucial for the success of the procedure. Knowing their experience and training instills confidence in the patient.
• How Are the Implants Positioned, and What Are Their Technical Details? Rationale: Understanding the technical details of the implants, including their position and specifications, contributes to a comprehensive understanding of the implant process.
• What Are the Short-term and Long-term Expectations? Rationale: Having realistic expectations is crucial. Knowing what to expect in the short and long term helps avoid disappointments and promotes patient satisfaction.
• What Financing Options Are Available? Rationale: Discussing financing options allows the patient to plan adequately and address the financial aspect of the procedure.

Conclusions: Asking key questions before undergoing an implant procedure with the Galileus Cerclage Sinus® is essential for an informed decision and accurate planning. This questioning phase contributes to establishing mutual trust between the patient and the surgeon, creating a solid foundation for a successful procedure and satisfactory results.