(All-on-4, All-on-6, Straumann, Nobel, Megagen, Medentika, Osstem)

Nuair a chuardaí cuardaíonn le haghaidh “teip ar churam fiacla”,”fadhbanna All-on-4,”,”Straumann vs Nobel vs Megagen,”,”rátéis éachta incrostaithe Osstem” is fearr béim orthu ar cheist phríomhúil a bhaineann leis seo:

“Conas is féidir liom a bheith cinnte go mairfidh mo churam fiacla ar feadh na mblianta?”

Sa alt seo, mínímid i dteanga shimplí cad a chiallaíonn teip ar churam, na fachtóirí a mhéadaíonn nó a laghdaíonn an riosca seo, agus cad a dhéanaimid céim ar chéim ag an bpointe seo chun ráta teip a chosc chomh beag agus is féidir. Le linn an aiste, pléifimid freisin coinbhinsiúin churam coitianta cosúil le All-on-4, All-on-6 agus brandaí churam cáiliúla cosúil le Straumann, Nobel, Megagen, Medentika, agus Osstem.

1. Cad é teip ar churam fiacla?

Is gnách gur áitíonn torann titanaí beag “freastalaí” isteach sa bhéal alveolaire. Tar éis oibríochta, fásann an cnámh timpeall ar an churam agus cruthaíonn sé ceangal láidir. Glasann an próiseas seo oseointegration.

Briseadh ar churam fiacla is ciall é nach bhfuil an ceangal seo ag teacht i gceart riamh nó éilíonn sé a bheith caillte ina dhiaidh sin. Fanaíonn an churam míshábháilte, pianmhar, nó i mbaol galair go bhféadfadh bheith sé ar iarraidh.

Léirítear na comharthaí agus na comharthaí de churam míshástáilte le:

Pian leanúnach nó ag méadú timpeall ar an churam

Gluais (mothaíonn an churam nó an chóiréadán lag)

Méad agus deargadh nó pus thart ar an nguma

X-ray showing progressive bone loss around the implant neck

Our goal as a clinic is to make sure that every stage – from planning to surgery to prosthetic design and long-term maintenance – is optimized to keep the risk of dental implant failure as low as possible.

2. Success starts before surgery: diagnosis and planning

The real secret of a high dental implant success rate is proper planning before we ever touch the bone.

2.1 Clinical and radiographic evaluation

Before placing any implant, we perform a detailed examination:

Full clinical examination of the mouth, bite and soft tissues

Panoramic X-ray for general overview

CBCT (3D cone beam CT) to evaluate:

Bone height and width

Bone density

Location of critical structures (nerves, sinus, nasal cavity)

For complex cases like full-arch restorations (All-on-4, All-on-6), CBCT-based planning is essential. It allows us to:

Choose the ideal implant length, diameter and position

Avoid anatomical structures like the sinus and nerve

Decide whether we need additional procedures like sinus lift or bone grafting

Simulate the final prosthetic result before surgery

By using digital planning tools together with high-quality implants such as Straumann, Nobel, Megagen, Medentika, or Osstem, we significantly reduce the risk of technical and biological complications.<\/span>

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3. The role of implant brands: Straumann, Nobel, Megagen, Medentika, Osstem<\/span><\/h2>

Many patients ask:<\/span><\/p>

“Which implant brand is the best? Straumann? Nobel? Megagen? Medentika? Osstem?”<\/span><\/p>

The honest answer is that <\/span>no brand can guarantee 100% success<\/strong>, but some systems have:<\/span><\/p>

Strong scientific background<\/span><\/p>

Long-term clinical studies<\/span><\/p>

Advanced surface technology<\/span><\/p>

Stable connections and high precision<\/span><\/p>

These features contribute to a <\/span>lower risk of implant failure<\/strong> when used correctly.<\/span>

3.1 Straumann<\/span><\/h3>

Known worldwide as a <\/span>premium implant brand<\/strong><\/p>

Advanced surface technologies designed to speed up osseointegration<\/span><\/p>

Strong scientific documentation and long-term follow-up studies<\/span><\/p>

3.2 Nobel Biocare (Nobel)<\/span><\/h3>

Pioneer of the <\/span>All-on-4<\/strong> concept<\/span>

Full system covering implants, multi-unit abutments, guided surgery and prosthetic components<\/span>

Widely used in full-arch cases where immediate function is planned<\/span>

3.3 Megagen<\/span><\/h3>

Especially popular with the <\/span>AnyRidge<\/strong> line, which offers:<\/span>

Aggressive thread design for high primary stability

Good performance in soft bone

Frequently used in immediate loading and All-on-4 / All-on-6 cases

3.4 Medentika

Known for compatible components and cost–effective implant systems

SLA-type surface with reliable integration properties

Often chosen for multiple implant cases where quality and affordability must be balanced

3.5 Osstem

One of the most widely used implant systems globally

Broad product range suitable for different bone qualities

Good clinical performance with competitive pricing, making full-arch treatments more accessible

Important:

A high-quality implant system like Straumann, Nobel, Megagen, Medentika or Osstem is an important part of success, but the surgeon’s knowledge, planning, surgical technique and prosthetic design are just as critical.

4. All-on-4 and All-on-6: how we reduce failure risk in full-arch cases

For patients who have no teeth or need all their teeth removed, concepts like All-on-4 and All-on-6 allow us to restore an entire jaw with a fixed bridge supported by 4 or 6 implants.

4.1 Correct case selection

All-on-4 and All-on-6 are not “one size fits all” solutions. Before recommending these treatments, we evaluate:

Ginear-health (diabetes, osteoporosis, immune problems, etc.)

Smoking habits

Bone quality and volume

Bite forces and habits (clenching or grinding)

In borderline or extremely resorbed cases, we may consider other options such as zygomatic implants or staged bone grafting to avoid an unacceptable risk of implant failure.

4.2 Correct implant distribution and angulation

In a classical All-on-4:

Two front implants are placed vertically

Two posterior implants are tilted (30–45 degrees) to avoid sinuses or nerves and to create a larger prosthetic support polygon

In All-on-6, we add two more implants to distribute forces even more safely.

Key goals:

Minimize cantilever length

Spread the chewing forces across all implants

Keep forces as axial as possible

This careful distribution significantly lowers the stress on each implant and therefore lowers the risk of mechanical or biological failure over time.

4.3 Immediate loading done safely

Many full-arch patients receive fixed temporary teeth on the same day. This is called immediate loading. It is attractive for comfort and aesthetics, but it must be done under strict conditions:

Each implant should reach sufficient primary stability (often ≥ 35 Ncm torque)

The temporary prosthesis must be designed to reduce excessive loading (no heavy chewing on the first weeks)

The bite must be carefully adjusted to avoid early overloading

By respecting these principles, we can offer immediate teeth while still keeping a very low risk of failure.

5. Surgical protocol: gentle, sterile and precise

Even with perfect planning and strong brands, poor surgical technique can cause implant failure. We follow strict protocols to protect the bone and soft tissues.

5.1 Atraumatic drilling and temperature control

We use sharp drills, appropriate speeds and abundant sterile irrigation

The goal is to prevent the bone from overheating (over 47°C can damage bone cells)

We carefully control insertion torque to achieve stability without crushing the bone

5.2 Sterility and infection control

Infection is a major cause of early implant failure. To prevent this:

We respect all surgical sterilization protocols

When indicated, we use prophylactic antibiotics

We give clear post-operative instructions to the patient about mouthwash, medication and smoking restrictions

5.3 Soft tissue management

Healthy gums around an implant are as important as healthy bone.

We design flaps and sutures to achieve good soft tissue closure around the neck of the implant

Nuair atá gá, úsáidimid teicnící nó graftaí chun méadú a dhéanamh ar an gengivéar karatíníste

Cruthaíonn sé seo deiliteacht bitholaíochtúil níos fearr agus laghdaíonn sé an riosca peri-implantitis níos déanaí

6. Pleanáil próiseála: cá dtá an rath fadtéarmach buachan nó caillte

Is féidir le implant comhtháthú go foirfe, ach má tá deilite abhann nó droimlánna rud mícheart, tá castaí beagnach ráthaithe.

6.1 Occlusion agus dáileadh lucht

Roghnaímid gníomhú go cúramach chun stop a chur le déacrachtaí faoi uisce ar chinnteoga implant

Maidir le hailt, a bhfuil bréagáin nó greilleann siad, molaimid go minic cosán oíche

San All-on-4 agus All-on-6, rialímid fad cantilever agus deilite a dhearadh chun fórsaí a scaipeadh go cothrom

Is féidir le ró-úsáid fórsa ar pháirt amháin de implant a chur le:

Meáchan sceoladh

Briseadh na próiseála

Laghduithe cnámha ag dul i méid agus teip deifnídeach ar an implant

6.2 Rogha ábhar agus ceangail

Oibrímid le hábhair éagsúla mar:

Zirconia droimhéadair

Athghineachta miotal-ceramacha

Prostheses meicniúla-inchruthaithe (miotal + acrylic)

I gcásanna ard-fhiacla, molaimid de ghnáth dearbháil sceabánacha toisc:

Is féidir leo a bhaint den fhoirgneamh le haghaidh glanadh agus cothabháil ghairmiúil

Níl aon riosca ann go ndúnfar an dáileadh iomarcach faoin guma (is féidir leis seo peri-implantitis a chur faoi deara).

An combo de ceart nascadh-maisle tréithníon (e.g. nascadh chorcinte ó bhrandaí móra cosúil le Straumann, Nobel, Megagen, Medentika, Osstem) agus proiséascán dea-dheartha tá riachtanach chun cobhsaíocht fadtréimhseach a bhaint amach.

7. Sláinte córasach, toitíní agus cógais

Tá tionchar díreach ag sláinte ghinearálta an othair ar rath na nasc

Déanaimid athbhreithniú ar:

Galar diabéite: déanann diabéit salach le haghaidh strus t-orgánach agus lughdaíonn sé athléimneacht

Osteoporóis agus cóireáil bisphosphonate

Galar autoimmune agus úsáid fada steroids

Réamh-ráiteas radiotherapy chuig an gceantar gnédh

Tá toitíní eile ina fhachtóir mór eile. Tá ráta níos airde acu siúd a toiteann go trom agus bíonn siad níos mó i mbaol teip na nasc agus caillteanas na cnámha. Chuirimid moltaí láidir ar passainte toitiú nó laghdú toitiú roimh agus tar éis oibríocht

8. Ról na n-othair: ghlantacht agus cothabháil

Ní féidir leis an spp ag feidhm is fearr, an t-othar is fearr agus an nasc nasc is fearr a sholáthar sláinte béil laethúil maith.

8.1 Cúram baile laethúil

Múineannamar gach othar nascadh conas sláincéim a ghlanadh:

Brushing ar a laghad dhá uair sa lá le brús bog

Úsáid scuabanna idirfhilleadh nó superfloss faoi chonagairí agus timpeall nasc

I gcásanna áirithe, rinsí béil bhreise ar feadh tréimhse theoranta

šíces speisialtaims for full-arch All-on-4 agus All-on-6 prostheses, áit a bhféadfadh bia tarchur i gceann na héidreachta má ní ghlantar i gceart.

8.2 Seiceáil ghnáthmhaitheas

Broinn faoina rath fadtéarmach ag brath ar maintenance gairmiúil rialta:

Seiceáil chliniciúil gach 3–12 mí (smaoin ar chás)

Glantachán gairmiúil ar instealltaí agus ar tháirgí prosthetic

X-ghaicoideachas tréimhsiúil chun monatóireacht a dhéanamh ar leibhéil cnámh timpeall na n-instealltaí

Ligimid dár bhfoireann cinntiú go dtomhaistear fadhbanna luatha amhail limistéir bháisín, laigeán beag ar na scriú nó tús le cailliúint cnámh sula mbainfidh siad acu fadhbanna troma.

9. Ceisteanna coitianta faoi mheáchan insteallta

“Cad é ráta ratha na n-instealltaí fiacla?”

Do ghalar sláintiúil a chóireáil le pleanáil agus prótacal chuí, d’fhéadfadh instealltaí fiacla nua-aimseatha le deiseanna ard, mar Straumann, Nobel, Megagen, Medentika agus Osstem, a bhaint amach ráta ratha fadtéarmach sách ard. Mar sin féin, bíonn céatadáin díreach ag brath ar:

sláinte agus nósanna an othair

Fíochán fiacla (uas vs íochtar) agus cáilíocht cnámh

Cineál na hathshlánaithe (céadphíosa aonair vs caradh iomlán)

Taithí an surgeon agus leanúnachas na hobiúil

“An féidir le All-on-4 nó All-on-6 mífheidhmiú?”

Sea, is féidir aon chóireáil mífheidhmiú má tá pleanáil go héagórach nó má éiríonn í admháil go dona, nó má chuireann an t-othar neamhaird ar na treoracha. Áfach, le:

Roghnaíocht chúramach cás

Stádas tosaigh ard

Deisimh ceart ar dhiagnóis

Glanadh maith agus seiceáil rialta

Is féidir le All-on-4 agus All-on-6 torthaí an-taitneamhach agus fadbhréadúil a sholáthar.

10. Summarized: conas is iomaíth a chothromú go bhfuil riosca loit insteallta chomh híseal is féidir

Chun an riosca a íoslaghdú maidir le teipeadh insteallta fiacla, comhleáimid:

Diagnóis chruinn agus pleanáil digiteach (san áireamh CBCT)

Réamhchúram agus rogha chúram ceart(fiaclóireacht aon insteall, droim, All-on-4, All-on-6, srl.)

Úsáid ar insteallta sócmhainnísárchaighdeán amhail Straumann, Nobel, Megagen, Medentika agus Osstem

Teicníocht húiteach, neodrach agus chruasciéntúil

Dearadh prosteiseach agus oiriúnú occlusal atá bunaithe ar eolaíocht

Aird chriticiúil ar shláinte chórasach agus fachtóirí riosca cosúil le caitheamh tobac nó diaibéiteas

Oideachas mionsonraithe do dháileadh sa bhaile

Leas greanta gairmiúil agus maoirseacht agus faireachán

Nuair a oibríonn na he'saigh go léir le chéile, téann an dóchúlacht go dtarlóidh teip insteallta an-éadrom, agus is féidir le hothair fiacla láidir, chothrom agus aesthetically-lasting a bheith acu le blianta fada— cibé acu is ait an corón amháin, droim beag nó fíorshúile ar fad All-on-4 / All-on-6.