Dentoalveolar surgery offers solutions for some complicated dento-maxillary problems, such as: apical granulomas, maxillary cysts, included or semi-included wisdom molars, included canines, difficult tooth extractions, dental dentine abscesses, preoperative surgical treatment, bone augmentation, sinus lift, etc.

Grandismedozon Clinic offers the following types of surgery:

• Simple dental extraction;
• Surgical dental extraction;
• Extraction of superficial deep debris;
• Apical resection;
• Extirpation of cysts;
• Abscess incision;
• Pre-protective Surgery: Alveolectomy, Alveoplasty, Flenectomy, Excision and Tissue Repositioning;
• Surgical exposure of a tooth that has not erupted;
• Odontoctomy of the included and semi-included teeth;
• Periodontal open curettage in the open field (flap operation);
• Periodontal regenerative surgery;
• Periodontal plastic surgery: gingival graft surgery, increasing keratinized gum volume and width, recessive coverage (gingival retraction);
• Dental implant and bone augmentation;
• Sinus augmentation (sinuslifting);

As a result of centrifugation of the blood sample separation of the red blood cells from the bioactive therapeutic elements (platelets, fibrin, plasma, leucocytes, growth factors, etc.) will occur. Their use offers the advantage of enriching the affected area with regenerative blood cells and encouraging the repair process, stimulating and speeding up healing.

Fibrin rich in platelets and leukocytes (L-PRF) is the # 1 regeneration graft used by the Grandismedozon clinic in cases of maxillofacial surgery, bone growth and bone regeneration.

L-PRF is 100% autogenous and 100% derived from the patient’s blood and it is used as a perfect graft matrix, as it initiates a dense, healthy and incredibly robust bone growth, or it is the purpose of a bone or tissue graft.

The centrifugation process results in a thin, compressed layer of fibrin which is strong, flexible and suited for suturing. This natural fiber network is rich in platelets, growth factors and cytokines, all derived from blood platelets and blood leukocytes, which work together to produce angiogenesis (formation of new blood vessels), to alter the metabolism and physiology of the area undergoing surgery. According to studies and clinical data, the presence of these proteins stimulates a much better regeneration response and produces rapid healing, especially during the first seven days after application. In addition, this network promotes more efficient cell migration and proliferation without the need for supplementation with chemical additives and reduces post-operative complications in a multitude of therapeutic interventions for bone and soft tissue regeneration such as:

• Guided bone regeneration (GBR),
• Guided Tissue Regeneration (GTR),
• Sinus lifting procedures,
• Alveolar preservation interventions following dental extraction,
• Periodontal operations for the treatment of gingival recession,
• Procedures for the regeneration of periodontal intra-bone defects,
• Procedures for the regeneration of peri-implantation bone defects, etc.

L-PRF cell therapy is a highly effective, beneficial and an extremely safe technology because it is produced from the patient’s own blood, making it 100% natural, with excellent results proven by scientific evidence.

Dr. Andrei Pîrgari, specialist in dental implantology, explains:

“The best results are those created from the body’s own biological materials and, frankly speaking, are the simplest and safest to create and use. When we follow the nature and natural biology of our body, it is logical to be safe and avoid any manufactured additives”.

Periodontitis or periodontal disease is an autoimmune, systemic and complex disease characterized by localized infections and inflammatory disorders directly affecting the teeth support structures.

The etiology of periodontal disease is complex and still incompletely understood; one of the most often cited causes of this disease are the so-called ‘biological factors of disease development’.

Certain microorganisms, which stick to the surface of the tooth and the pockets surrounding the tooth, multiply and form a bacterial plaque. If unremoved, it may develop into an outbreak of infection and, as the immune system reacts, bacterial endotoxins are released, chronic inflammation occurs, and the immune system can trigger more immunological responses. Due to body’s autoimmune response, this disease affects one or more of the periodontal tissues: the alveolar bone, periodontal ligament, cement and gums, leading to tissue destruction and bone loss, ultimately being the main cause of teeth loss.

Autoimmunity can be defined as the disturbance of the mechanism responsible for self-tolerance and inducing an immune response against its components, in other words, the body is attacked by its own immune system. The antibodies no longer recognize the body’s structures and attack them, as they would with antigens.

Untreated periodontitis will eventually lead to tooth loss and may increase the risk of stroke, heart attack and other major health issues. The presence of the infection can be a primary triggering cause of autoimmune disorders and inflammatory dysfunctions in the body, which may require a holistic systemic approach for removal.

Medical ozone therapy, although little known in conventional medicine, has been widely used in Grandismedozon clinic for more than 20 years, with research and practice being crystallized in numerous scientific articles and the doctoral thesis in medical sciences developed by Dr. Andrei Pîrgari “The effect of active oxygen in its allotropic form in the complex treatment of marginal periodontitis”.

Thus, ozone therapy is successfully applied in the complex treatment of periodontal disease, being an unique therapy in its own way, with a powerful antioxidant effect that modulates the antioxidant system and the immune system, and it is also a huge anti-infectious nontoxic and anti- inflammatory, managing to calm the autoimmune response, stopping the disease. Regenerative periodontal surgical procedures are part of a complex treatment of periodontal disease that attempts to regenerate the lost periodontal tissues.

Grandismedozon Clinic offers complex treatment of periodontal disease, which involves a combination of bio-oxidative and surgical regenerative therapies aimed at stopping and repairing its lesions.

Bone augmentation is a sum of techniques aimed to increase the volume of the maxillary bone. This technique is one of the most common techniques used in our clinic for the treatment of bone loss.

In maxillofacial surgery an autogenous bone graft is considered the gold standard due to its osteoinductive and osteoconductive characteristics and the fact that it does not cause immunological problems. However, the use of these grafts is limited because they involve a second operative site and have a period of uncontrolled resorption. As a result, to reduce these disadvantages, artificial bone or alloplastic (synthesis) bioactive, non-toxic and non-immunological materials have been created. From this range, the most common is beta-tricalcium phosphate (β-TCP), having high bio-compatibility and osteoconductivity properties. Due to these features, β-TCP leads to bone deposition in areas that come in contact with the material.

Having in mind the fact that Grandismedozon clinic focuses on minimally invasive and regenerative techniques, but also on the experience gained over the past 20 years, and on scientific and clinical research in this field, our approach is to combine the use of beta-phosphate (β- TCP) and platelet concentrates, especially platelet rich fibrin (PRF) derived autogenously from the patient’s own blood. The combination of these biomaterials can greatly increase regeneration and accelerate bone healing with a beneficial impact on the desired outcome.

Do you think there’s nothing serious if you lose one or two teeth and the rest remain intact? The answer is not that simple! Researchers have shown that humans have no extra organs, and teeth are no exception. Each tooth has its function and you need all the teeth at the same time. What can happen if at least one of them is missing? Its function will pass to the neighboring teeth, overloading them, as a result, the chewing will only be done in one part, so the teeth will wear out more quickly, the muscles will become hypertrophied on this part, the temporo-mandibular joint will be affected, and it may even cause pain. The remaining teeth will move towards the gap, eventually altering the dental occlusion, which will lead to an incorrect skull position, which in turn will affect the posture of the body (the cervical and lumbar column).

Without proper treatment, the consequences are often difficult to bear. Ranging from an anesthetic appearance of teeth, masticatory inefficiency, joint pain, hearing disorders or periodontal disease can occur. The discomfort of chewing determines on the one hand the choice of safer and cheaper foods, but which are calorie rich and less healthy, and may result in gastrointestinal disorders that lead to nutritional deficiencies over time. And posture change can trigger a large number of symptoms and even chronic degenerative diseases (such as cystic cifosis, lordosis and scoliosis, compression of muscles, nerves, blood vessels, arteries, veins and organs).

Dental implants are the ideal treatment solution for missing teeth and for patients with partial or total edentations (one or more missing teeth).

A dental implant is the artificial replacement of the root of the tooth. It takes the form of a “bolt” that anchors in the bone at the level of the missing tooth cell and supports an artificial crown, bridge or support on its upper portion or provides support for the fixation of a dental prosthesis. The implants are made of well-tolerated materials that integrate effectively into bone tissue.

Treatment with dental implants is the preferred method of tooth replacement in most situations due to their significant benefits over other restoration options.

Some of the benefits of treatment with dental implants include:

• Dental implants preserve the bone, replacing the missing dental root.
• Dental implants improve face aesthetics, helping to maintain and develop the bone, thus providing natural support for the muscles and the skin of the face (especially around the lips and mouth), correcting the oval of the face, attenuating the wrinkles, and redefining the nasolabial recesses to achieve a youthful look.
• Dental implants protect the adjacent natural teeth, preventing them from moving.
• Dental implants improve breathing and oxygenation of the blood due to the decrease of the vertical occlusion level in case of toothless patients when they remove the mobile prostheses during sleep, the natural movement of the airflow into the body may be blocked, which may cause or exacerbate sleep apnea syndrome.
• Dental implants improve the chewing function by correcting the teeth length and restoring the dental occlusion, which will evenly distribute the masticatory forces between the arches and the teeth equally.
• Dental implants reduce rapid and severe wear of other teeth, protecting other teeth and maintaining proper alignment and smile proportions (which becomes less attractive when teeth are used), increasing their long-term longevity.
• Dental implants contribute to superior long-term aesthetics which is achieved by preventing a visible denture defect.
• Dental implants contribute to a better hygiene of the oral cavity, an implanted crown is more hygienic than a dental bridge, because it is cleaned as a natural tooth and does not accumulate food debris beneath it.
• Dental implants protect the natural healthy teeth, preventing their preparation or even worse root-canal treatment for prosthetic purposes.
• Dental implants significantly reduce the risk of periodontal disease occurrence at the spot of implant insertion due to regeneration of bone and gingival tissue and continuous support, compared to a bridge that usually leads to poor hygiene, and consequently poor hygiene contributes to maintaining periodontal disease, disease progression, gingival recession and, finally, progressive loss of bone tissue.
  Dental implantation is a solid investment, documented clinical trials indicate a success rate of 95-98%, and dental implants can last for 20-30 years provided on the one hand that the required surgery techniques are observed and the correct execution of the prosthetic part on the other hand. Another requirment deals with maintaing a good general and oral health, having a good oral hygene, is not an excessive smoker or alcohol consumer (although smoking is bad for healing, it is not absolutely prohibited, thus 3-5 cigarettes per day are allowed).

Keeping a proper oral hygiene has a crucial role in successful implant treatment because the microbial factor can permanently damage this success.

The quality of the implant used in the treatment is very important as well, as it must be made of high quality materials and under special conditions, having all the necessary certifications and approvals of the accredited bodies.

As this is an essential surgical treatment at Grandismedozon Clinic, sterilization conditions are very rigorous, aseptic and antisepsic rules being rigorously observed.

Among the disadvantages of dental implants should be mentioned:

• More planning time and necessary treatment time,
• The treatment requires a surgical procedure,
• Higher costs (but result in long-term stability and fewer future investments for revisions)
• Immunological (allergic) response to titanium metal dental implants and titanium alloys.

How to choose your implants: titanium or zirconium?

Grandismedozon clinic offers implants from a commercially pure titanium alloy (CP4) with a specialized surface consisting of nano-calcium ions structure embedded on the implant surface that activates bone deposition around it, maximizing thus the osteointegration of the dental implant, and the prosthesis (abutment) is manufactured in the “hybrid” individualized version of the 3D CAD / CAM computerized technology. In our opinion, a titanium implant with an individual zirconium bin is the best solution at the moment.

However, given that allergy *to metal has a high prevalence among the population, in the case of dental implants, extremely rare cases of titanium sensitization have been described in patients with prosthesis failure, who were allergic to other metals as well. Titanium dental implants and titanium alloys induce developing sensitivity or even allergy of the gingival hyperplasia, which subsequently due to the microbial factor can permanently compromise the implant treatment.

On a large scale, the contact surface of the dental implant with the bone is rather small, since the bone has a very low reactivity potential. On the other hand, oral mucosa and skin behave differently from an immunological point of view, partly due to the influence of specific immune systems for each organ, such as lymphoid tissue associated with the skin and lymphoid tissue associated with the mucosa.

The evaluation of the skin sensitivity potential to nickel, chromium, and titanium salts demonstrated that a significant amount of titanium ions was required to cause a skin reaction. The amount of titanium ions released from titanium alloys was considered low due to surface stabilization and corrosion resistivity of titanium oxide formed on the surface of titanium alloys. These results can explain the extremely rare cases of sensitivity to titanium contact, and the emergence of immunological reactions is due more to titanium alloys (nickel or vanadium) than titanium itself.

Currently zirconium implants are the only viable titanium-free alternative. Zirconium is a material that has been used successfully in implantology because it has proven to be highly biocompatible, has no allergic effect (as it is not a metal), has very interesting micro-structural properties, is osteo-conductive, strong and resistant, has a color that fits with natural teeth and low affinity to bacterial plaque.

Grandismedozon offers you the choice between titanium implants and zirconium implants.

^*Jacob P. Thyssen, Torkil Menn. Metal Allergy – A review on Exposures, Penetration, Genetics, Prevalence and Clinical Implications. In Chem. Res. Toxicol., 2010, 23 (2), pp 309–318, 2009.

Manish Goutam, Chandu Giriyapura, Sunil Kumar Mishra, and Siddharth Gupta– Titanium Allergy: A Literature Review Indian. J Dermatol. 2014 Nov-Dec; 59(6): 630.

https://www.researchgate.net/publication/23173462_Titanium_allergy_in_dental_implant_patients_A_clinical_study_on_1500_consecutive_patients

https://www.peertechz.com/Dental-Problems-Solutions/JDPS-4-144.php

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248517/

The maxillary sinus is a cavity full of air located bellow the cheeks level. Every person has two maxillary sinuses, one on the left and one on the right, not communicating with each other.

In the case of tooth loss in the lateral areas, premolars, and especially the upper jaw molars, the bone density in that area decreases naturally and is reabsorbed over time. Because in the given situation there is not enough available bone to secure an implant, the sinuses must be moved upward, so in the given area a necessary space for artificial bone augmentation is created, which will ultimately help to stabilize the implant.

For the sinus lifting procedure at Grandismedozon clinic, we use state-of-the-art innovative technology that allows the maxillary sinus to be augmented by a minimally invasive internal method and concomitant dental implants placement.

The advantages of this revolutionary process:

• Minimally invasive lifting procedure of the maxillary sinus, allowing rapid healing and perfect bone regeneration,
• Rapid technique with increased control and safety, with minimal risk of sinus membrane damage,
• The possibility of approaching the maxillary sinus with 1-2mm thick bone thickness,
• Trauma-less procedure with reduced postoperative edema – the patient swells much less than in the classic sinus lift external procedure,
• Reduced post-operative pain,
• The procedure is done with immediate insertion of the dental implant,
• The same results are obtained as in an external sinus lift procedure.