Columbus Birdge Protocol © 2011

Patient’s page

Welcome to the page addressed to those who want to have further information about the Columbus Bridge Protocol.

Below you will find a list of 10 F.A.Q. concerning the implant treatment in question.

1-Who can benefit of a treatment with fixed prosthesis on implants with immediate load technique?

The Columbus Bridge Protocol appeals mainly to persons with denture at the terminal stage who require a decisive and reliable treatment without having to undergo a transitory treatment with mobile prosthesis.

Even those who already bear total removable prosthesis, the so called dentures, can benefit of the treatment.

Sometimes, elderly patients wonder whether their age can prevent them from enjoying the benefits of dental implants. However, wealth is more decisive than age.

2-Which are the advantages of the Columbus Bridge technique in comparison to other implant solutions?

The Columbus Bridge Protocol is characterized by:

- reduction of the number of implants to be inserted. Usually the treatment of a whole edentulous arch requires 4 implants;

- use of tilted implants, is necessary, to optimize the exploitation of the residual bone of the patient, i.e. all the natural bone support remaining in the mouth after dental extractions or infections;

- exclusion of surgical technique implying bone graft, which require longer treatment time (up to one year), higher costs and reduction of the reliability of the treatment since the quality of the artificially recreated bone cannot be compared to that of the natural bone ;

- delivery of a fixed denture of high aesthetical and functional standards within 24-48 hours 

3-Which are the most frequent contra-indications?

The most frequent contra-indications are anatomical and medical. As to medical contra-indications, some diseases can represent a risk factor for the treatment of edentulism with dental implants.

After a careful examination of your anamnesis, the dentist will assess if you are a suitable candidate to receive a fixed treatment on implants according to the Columbus Bridge Protocol.

Other negative prognostic factor, such as nicotinism (over 10 cigarettes a day), poor oral hygiene and involuntary grinding of the teeth (the so-called bruxism), even if not absolute contra-indications can increase the risk of complications after the insertion of the implants. Usually, a highly motivated patient will try to overcome these obstacles with the help of the dentist.

The anatomical limits are imposed by the quantity of bone present in maxillary bones.

The available bone volume varies from patient to patient and partly depends on the time passed from the last dental extractions. In fact, after a tooth extraction the mouth undergoes remodelling processes including a reduction of the quantity of bone tissue.

The Columbus Bridge Protocol technique has the peculiarity of optimizing the exploitation of the residual bone of the patient and enables positioning the implants even in subjects with advanced bone resorption.

In any case, the Columbus Bridge Protocol excludes surgical techniques of bone graft aimed at reconstructing the ideal bone volumes since the quality of the artificially recreated bone cannot be compared to that of the natural bone.

Besides, bone reconstruction interventions require longer treatment times (up to one year), and increase in the costs and a reduction of the reliability of the treatment.

4-Does the risk of rejection still exist?

The dental implants are titanium screws comparable to orthopaedic devices.

Their biocompatibility and inertia make sure that rejection, typical of old devices, has been completely overcome. Yet there is still the possibility and imperfect healing of the bone around the implant, which would imply the necessity to remove the device and to substitute it.  .

5-Which exams are necessary to understand if a patient is suitable to receive this type of treatment?  

The diagnostic procedure includes a starting orthopantography (the so-called dental panorex or panoramic scanning) to assess the general conditions of health of the mouth. Having this exam already at the moment of the first visit in the dental unit is of advantage.

Later on, after the clinical exam performed by the dentist a CAT (COMPUTERIZED Axial Tomography) of the maxillary bones is prescribed to asses the quantity of available bone for the insertion of the implants.

The diagnostic framework is completed with the request of a haemachrome (blood analysis). 

6-Which type of anaesthesia is given during implant insertion?

Usually the implants are inserted under local anaesthesia, i.e. the same anaesthesia used by the dentist to extract the teeth. Only in some clinical cases with intense vomiting reflex of insurmountable states of anxiety towards dental care, it is possible to perform the implant intervention under sedation with the support of an anaesthetist.

7-What are the times of the treatment of Columbus Bridge Protocol?

The sequence of the appointments includes the following steps:

Visit and preliminary screening for the assessment of the applicability of the technique.

Assessment of the radiography; cast taking for the study of the case, choice of the colour and pre-post surgical indications.

Surgery with tooth extractions, if necessary, insertion of the implants and cast taking for the manufacturing of the immediate prosthesis.

The session takes about 3 hours.

Twenty-four or forty-eight hours after the surgery the immediate load fixed bridge is connected. The patient is instructed about the hygienic and dietetic rules to be followed. 

Seven to ten days after the surgery the suture is removed.

Then check appointments are scheduled for each patient.

After four to six months, the provisional implant is re-assessed to finalize the prosthetic treatment with a simple correction of the manufacture or, if necessary, with the manufacture of a new prosthesis.

8-How shall I behave after receiving the fixed denture?

Forty-eight hours after the surgery the patient can benefit again of a fixed denture.  

The return to a normal diet must happen gradually in the following days to allow the healing of the bone around the implants.

The maintenance of the new manufacture requires manoeuvres of oral hygiene and specific dietetic indications subdivided into stages according to the healing time. The medical staff of the Dental Unit will instruct the patient and follow the post-surgical course during the scheduled checks.

It is important to remember ho in the first months of function the failure to observe the dietetic rules recommended, poor hygiene and smoke are negative prognostic factors for the healing of the bone around the implants and, consequently, they are responsible for the increase of the arising of complications.  Statistic studies prove that, observing the surgical-prosthetic protocol proposed, the percentage of implant success are over 95% and possible complications usually occur in the first 3 to 6 months of function.  

9-What is the durability of dental implants? 

The implants, as artificial roots substituting natural teeth, can have durability comparable to the life of a natural fixed denture. Prosthetic treatments need periodical individual hygienic checks according to the characteristics of the fixed bridge and the capacity of the patient to maintain a high standard of hygiene.  Similarly to any other oral treatment, in the course of the years the bridges on implants can present slight complications and therefore the need for repairs.