24 Feb Protesi mobile scheletrica con ganci metallici, estetici, attacchi di precisione
Quando il paziente non ha perso completamente i denti e particolari condizioni cliniche non consentono di impiantare protesi fisse, una soluzione ottimale è rappresentata dalla protesi mobile parziale scheletrica (o scheletrata) con o senza ganci meccanici. Essa viene ancorata per mezzo di ganci ai denti naturali residui, che fanno da supporto, ed è costituita da una struttura in lega di metallo (lo scheletro appunto), costituita da cromo, cobalto, eccetera.
Consente di ripristinare la funzione masticatoria con costi più contenuti rispetto agli impianti, anche se la presenza in alcuni casi di ganci metallici e la natura removibile del manufatto protesico pongono la protesi mobile scheletrica su un livello non equiparabile alla soluzione implantare fissa. La protesi scheletrata è formata principalmente da tre elementi principali: la struttura portante di metallo di cui sopra, la flangia finta che simula la gengiva con il duplice compito di ristabilire l’estetica e nascondere il metallo sottostante e infine i denti protesici. La mobile scheletrica con ganci è solitamente meno costosa rispetto alla protesi che al posto dei ganci tradizionali presenta attacchi di precisione (vedi in seguito) e la sua realizzazione comporta tempi più rapidi.
La stabilità della protesi in bocca è garantita dalla presenza di ganci metallici a filo che abbracciano i denti naturali. Gli svantaggi sono che i ganci di metallo possono essere visibili quando si sorride e che i denti naturali su cui poggiano i ganci sono inevitabilmente soggetti a maggiori stress meccanici e a maggior ristagno di placca. Per quest’ultima ragione sono fondamentali visite di controllo regolari e un’igiene orale domiciliare molto accurata. La protesi scheletrica, come detto, può essere molto stabile, ma non è comunque fissa per cui va rimossa dalla bocca per poter eseguire corrette procedure di igiene domiciliare e per poter pulire adeguatamente la protesi stessa. La protesi mobile con ganci estetici può essere provvisoria o definitiva, con la differenza di non avere componenti metalliche, neppure per i ganci a filo. E’ infatti interamente costituita da nylon termoplastico flessibile, dotato di particolari proprietà fisiche, chimiche e meccaniche. Non si notano perchè non hanno ganci in metallo, sono più sottili e il nylon lascia trasparire il colore naturale dei tessuti; inoltre è un materiale biocompatibile estremamente leggero e resistente alle cadute. E’ indicato per tutti i pazienti allergici alle resine acriliche e può essere una soluzione estetica provvisoria, prima della protesi fissa, sia come soluzione finale, sulla base delle caratteristiche della bocca valutate dall’odontoiatra implantologo.
La protesi mobile senza ganci tradizionali utilizza attacchi di precisione ancora più stabili e, soprattutto, non visibili e flessibili. E’ necessario, in questo caso, incapsulare i denti naturali, che altrimenti non sono in grado di sopportare i carichi masticatori, e ricoprirli con corone o ponti in cui si andranno a inserire gli attacchi della protesi mobile scheletrata (per questo si parla di protesi combinata, in quanto costituita da una parte fissa e da una removibile dalla bocca). La realizzazione di questo tipo di protesi ha un costo maggiore e richiede più tempo della protesi mobile con ganci. Il dentista di fiducia saprà consigliare il tipo di protesi più adatta in base alle esigenze e alla condizione di denti e gengive.
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