What is a Dental Implant?
A dental implant is a roller-shaped screw, similar to the root of the tooth, made of bio-friendly material (titanium). Type and size of the implant, as well as their number, are selected based on your needs and possibilities. Implant survival in the jawbone is no different than the survival of the tooth. Just like teeth, implants may be lost due to inadequate care.
How to start?
Implant treatment starts with a thorough dental exam. The surgeon evaluates the general health of the patient, condition of the teeth and the oral cavity mucosa, as well as bone quality and volume. For the correct assessment of the jawbone, an X-ray is needed (OPT scan). The surgeon and the dental practitioner prepare a detailed implant draft based on the performed examinations. The examination is supposed to be a two-way exchange of information.
Tell your surgeon about any underlying or prior illnesses, medications you take on regular basis or used to take, allergies, surgeries. During the examination, ask your surgeon whether this affects implants and in what way.
Prior to implant placement, it is necessary to treat all existing dental issues (e.g. caries), illnesses of the supporting tissues (e.g. periodontal pathologies) and the oral mucosa, which could compromise the success and durability of the implant.
In local anesthesia (numbing of the tissue by injecting an anesthetic), rarely in general anesthesia (narcosis), painless access through the oral mucosa to the implant placement position is enabled.
Course of a Procedure
Using a special instrument, we prepare the recipient site in the bone where we place the implant. If needed, we at the same time augment the bone. We close the mucosa (gums) with a suture. After the procedure, there may be facial or lip swelling, as well as mild pain, but these may be completely alleviated by taking painkillers (analgesics). Sutures are removed after 7-14 days following surgery. In certain cases, the implant is placed immediately upon tooth removal. This is called immediate implantation. This technique significantly shortens the period of treating edentulism. The decision about this option is made by the surgeon during the initial examination.
Healing and Fixing
As a rule, it takes three months. After this period, the gums above the implant are cut in a short procedure. An element which enables shaping of the gums around the connection between the implant and the prosthetic restoration which will be made is screwed onto the implant. This takes about two to three weeks. During the healing and fixing of implants, it is possible to use a tailor-made prosthetic restoration (denture) in order to ensure esthetic criteria are met. Due to the swelling of the mucosa, it is recommended to start using prosthetic restorations after the removal of the sutures. Time of healing and fixing of the implant may be shortened under certain good bone conditions. In some cases, the prosthetic procedures may be started immediately upon implant placement. This procedure is called immediate loading. A prosthetic restoration made in this way is, as a rule, temporary and is replaced with a permanent restoration in six months.
Do I need Dental Implants? Indications for Implants.
LOSS OF A SINGLE TOOTH
When you lose a single tooth in the dental arch, there are two options for a permanent solution:
By preparing (grinding down) two adjacent teeth, the area is restored with a bridge, i.e. crowns on the ground down teeth and the inserted bridge member, which restores the lost tooth.
By placing an implant in place of the lost root, avoiding grinding of adjacent teeth.
INTERRUPTED OR SHORTENED DENTAL ARCH
As when restoring a single lost tooth, it is possible to grind the back teeth and restore the missing teeth with a bridge. If the back teeth are missing, making a bridge is not possible. It is necessary to make a removable denture. With dental implants, it is possible to restore each missing tooth. It is also possible to put fewer implants and a bridge between them. In some cases, it is also possible to make a bridge between the tooth and the implant.
In case of loss of all teeth, in the pre-implant era, the only possible solution was complete removable dentures. Wearing complete dentures, especially in the lower jaw, becomes difficult over time, sometimes even impossible since its functionality and stability worsens. By placing two (in the upper jaw) or four implants, it is possible to fix the dentures very well. By placing six implants, it is possible to make a bridge for fixed restorations of all teeth.
BONE MANIPULATION PROCEDURES
When you lose a tooth, loss of surrounding bone and gum tissue also occurs. The lack of these tissues is bigger if the process of losing teeth lasts longer (e.g. chipped tooth, periodontal pathologies). Long-term edentulous state where the jawbone is not loaded weakens the bone, until it gradually disappears.
High success rate and permanency of the implant may be expected when the implant of appropriate length is entirely surrounded by bone. This is why, there are procedures to restore the missing bone with the aim of achieving an adequate functional and esthetic result.
COMMON BONE MANIPULATION PROCEDURES:
Bone expansion enables placing a sufficiently wide implant near narrow jaw ridges. It increases the contact area between the bone and implant. It is done using a special instrument during implantation.
Synthetic bone grafting (artificial bone) includes use of additional material, which is very similar to the bone structure and which integrates with the bone. It is placed prior to or during implantation.
Autogenous bone grafting (bone transplant) is a process of transplanting bone from a place where it can be harvested to the place where we need it. Bone transplanted in this way is more durable than when artificial bone grafts are used.
Sinus floor lift is a method of restoring bone in the back part of the upper jaw. The lower part of the upper jawbone is moved upwards and the obtained space is filled in by bone substitutes. Implants are placed at the same time or in a few months.
Pre-op and Post-op Instruction
For a day or two after the surgery, do not smoke, drink alcohol, take part in strenuous activities, and eat softer food. After meals, wash the mouth out, do not touch the wound. Brush your teeth normally. Remains of food piling on surgical sutures should be wiped off gently with a cotton swab. Do not put medications or compresses onto the wound. If you have a tooth or teeth replaced by a removable denture, we advise you not to use it until the swelling goes down.
Up to six weeks after the operation, avoid physically strenuous activities, chewing in the area of the placed implant. Do not floss. If, in the weeks following the procedure, you have symptoms such as swelling, redness, pain or secretion, come in for a check-up.
Advice for Success
After the implant healing is complete, regular check-ups are needed. Follow the advice of your doctor or dentist. An unavoidable and necessary condition for long-term success of implants is permanent, regular and meticulous oral cavity hygiene. After each meal, remove any deposits from the teeth and implants in order to ensure permanent success. If you want long-term success, following this advice is unavoidable!
Frequently asked questions
Can you be allergic to implants?
Titanium implants have been used for about 40 years. There has not been a single reported case of allergies. This also applies to dental ceramics which is usually what prosthetics consist of.
Which diseases can pose a risk to implants?
We do not recommend implants for some cardiovascular and infectious diseases, and with weakened immune system capacities. A limitation for the surgical procedure itself is a blood coagulation disorder. Managed diabetes is not a risk to implantation success.
How much does it cost?
Price of implants depends on many factors: implant type and quality, bone manipulation procedure, type of prosthetics. When talking to the surgeon or dentist, ask about the approximate cost estimate. Bear in mind that an extremely low price of implants usually points to the low quality of the implant system.
Is smoking allowed with implants?
Smoking is a health hazard. Smokers have higher chances of developing complications in the post-operative period. Several-year success rate and longevity is reduced in smokers. Smoking is not a counter-indication for placing implants, but it is a success risk!
Is there the age limit for placing dental implants?
There is no upper age limit. No one is too old for implant placement. However, due to the unfinished jaw development, we do not recommend implant placement in patients younger than 17 years of age.
Is it possible to place a number of implants in a single procedure?
Certainly. In general, it is possible to place 12 implants in local anesthesia in a single procedure. If the placement of implants is accompanied by a substantial bone augmentation and larger number of implants, procedures can be done in two parts.
Is rejection of implants possible?
Possibility of implant rejection is 1-2%. Rejection of implants after placement depends on the type of surgical procedure and implant localization. A trained and seasoned surgeon can overcome such rejections. In that case, it is possible to replace the implant within a few months. Later losses of implants with properly made prosthetics and adequate oral cavity hygiene are rare.
Which medicines compromise the healing of implants?
Medicines which decrease bone density (e.g. corticosteroids, some medicines for treating osteoporosis) and which affect the defense mechanisms of the body or blood coagulation.