Dental Implants
Dental Implants

This content created by Sevda Sönmezer, Msc. Dt. with attribution to scientific articles.

Dental Implants

What Is Dental Implant?

The dental implant is a surgical component that supports a dental prosthesis such as a crown, bridge, denture, facial prosthesis to act as an orthodontic anchor. Dental implants are a biological process which name is osseointegration in materials like titanium an intimate bond to the bone.

The implant fixture is initially placed so that it is likely to osseointegrate, then a dental prosthesis is added. A personally varying recovery time is required for osseointegration before the dental prosthesis is attached to the implant or an abutment capable of holding the dental crown is applied.

The success rate of implants depends on the health of the person receiving the treatment, drugs that affect the chances of osseointegration, and the problems of the health in the mouth. The stress that can affect implant and fixture during normal function is also evaluated.

Planning the location, number, and size of the implant due to the forces generated during chewing is important for the long-term health of the implant. The position of the implants, the position, and the angle of the adjacent teeth are determined using CAD / CAM and computed tomography. Requirements for long-term use of osseointegrated dental implants are healthy bone and gingiva.

In cases where the person cannot or can not remove the prosthesis or teeth from the mouth, the final denture can be fixed. In both cases, an abutment is attached to the implant fixture. Where the prosthesis is fixed, the crown, bridge, or prosthesis is fixed to the abutment either with delay screws or with dental cement. Where the prosthesis can be removed, a suitable adapter is inserted into the prosthesis so that the two parts can be fixed together.

Risks and complications related to implant treatment can be listed as those at the time of surgery such as excessive bleeding, those in the first six months such as infection, and those occurring in the long term. In the presence of healthy tissues, a well-integrated implant with appropriate biomechanical loads can have 5-year plus 93 to 98 percent survival rates for prosthetic teeth and a 10 to 15-year lifespan.

Who Are The Candidates For Dental Implants?

Implants can be placed in those whose bones are good and healthy. In people under the age of 18, the development of the jaws is not fully completed, and therefore, as the remaining teeth grow at the same time as the jaws, the implant will appear shorter than the other teeth, so these people cannot be implanted.

Implants are very important in people traumatized by traffic accidents or illnesses. These people have a much better life after the implant is placed.

The complete contraindications are:

  • Bone diseases.
  • Radiotherapy in the jaws. Implant loss less than 30% in the lower jaw and over 40% in the upper jaw.
  • Absolute contraindication if the patient develops a crisis in less than a month.
  • Myocardial infarction or stroke.
  • Prosthetic caps.
  • Unregulated Type II Diabetes Mellitus.
  • Dry mouth. Because of oral hygiene, it is better to wear a full denture rather than permanently bonding screw implants.
  • Paralytic joints and roar. Some patients at the overnight brush their teeth or bite them. As a result, the implants restorations on them become worn out and even destroyed.
  • At a further stage of the disease, there is a decrease in bone density and bone mass.
  • Acute osteomyelitis can be a treat after a complete cure.
  • Chronic kidney failure.
  • Platelet disorders like leukopenia, anemia, hemophilia, and agranulocytosis.
  • Patients after organ transplantation (In the first 3 to 6 months after transplantation).
  • Pregnancy. Radiographs and medicines can be given after pregnancy.
  • In people with impaired mental health, drug use, and alcoholics.
  • Patients with genetic diseases and diseases of the immune system and autoimmune diseases.
  • Diseases like chronic leukemia, Parkinson’s disease, scleroderma, common pemphigus, ectopic dysplasia, Sjogren’s syndrome, AIDS, cancer in treatment.
  • Taking drugs, as taking a bisphosphonate for over two years, long-term corticosteroids, and chemotherapeutic drugs.

The Steps of a Dental Implant

X-RAY

The dentist needs x-rays for evaluation and prognostic purposes. X-rays, panoramic X-rays, or a 3D CT scan will be used to identify bone and gum condition and identify warnings.

Measurement

The dentist will measure your mouth and provide a copy of your teeth, gums, and surrounding tissue. You will determine the correct plastic or metal impression tray for your mouth and fill it with a liquid such as an alginate or polyvinyl siloxane, then bite the plastic or metal impression tray. The liquid will harden and become solid after a minute or two. You will then open your mouth and the tray will be removed and sent to a lab for processing.

While most people don't have a problem, the measurement process can be uncomfortable for those with a gag reflex or those who panic because of the inability to open their mouth or swallow properly. In order not to gag or panic, breathe deeply and try to be distracted.

The measurement does not take as long as you expect, and like many other dental procedures, your mind will try to dissuade you. Also, remember that your dentist is on your side.

Tooth Extraction

The problematic tooth should be extracted. This can be done at the same time as implant placement. The dentist will explain what type of anesthesia you are planning but will choose a local anesthetic. The tooth extraction will not take long, but if it breaks, the dentist will be more careful. You will feel some pressure and pulling as the dentist moves the tooth.

You should not smoke, drink with a straw, spit excessively or blow your nose for at least 24 hours after the extraction.

Implant

After tooth extraction, the dentist will make a hole in the jawbone. In some cases, the dentist will make an incision in your gum to expose the bone, in which case a stitch will be required. The dentist will insert the implant deep into the jawbone. Thus acts as an artificial root for your new tooth.

Depending on the condition of your jawbone, bone grafting may be required. This can be done with artificial bone materials.

It is okay to continue your daily routines. However, you'll likely be on a soft food diet for up to a week.

Abutment Placement

As your jaw bone heals, it will fuse with the dental implant. This may take several weeks or months. Duration varies according to the patient. After the dentist determines that your implant is sufficiently stable, an abutment is placed on top of it to act as a connector for the crown. The abutment is tightened with a dental torque wrench to keep it in place during chewing.

Sometimes the abutment can be placed simultaneously with the implant. However, it will be visible as the abutment extends beyond the gum line. Be sure to discuss this with your dentist.

During Surgery

Placement of dental implants is a surgical procedure and carries the risks of surgery such as infection, excessive bleeding, and necrosis of the tissue flap around the implant. When the maxillary sinus has lining prolonged sinusitis, pierced with an implant, is rare. Failure to place the implant in the bone to ensure the stability of the implant increases the risk of osseointegration failure.

First Six Months

The stability of the titanium screw implant in the patient's bone tissue after surgery can be evaluated non-invasively using resonance frequency analysis.

The importance of implant stability decreases with the regrowth of bone tissue around the implant in the first weeks after surgery. When this healing process is completed, the initial mechanical stability becomes biological stability. Primary stability is critical to implantation success until bone regrowth maximizes the mechanical and biological support of the implant. Regrowth usually occurs within 3-4 weeks after implantation.

Insufficient stability, or high implant mobility, can lead to failure.

Problems During the Recovery Period

For an implant to fuse properly, it must be surrounded by healthy gums and bone. Many factors can affect an implant's ability to remain attached to the bone.

The implant may become loose during the postoperative recovery period. When this happens, there is usually no pain or infection. The patient may have a limited amount of bone to cover the dental implant. Patients who smoke or have diabetes are more likely to have problems with the bone involved in their implants.

Problems During Use

There may be problems with the implant after the recovery period. If the bone cannot handle the forces applied to it, the implant may loosen. To treat this problem, the implant is removed and the bone is allowed to fill the area. This is a surgical procedure that may require bone grafting and stitches and is likely done with a local anesthetic. Afterward, the dentist will replace the implant after the area is strengthened.

Bone loss can result in a loose implant. People who lost their teeth due to gum disease have a higher risk of bone loss around the implant.

There may be too much space between the implant and neighboring teeth because the implant may not be the same size or shape as the lost tooth.

More serious dental implant problems can occur if the implant becomes infected. Peri-implantitis is a disease that causes the loss of the bone that supports the implant and usually requires removal of the implant.

Structural Problems

An implant has some component: a fixture placed in the bone, the abutment that holds the dental work in place, and the prosthesis, which can be a crown, bridge, or prosthesis that acts as a tooth replacement. Although the abutment is usually made of gold, titanium, or zirconia, the screw connecting the abutment to the implant body may break. If part of your implant breaks or breaks, the dentist will determine what treatment is required for the problem.

If you grind your teeth, you could damage the crown on your implant. The dentist will give a night guard to limit the effects of teeth grinding in the crown.

After Surgery

Discomfort is natural and normal after dental implant surgery.

You can expect:

  • Swelling of the face and gums
  • Bruising of the gums or skin
  • Pain at the site of your implant surgery
  • Minor bleeding

If these symptoms worsen a few days after surgery, contact the dentist immediately.

To aid your recovery after surgery, the dentist will recommend a diet of soft foods.

While most dental implant surgeries are successful, there may be complications, including problems with the bone fusing into the implant. You can prevent them by:

  • Avoid using tobacco products
  • Practice proper oral hygiene by brushing twice a day and flossing at least once a day.
  • Attend regular dentist visits and examinations to stay on top of your oral health.
  • Avoid bad habits, like chewing on ice or hard candies

 

Published: 25 Ocak 2021
Updated: 25 Şubat 2021

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