A dental implant is a screw that replace the root of a missing tooth.
The branch of dentistry that deals with these tasks is called implantology.
What is an implant and what is it used for?
Implants are non-viable material placed in living tissue or organ. The relevant discipline in dentistry is oral implantology. A dental implant mimics the functions of the dental root. The implant directly bonds with the jaw bone, protruding from the gum towards the oral cavity and acting as a buttress for the tooth crown. Hence, it replaces a lost tooth. An implant eliminates the need for constructing bridges, which require cutting healthy teeth along on both sides of the empty space created by teeth loss. It also prevents the loose movements of dentures, which allows for the elimination of sore pressure points in the mouth by retaining the appliances.
How is implant treatment performed particularly in patients with loose dentures?
In patients who have lost all of their teeth in the lower dental arch, the bone tissue was reduced to retain the total denture, therefore, a moving tongue will also move the loose denture. For this reason, patients use adhesive powders and paste reluctantly. In these patients, 2-4 implants can be placed for the retainment of the lower denture.
Is bridging between the natural teeth in the mouth possible similar to the bridging between implants?
Yes. The aim of placing implants is to stabilize the loose teeth. This means that the purpose of placing an implant to the empty space adjacent to the respective loose tooth is to stop its wobbling during the time being. It has been demonstrated that bridging dentures are more durable when bridges are made using natural teeth.
How long does it take to place an implant?
After providing anaesthesia appropriately, a specialized dentist will perform the implant procedure in 5 to 10 minutes.
What are the other requirements for an immediate crown loading?
The bone quality should be good and the structure of the implant should allow for immediate loading of the crown.
What is the waiting period for the implants placed to support removable dentures?
These implants prevent the moving of the dentures in the mouth. Their heads are rounded in the form of a knob. The removable dentures can readily be fixed on these implants. No waiting period is required for this process because, in removable dentures, the chewing forces are transmitted not only over the implants but mostly over the mucosa. On the other hand, in fixed-bridge dentures, the exerted forces are directly inflicted upon the implants.
Will pain and swelling develop after dental implant placement?
During the process of placing the implant, local anaesthesia is applied. Therefore, patients do not feel pain at all. However, after the procedure and the numbness due to local anaesthesia is over, pain may occur. This pain can be relieved by the analgesic medications given earlier. Swollen gums usually occur as a result of retracting gingiva along with the underlying periosteum or as a result of placing implants at the same session of complicated bone surgery. This swelling resolves in the following 3-4 days. The degree of swelling is minimized with antibiotic medications administered before the intervention and by applying cold compresses. Swellings are not alarming in the absence of fever.
Which is healthier; titanium or zirconium implants?
Actually, zirconium implants are healthier since they do not emit ions within the body and do not cause electrical conduction in the mouth. They are not allergic either. Moreover, their white colour is an aesthetic advantage.
Can every dentist perform implant placement?
No. Currently, the indications for implant surgery cannot be overlooked and high success rates are achieved with placing implants only when they are applied by appropriately trained dentists. Otherwise, failures will occur. In addition, the implant surgery should take place in dental clinics complying with appropriate sterilization conditions.
In which individuals should an implant not be placed?
Pregnant and nursing women should not undergo implant procedures. People with severe systemic diseases should be carefully evaluated for implant procedures. Diabetes mellitus is a risk factor for achieving success with implants. However, implants can be applied to individuals, whose diabetes is well-controlled. It is also known that the success of the implant is reduced in smokers.
What are the indications to use implants?
Implants are applied to replace individual tooth loss, to replace missing teeth either on one side or both sides in the back of the mouth, to provide support to the remaining very few natural teeth, as well as, being applied to the total toothless patients.
Having a large portion of palate exposed in upper jaw dentures causes nausea. can an implant eliminate the need for palate exposure, thus, eliminate nausea?
Yes. By placing three or four implants in the upper jaw, the palate is set free from the exposure of the denture. This eliminates nausea and allows the patient to enjoy high palatability.
When a single tooth is extracted, is it more favourable to construct a bridge by cutting along the adjacent teeth or to place an implant with a crown?
If the teeth adjacent to the extracted tooth are healthy, an implant should be placed not to inflict damage to intact teeth. However, if root canal treatment or a filling was performed, bridging should be preferred, keeping the implant as an option.
How long should be the waiting period to place a crown over the implant or to make a bridge?
After placing the implant, a torque ratchet is used for measuring the strength of bonding of the implant to the bone. If the bonding force is sufficient, an immediate measurement is performed to fabricate a permanent or temporarily placed crown or bridge.
Which conditions require avoiding an immediate crown loading over the implant?
In patients with a poor bone quality or in the presence of teeth grinding or gnashing, implants should be placed in two steps. Dentures should be placed on the implants only when complete osseo-integration occurs after a waiting period of 2-4 months for the lower jaw and 4-6 months for the upper jaw. During this waiting period, no pressure should be applied over the implant.
Can implants be placed without gingival retraction and without a requirement for suturing?
Yes. If the type of the implant to be used allows and if the thickness and vertical size of the bone are appropriate, this is doable. This way, the pain and swelling are minimized.
What are mini implants and what are they used for?
They are smaller implants with a diameter of 2.2-3.00 mm. They are placed in thin bones and narrow spaces between teeth. They are easier to apply. Swelling or pain does not usually occur after the operation. They are also used in patients using anticoagulants (blood thinners), in patients at very old ages, and in patients with high blood pressure in order to eliminate the need for surgical interventions and to provide stability for the removable dentures.
Does the quality of implant play a role in achieving success?
In dentistry, ninety percent of the implants are made of titanium material. Unfortunately, some of the commercially available implants are made of cheap and harmful titanium with the potential of leading to cancer. Therefore, cheap and non-medically manufactured titanium implants should not be used.
What is the “all on 4 implant technique”?
Excessive bone structure loss in the dental arches at the back of the mouth or some specific anatomical conditions render the implant surgery highly difficult or sometimes impossible. Considering this issue, Dr. Paola MALO developed a method, in which four long implants at specified angles are placed in the jaw bone, fixing bridges over them. This method eliminated the need to use removable dentures.
What is the minimum appropriate age to place implants?
Implants should not be placed in girls younger than 13-14 years old and in boys younger than 15-16 years. Individuals at advanced ages (60-90 years old people) can undergo implant procedures.