Dental implants: Step-by-step guide
Missing a tooth or even several teeth can be life-changing for many people. Besides feeling self-conscious about your smile, the long-term consequences such as speech problems, bone structure shrinkage, difficulty chewing etc. may occur.
Dental implants are one of the best permanent solutions
Dental implants are artificial tooth roots that are surgically placed into the jawbone. Over the course of several months, the bone surrounding the implant grows, holding it securely in place. Replacement teeth are then attached with a metal connector to the implant, filling in the gap.
Dental implant procedures are done in several steps over a period of around 3 to 9 months.
Who is shown implantation?
Indications for treatment - the absence of one, two, three or all teeth in the oral cavity, bone atrophy, periodontitis, periodontal disease and even osteomyelitis of the jaw.
Through dental implantation, today it is possible to solve almost any clinical problem: it allows you to return the aesthetics of a smile, solves the patient's social problems1. But, of course, with limitations: before treatment, an anamnesis will be collected, an examination of the state of the jawbone will be carried out, if necessary, the patient will be sent to take blood tests and to a specialized specialist - it is very important to exclude possible contraindications that may cause the occurrence of complications and even cause rejection of installed implants.
It is also worth noting that implantation in women has its own characteristics due to special and regular changes in the hormonal background.
PATIENTTYPES OF MODERN DENTAL IMPLANTATION
Modern dental implantation is represented by two treatment protocols: a two-stage with a delayed load, as well as a one-stage prosthesis with an immediate load. In the first case, crowns, a dental bridge or a conditionally removable prosthesis are fixed after complete engraftment of the implants, in the second, the prosthesis is fixed immediately.
Marina Dentists specialize in the most modern methods of dental implantation. Each of them has its advantages and disadvantages and is used for certain indications. We use an exclusively individual approach and select the most optimal prosthetic option for the patient, depending on the number of missing teeth, the condition of bone tissue and gums, bite and work of the jaw joint. We it is important not so much to restore teeth as to give our patients the opportunity to return to a full life without pain and discomfort.
In addition to common methods or protocols, there are also various ways to install the implants themselves:
- patchwork: the structure is installed through exfoliation of the gum flap, while a bed is drilled into the bone tissue with the help of boron under the implant. This method is used to fix two-component implants,
- minimally invasive: the installation of implants is carried out by puncture of tissues, without incisions and suturing. Due to this, the recovery period is reduced to 2-3 days. The implant is literally screwed into the bone, while the bone tissue is compacted around the structure, rather than being removed from the hole, which provides a tighter attachment of the titanium "screw" in the jawbone. The method is used to fix single-component implants,
- into the socket of the extracted tooth: the implant is placed in the hole where the living tooth was previously located. Two operations are performed simultaneously. Depending on the situation, it is possible to use both
- single-component and two-component implants,
- lateral: This is an outdated method that is practically not used today. It was used to install implants with a disc base - through a lateral incision in the gum and bone. Quite traumatic, in addition, the implant models themselves have ceased to be used because of the high risk of rejection.
How is dental implantation better than prosthetics?
Dental implantation is more expensive than classical prosthetics, but wins in all respects:
- longer service life: the implants themselves with professional installation and careful care will last at least a couple of decades, the installed prostheses - at least 10 years. Replacement of crowns is carried out without re-installation of implants,
- better appearance: the aesthetics of prostheses on implants are much higher, since they have smaller dimensions, accurate positioning in the jaw taking into account anatomy and bite,
- solution of any problems: implantation allows you to restore both one and all teeth, and absolutely any prostheses can be fixed on implants, which means that the patient has a large selection of prosthetic options,
- increased degree of fixation of prostheses: even removable dentures are securely held on implants, they do not need to be constantly removed and you should not be afraid that they will fall out of the mouth when talking or eating food,
- preservation of own teeth: when restoring 1-2 teeth, neighboring ones are not affected and are not sharpened, since they are not used as a support for the dental bridge. Implantation, on the contrary, restores the condition of the entire jaw apparatus - crowns provide support for antagonist teeth, and also protect neighboring teeth from displacement towards empty space in the row,
- bone tissue restoration: it is implantation, unlike dental bridges or removable dentures, that provides the jawbone with a load. When chewing food, the pressure on the tissue falls on the side of the installed implants (similarly, if living roots were preserved in the jaw). Due to this, metabolic processes are activated inside it, the bone functions naturally and does not atrophy.
The patient should not be afraid of surgical intervention - the installation of implants is necessarily carried out under anesthesia, and modern methods allow you to do without a long rehabilitation and soreness after the operation.
Disadvantages of implantation
Dental implantation is becoming an increasingly popular solution to the absence of teeth every year. But in addition to significant advantages, it has certain drawbacks: a higher cost of treatment compared to traditional prosthetics, the need for surgical intervention and drug therapy, the likelihood of complications, a rather long rehabilitation. In addition, implantation has certain contraindications for health reasons. In general, this method of restoring teeth in the long term justifies all investments: both material and temporary. Prostheses and implants serve for several decades, allow you to fully eat and smile without embarrassment.
ENGRAFTMENT OF DENTAL IMPLANTS AND POSSIBLE COMPLICATIONS
According to statistics, implants take root in 98%. Isolated cases of rejection arise mainly due to the inexperience of the doctor, due to mistakes made or unaccounted diseases of the body, as well as due to patients ignoring the rules of rehabilitation and oral care. After installation, complete osseointegration (engraftment or fusion of the implant and bone tissue) occurs on average in six months. At this time, the load must be slightly reduced, including through the choice of lightweight models of prostheses (temporary or permanent, created from plastic).
The quality of implant engraftment depends on several factors:
- the quality of the implant itself,
- exclusion of contraindications to treatment,
- professionalism of the doctor,
- the right tools for the job,
- sterility during the operation,
- compliance of the patient with all the requirements of the attending physician.
Implantation in the center "Smile-at-Once" is carried out by professional implantologists, maxillofacial surgeons with many years of experience and knowledge of the anatomy of the jaw system. Specialists of the center annually participate in world symposiums and seminars, undergo trainings and advanced training. Doctors of the clinic are members of the world communities of dentists and implantologists, regularly presenting their own developments in the field of implantology to colleagues. All this allows us to solve even the complex problems of our patients.
Maxillofacial surgeon, implantologist, orthopedist
Work experience 35+
How to care for dental implants?
The rules for caring for implants are very simple - you need to regularly clean dentures, remove food residues after eating and visit the dentist 1-2 times a year to conduct a complex of professional hygiene in order to remove plaque and hard stone. In the presence of implants, it is very important to pay attention to the condition of the gums, preventing their inflammation. To do this, it is recommended to use an irrigator - a device that allows you to clean hard-to-reach gaps, especially between the prosthesis and the gum - where the tops of the implants are located.
According to official data, dental implants last 10-15 years (middle-class models) and 20-25 years (premium segment models). However, in practice, implants installed professionally, fully accustomed and not giving complications in the first 1-2 years, can last until the end of life. And this is damaged by real situations: even the very first implants installed in the 60s of the last century still serve their owner. But during this time, technology has made a huge step forward.
We provide our patients with two types of guarantee: lifelong not only for implants (installed by the manufacturer), but also for the work of doctors on their installation. In order to maintain the guarantee, the patient must strictly follow all the recommendations of the attending physician on the load on the implants, lifestyle after surgery, the rules of rinsing and taking prescribed medications, and also not to miss preventive examinations that allow you to assess the quality of the treatment.
Alternatives to implantation
Alternative implantation methods are options for prosthetics based on their own living teeth, or on the gums. Since implantation solves the problems of missing teeth along with the roots, only dental bridges or removable dentures can be other options. They have their pros and cons, but the main drawback of such structures is the complete lack of protection of the bone from atrophy - due to the lack of load, it sags under the prostheses.
Dental bridges are several crowns, the outermost of which are fixed on two supporting teeth. Previously, their tops are quite strongly sharpened, which later, after the bridge fails, will require the restoration of their own supporting teeth.
Removable dentures are used to restore any number of teeth - from one to a full dentition. They have hooks (made of metal or plastic) that cling to the supporting living teeth. This is the most inexpensive option for restoring lost teeth, but at the same time relatively comfortable and aesthetically pleasing.
Types of implants - an overview of the best systems
More than 30 brands of dental implants are used in New Zealand clinics today (and these are only popular manufacturers that have been on the market for more than 10-15 years). Prices for dental implants, of course, differ markedly. But you should not evaluate the quality of products only by cost. The main thing in dental implantation is to find an experienced doctor who can professionally install both inexpensive and premium implants.
Marina Dentists clinics cooperate only with trusted dental implant manufacturers. In our own practice, we have selected several brands that have proven themselves from the best side - they have been on the market for more than a decade, offer a variety of models for solving any clinical situations, are distinguished by high quality of osseointegration (engraftment), ease of operation and prosthetics capabilities. Today we work with brands such as Straumann (Switzerland) and Osstem (South Korea).
How to choose a quality dental implant?
When choosing a dental implant of a certain brand, first of all, it is necessary to pay attention to several product characteristics:
- material: the most modern implants are made of almost pure titanium (its content is about 99%). This is a metal that is fully integrated in our body and is not rejected by it. The composition of inexpensive implants may contain impurities of cheap metals, which can cause disruption of the engraftment process and a reduction in the service life of the product,
- spraying: the surface of the dental implant must be carefully processed (sandblasting followed by acid etching). Each company uses its own method, the goal of which is to obtain a rough or porous surface with a minimum amount of impurities (that is, sterile) - the success of the engraftment of structures and the rate of fusion with bone tissue depends on this. Its cells literally penetrate the pores of the implant,
- shape and lineup: a company that strives to create quality implants should not release just one model. An implantologist who chooses a certain company for work needs a choice, because the condition of the bone tissue is different for each patient.
The dental implants themselves can be of various shapes: tapered, cylindrical, with a disc base, extra bone, or those that are attached under the mucous membrane without using bone tissue. However, in most situations, the classic tapered model is used, which resembles a normal root - this is the most physiological design.
There are also one-piece and two-piece implants. In the first, the abutment (this is the tip on which the prosthesis is attached) is connected to the intraosseous part, in the second, the abutment and the implant body are two separate elements. One-piece models are used for immediate loading, two-piece models have long been used in the delayed prosthesis loading protocol. However, modern models of demountable structures can also be loaded with artificial crowns immediately after installation.
Features of the choice of implants for immediate and delayed loading
Today, more than three dozen different implants are produced, and these are only well-known brands. It is quite logical that many are heard by patients, while others are completely unknown, which means they cause concern. In part, this is quite true - the older the company, the more experience it has. The more expensive implants are (as a rule), the more funds are invested in their improvement and research work, the better they are clinically tested.
In general, there is no ideal implant and 90% of the success of treatment depends on the work of the doctor, on his experience and professionalism. Nevertheless, the implant is also important - it should be comfortable to work with, it should be suitable for a specific patient and allow for high-quality prosthetics. In general, the quality of the implant depends on the following characteristics:
1. Shape of the implant
Modern implants must exactly follow the shape of the tooth root, that is, disc bases and various plates are not allowed. World practice has shown that these are not effective solutions. Today, implants are in the form of a cylinder with an active thread or a tooth root (cone). Their length is from 7 to 60 mm for fixation in various parts of the bone structure, and not just in the jawbone, but also in other bones of the skull. In particular, in the area of the cheekbones, chin.
2. Material of the implant
It should be pure titanium without extraneous impurities (in particular, vanadium or aluminum), otherwise the osseointegration indices of the implant deteriorate. But a number of companies offer more advanced alloys: for example, in the Straumann assortment there is a line of Roxolid implants, which are created from pure titanium with the addition of zirconium dioxide. In combination, these materials give incredible strength, so the structures are thinner - the boundaries of their use are significantly expanding. The risk of rejection is also minimized (like titanium, zirconium is completely biocompatible). The coverage of the models is active, so that engraftment also remains at the highest level.
The Straumann product range also includes another unusual solution: ceramic implants, which are intended for aesthetic areas.
3. Outer surface
It is desirable that it be micro-rough. Bone cells penetrate into the pores, thereby providing reliable adhesion to the body of the implant, literally growing into it. Today, the RBM coating has gradually become a thing of the past (only sandblasting was carried out). It was replaced by the SLA technology, which additionally implies acid etching. But some manufacturers have gone even further - for example, Nobel and Straumann have created active coatings with various chemical applications that further stimulate the growth of bone cells. As a result, the implants grow together with the bone faster, which means that not only immediate, but also accelerated loading of the prosthesis is possible.
4. Implant thread
It should promote self-cutting and compaction of the bone during installation, and not its loss. This significantly improves the degree of primary implant stability. In addition, implants should be designed in such a way that their design contributes to the preservation of the level of the marginal bone, which borders the gum. According to studies, in a 5-year perspective, it sags by 1.5-2%, which is the norm. But a larger indicator is no longer acceptable - and this largely depends on the specific implant model.
It should be precisely aligned, without micro-gaps, with well-developed positioning of the abutment. Since this directly affects the distribution of the load on the implant and the durability of the installed denture. In addition, it is very important to use original product that have been developed in combination. That is, to use implants and abutments of the same brand, otherwise there is a high risk of too early failure of all structures.
Rating of the best brands of implants
Based on the data presented, it is possible to compile a rating of implants that are ideal for immediate and delayed loading.
BEST IMPLANTS FOR DELAYED LOAD:
- Straumann: high rates of primary stabilization, which allows prosthetics to be carried out even according to a two-stage protocol in 2-3 months; have one of the highest long-term implant survival rates,
- Nobel: Along with Straumann, it is the company that creates the world's best implant models. With excellent bone control, high stability and minimal rejection,
- Osstem: According to numerous studies, they have a unique hydrophilic surface, which provides high levels of primary and subsequent stability in the bone.
BEST IMPLANTS FOR IMMEDIATE LOAD PROTOCOLS:
- Nobel: They are rightfully considered one of the best solutions for immediate loading. Firstly, due to the active external coating, and secondly, due to the presence in the line of the zygomatic Zygoma models, which allow solving the most difficult situations of complete or partial absence of teeth in the upper jaw,
- Straumann: Due to their hydrophilic surface, these implants are excellent for immediate loading due to the highest primary stabilization in the bone,
- Oneway Biomed: This is a line of implants specifically designed for immediate loading. The models use even the deepest sections of the bone tissue, use other cranial bones, so their stabilization remains at the highest level immediately after installation, and several years after the active use of new teeth, it is significantly enhanced due to the growth and restoration of the jawbone
Brands we work with
We have selected brands of implants with which the maxillofacial surgeons and implantologists of our center have been working for more than a decade and have both their own proven treatment results and those presented directly by the manufacturing companies. Here are the main ones:
Premium Swiss implants. They are used for one-stage and two-stage implantation. Allows to achieve very high aesthetics. They are created from an innovative alloy, which, in addition to titanium, contains zirconium. This allows you to create thinner implants, which are in no way inferior in strength to classical models, and to use them in the presence of a narrow alveolar ridge and a lack of bone tissue. They have a patented coating, which allows reducing the time of implant engraftment to 3-4 months.
Mid-range South Korean implants are designed for both immediate and delayed loading. Due to a special innovative coating, they are distinguished by a high rate of engraftment - permanent prosthetics is possible after 6-8 weeks. They are distinguished by the presence of an aggressive thread, which provides high primary stabilization in conditions of a sufficient volume of bone tissue.
All companies give a lifetime warranty for their products, the implants have accurate and predictable positioning in the bone tissue, and are distinguished by high rates of survival.
The choice of the type of dental implant is dictated primarily by the clinical picture - the initial quantity and quality of bone tissue, the presence or absence of living teeth, as well as the desire and financial capabilities of the patient. Regardless of the choice of the implant model, the operation for its installation will be performed at the highest level with a guaranteed long-term treatment result.