What Are Dental Implants?
Dental implants are the best and, in some cases, the only solution for the restoration of various defects in dental arches. They replace missing teeth in their entirety, including the roots. They are implanted in the bone in the place of missing teeth.
Implants have obvious advantages with respect to the restoration of missing teeth compared with any other method. In the long run, they are aesthetic, functional and comfortable. Their main advantage is that they do not affect any other teeth (with dental bridges or removable dentures the adjacent teeth are inevitably affected). The placing of a bridge or denture after the loss of one or several teeth usually leads to bone loss in the affected area, while no bone loss is observed with dental implants.
- General dental examination. X-ray photographs and imprints for implantological analysis may be needed
- Depending on your condition, a treatment plan is drawn up. The number, type and size of the implants are assessed; we discuss if there is a need for an additional surgical manipulation (bone augmentation, sinus lift etc.), and the future denture is planned. It is recommended that the oral cavity be sanitized before starting any surgical manipulations
- During the planning phase we consider information about your general health and some of your habits. You must warn us about illnesses you might suffer from, any medicines you might take, any allergies you might have, or any infectious diseases you had in the past
- In order to control the pain during the implant procedure we could use local anaesthesia or sedation, depending on the medical indicators
Our team will instruct you in detail what your behaviour before and after the surgical manipulation is expected to be in order to reduce the risk of complications and unpleasant experiences.
A certain period of time (between 3 and 8 months, depending on whether an additional surgical manipulation has been performed or not) is required after the implant placement.
Once the implant has been integrated into the bone, we proceed to its uncovering and shaping the gum. The so called abutment is placed on the implant – a superstructure made of titanium or zirconium, on which a permanent crown will be placed subsequently. Shortly before the uncovering of the gum or after a certain period of time a temporary crown is prepared. It helps to shape the gum.
Imprints for preparing a permanent crown may be taken at least 4 weeks after the implant has been uncovered.
Cementing the crowns on implants with temporary cement is a common practice.
You should take good care of the implant. It is obligatory to maintain good oral hygiene, use special dental floss, and have regular professional cleanings and check-ups.
The quality and the quantity of the bone in which the implant will be placed are of utmost importance.
Masticatory movements exert enormous pressure on the bone. If the bone is insufficient or not healthy enough, you might lose the implant after a certain period of time, and in some cases opting for implants might be impossible altogether. That is why your doctor should decide if there is a need for an additional surgical procedure, the so called bone augmentation. This term designates various surgical interventions through which additional bone material is added in order to provide enough volume for implant placement. This surgery can use the patient’s own bone material as well as bone substitution material.
Bone augmentation can be:
- Completed in a single phase – when it is carried out together with an implant placement (with smaller bone defects)
- Completed in two phases – when the volume of the jaw bone is increased first, the implanting is carried out 6-8 months later
There is vertical and horizontal bone augmentation. Vertical bone augmentation aims to increase the bone in height, and horizontal bone augmentation aims to increase the bone in width.
A sinus lift often precedes the implant placement in the area of the rear teeth of the upper jaw. When these teeth are extracted for whatever reason, the bone disappears very fast. As a result, the maxillary sinus grows in order to fill the newly opened space. Sometimes the roots of the rear teeth are in the sinus and when they are extracted, it turns out that it is not possible to replace them with implants because there is no bone left there.
In such cases, it is essential that the so called sinus lift be performed before placing the implants.
This is a procedure which first increases the bone material in the area of the maxillary sinuses. The bone graft should be placed in the gap between the natural bone and sinus mucosa. This is achieved by lifting the sinus floor membrane first, and then filling up the space with bone material.
herapy with platelet-rich plasma (PRP) might speed up the bone and tissue growth as well as wound healing, thus helping to guarantee the long-term results of teeth implants. It boosts the regenerative powers of the body. During the implant placement procedure the application of PRP might give a flying start to bone growth and thus provide stability of the implant in two-three weeks which shortens the time between implant placement and placement of the permanent crown.
Before this procedure a certain amount of the patient’s blood is taken in a sterile test-tube. The blood is then centrifuged at certain parameters for 5-8 minutes. When the centrifugation is over, the plasm is divided in 3 layers:
- Platelet-poor plasma
- Red blood cells (erythrocytes)
- The so called PRP – a fraction rich in thrombocytes and white blood cells (leukocytes)
The procedure uses the last fraction whose concentration of thrombocytes is 8 times higher than the blood average. Furthermore, it contains leukocytes and a great number of growth factors. Growth factors found in the thrombocytes are responsible for:
- Tissue regeneration and rejuvenation
- Increase of collagen production
- Stimulation of migration, division and differentiation of cells and their production of a number of substances and enzymes
- Affecting mainly the mesenchymal stem cells for their differentiation into fiber types producing collagen and elastin
- Growth factor separated from the leykocytes (VEGF) stimulating the formation of new blood vessels (angiogenesis), thus improving microcirculation
PRP is used in dentistry when bone material is missing. PRP helps cell division, and hence the formation of new bone material. When osteoplasty is necessary, animal or human PRP facilitates the ossification of the engrafted bone and its acceptance by the body. To reinforce this acceptance, PRP should be added before placing the new bone.