Implant dentar: Ghidul pacientului in 2021 cu Dr. Nassar

WHAT IS A DENTAL IMPLANT?

Implantul dentar este un dispozitiv fabricat din titan cu grad de puritate 5, material compatibil cu corpul uman.  Implantul are forma unui surub si rolul de a inlocui radacina unui dinte compromis.

Caracteristici generale

• Titanium with a purity grade of 5 is used in dental implantology, orthopedics, neurosurgery, but also in the aeronautical industry, in the manufacture of spacecraft.
• Classic implants, also called screw type implants, are most often used among dental implants. Their threads give better stability and automatically a safer integration.
• The dental implant provides the basis for restoring a tooth, several teeth or an entire dental arch.
• Robust, with a large diameter and height, classic implants are used only if the jaw bone has the appropriate width, height and structure.
• If the bone is not wide and high enough, bone reconstruction methods are used, so that the implant is inserted in optimal conditions.
• Depending on the bone volume and the area in which they will be inserted, implants are chosen with shapes, surfaces, diameters and the corresponding size.

components

When we talk about implants we tend to think of an artificial tooth that replaces a fallen tooth. In reality, however, the implant consists of:

1. The implant itself (titanium screw);
2. The prosthetic abutment, the piece that is inserted into the implant and has the role of "tying" the implant to either a crown or a bridge or denture;
3. Crown / bridge / prosthesis - is placed over the abutment and has / have a functional and aesthetic role.

Beneficii tratament

Comparativ cu orice alta solutie de inlocuire a unui dinte lipsa, tratamentul cu implanturi dentare are urmatoarele avantaje:

• Imita radacina dintelui compromis si se simte ca un dinte natural;
• Prezerva sanatatea dintilor vecini ce nu mai trebuiesc slefuiti asa cum se intampla in cazul pivotului dentar;
• Stopeaza retractia osoasa si ofera stimul maxilarului/ mandibulei in zona in care dintele a cazut;
• Impiedica migrarea dintilor de pe arcada care ar incepe sa se miste, in timp sa migreze, si in final sa cada;
• Mentine estetica faciala, oasele maxilare isi mentin volumul si impiedica avansarea catre aspectul de „fata cazuta”;
• Elimina respiratia neplacuta pentru ca sub marginea coroanei nu se aduna resturi de mancare care putrezesc (noul dinte se perie simplu, exact ca dintele natural);
• Restaureaza vorbirea normala fara a mai exista situatii jenante, problemele de pronuntie/ improscarea cu saliva in timpul unei discutii;
• Restaureaza complet functia de masticatie;
• Cheaper than any other tooth restoration solution.

Citeste mai multe detalii despre beneficiile implantului dentar.

Types of implants

Implanturile dentare se prezinta sub o multitudine de tipuri si se pot clasa in functie de: forma geometrica, modalitate de fixare in os, rapiditatea tratamentului si modalitatea de fabricare.

Implanturi clasificate dupa forma geometrica

Forma geometrica si tipul de implant de stabileste in functie de situatia dentara. Daca osul este sanatos se poate utiliza tipul de implant cu forma cilindrica sau conica. Atunci cand osul prezinta un grad avansat de resorbitie exista 2 variante:

• Refacerea osului cu biomateriale (aditia de os) si ulterior inserarea unui tip implant cu forma conica sau trapezoidala;
• Inserarea directa a tipului de implant cu forma piramidala fara a mai fi necesara procedura de aditie osoasa.

Clinica Dr. Nassar este reprezentant unic in Romania al AB Dental, liderul cu cea mai variata gama de implanturi dentare din lume. Practic, in orice situatie te-ai afla, noi avem tipul de implant cu forma geometrica si dimensiunea potrivita.

Implanturi clasificate dupa modalitatea de fixare

Dupa modalitatea de fixare exista 3 tipuri de implanturi:

• Intraosoase – se utilizeaza in majoritatea cazurilor si se fixeaza in os;
• Subperiostale – se utilizeaza in cazuri grave si se fixeaza pe os;
• Transosoase – nu se mai folosesc in prezent, se fixau prin strapungerea totala a osului.

Implanturi clasificate dupa rapiditatea tratamentului

Dupa rapiditatea tratamentului, adica timpul trecut de la insertie si pana la montarea coroanelor, implanturile se pot clasifica astfel:

• Implantul rapid cu incarcare imediata este cunoscut sub denumirea de Implant rapid si reprezinta procedura de insertie a implantului si aplicare a coroanei dentare in aceeasi sedinta;
• Implantul intr-o zi, cunoscut sub denumirea de Teeth in a day reprezinta procedura de insertie a implanturilor pentru toata gura si montarea coroanelor sau protezei dentare in aceeasi zi;
• Implantul cu incarcare tardiva reprezinta procedura clasica in care implanturile sunt inserate si dupa perioada de osteointegrare de 3 – 6 luni se revine la clinica pentru montarea coroanelor definitive.

Un implant dentar rapid cu Dr. Lorelei Nassar dureaza in medie 7 minute/ dinte. Avantajul unei insertii rapide inseamna invazivitate redusa si timp de vindecare mai scurt.

Implanturi clasificate dupa modul de fabricare

Exista 2 tipuri de implant dentare ce se pot clasifica dupa modul de fabricare:

• Implanturile prefabricate sunt implanturile geometrice tip surub (cilindrice, conice, trapezoidale, piramidale), gata fabricate, cu diverse lungimi si grosimi.Chirurgul alege implantul cu lungime si grosime prestabilita pentru a fi inserat pacientului;
• Implanturile personalizate sunt implanturi dentare unice, fabricate la comanda, deci care se adapteaza danturii intr-un mod superior celor prefabricate.

La clinica de implantologie Dr. Nassar din Bucuresti, indiferent de situatia in care te afli, daca ai unul, mai multi sau toti dintii de inlocuit, iti punem la dispozitie implanturi personalizate, fabricate in laboratoarele ultraperformante AB Dental prin nanotehnologie digitalizata 3D.

Tipuri de proteze pe implanturi

Protezele dentare se pot clasifica in doua tipuri: proteze fixe si proteze mobile.

Protezele fixe pe implanturi se impart la randul lor in 2 categorii:

• coroane dentare fixate prin insurubare sau cimentare pe implanturi;
• punti dentare fixate pe implanturi prin cimentare.

Protezele mobile pe implanturi sunt punti dentare formate din coroane lipite una de alta si care se ataseaza pe tipurile de implanturi prevazute cu bile/ capse. Protezele mobile se detaseaza manual si intretin/ curata mai dificil decat protezele fixe.

Coroane dentare pe implanturi

• If only one tooth fell out. Situatia ta nu este grava, probabil ca osul nu s-a resorbit inca. Poti recurge la operatia de implant si beneficia de toate avantajele mentinerii unei danturi sanatoase. Tipul de implant (conic, cilindric trapezoidal, scurt, lung, cu sau fara striatii, etc) si tipul de proteza dentara (coroana ceramica/ ziconiu) se aleg in functie de cazul particular in care te afli.
• If more teeth have fallen out. Situatia ta necesita actiune; uneori este nevoie si de proceduri conexe precum aditie de os sau sinus lift. Inserarea de implanturi va stopa actiunea de migrare a dintilor vecini: ii va impiedica sa se degradeze si sa cada. Alegerea implanturilor se va face conform cu statusul gingiei si osului din zona dintilor cazuti. Intr-un loc s-ar putea sa ai nevoie de un anumit tip de implant, iar in alta parte de altul. Protezele dentare, adica coroanele, se insurubeaza sau cimenteaza pe implanturi si poti zambi din nou, asa cum o faceai inainte.

Sisteme de proteze pe implanturi

If all your teeth fell out. Situatia ta este grava, ai nevoie fie de inlocuirea dintilor cu o proteza dentara fixa pe 4 sau 6 implanturi (sistem FIX-IT ON 4/ FIX-IT ON 6), fie de inlocuirea fiecarui dinte cazut cu cate un implant si o coroana (One by One). Daca bugetul este limitat, poti alege ca solutie proteza mobila fixata prin capse pe 4 sau chiar 2 implanturi.

Stages of dental implant

Any implant insertion operation requires good planning, both by the doctor and the patient. In order to benefit from a correctly inserted implant that will last for decades or a lifetime, it is necessary to follow the following steps:

1. Consultation

During the consultation, the surgeon will analyze the general dental condition and possible dental disorders of the jaw. Then he will ask you questions about past and present illnesses.

2. Panoramic dental radiography / 3D tomography

• The doctor will ask you to perform a panoramic radiograph, accompanied in some cases by 3D dental tomography.
• Panoramic radiography and tomography show the condition of the bone tissue, if related procedures are needed (reconstruction, bone addition or sinus lift).
• Radiological images also determine the type of implant to be used: its length, diameter and surface;
• The x-ray must not be older than 6 months.

3. Blood tests

The following blood tests must be performed before surgery:

• CBC
• glucose
• Serum calcium
• cholesterol
• Bleeding times
• Coagulation times
• Uric acid
• Urea
• ESR

4. Rehabilitation of the oral cavity

To reduce the risk of infection and implant loss, your doctor should clean your oral cavity of possible cavities, periodontal pockets, and infections.

• If there are compromised teeth which can maintain the infection, they are treated or extracted.
• The situation of the teeth can mean several visits to the doctor: the implant cannot be inserted as long as there are infestations with harmful bacteria.
• The end of the stage ends with a complete sanitization (descaling + brushing + air-flow), preparatory to implant insertion.

5. Surgical stage

Before insertion, the bone must be in optimal condition to receive the implant. If bone extractions or additions are required, they can be performed on the same day, immediately before insertion. The operation is performed under anesthesia and is performed with the help of laser, equipment and instruments specific to implantology. After making the incision, the implant is inserted into the bone, then the gum is sewn - the implant is no longer visible.

6. Prosthetic stage

Late loading (delayed)

After 2-3 months, when the implant is properly integrated into the bone, return to the clinic for the prosthetic stage. The implant is discovered under the gum and the prosthetic abutment is screwed into it - the connecting piece between the implant and the crown. The final crown is placed on the abutment.

Immediate loading (Teeth in a day)

Depending on the patient's priorities, the implant may be loaded on the same day with transient crowns or prostheses. They have an aesthetic identical to the final ones made of ceramic or zirconium, but they are used because they have a lighter weight and do not alter the stability of the implant.

Immediate loading has the following features and requirements:

• The patient has teeth immediately; the waiting period of 3 months is no longer necessary;
• Care must be taken that in the next period the food has a semi-solid consistency;
• Transient prostheses or crowns are replaced with permanent ones after the implant has been perfectly integrated into the bone

Operatia de implant dentar

Candidatul la operatie

Candidatul ideal este cel cu un status si istoric medical favorabil. Pentru a beneficia de orice operatie de implant dentar, trebuie sa indeplinesti urmatoarele conditii:

• to be at least 17 years old;
• present the set of blood tests requested by the doctor;
• to make a panoramic radiograph;
• optionally, the doctor may request intraoral pictures and / or a tomography of the jaw.

The implant is a complex operation, but for an experienced implant surgeon the procedure is common. At the Dr. Nassar Implantology Clinic, we have patients over 80, so age is relatively low. What really matters is the general health of the patient.

Anestezia

The implant is made in 90% situations using local anesthesia, as in any dental procedure. Local anesthesia may be accompanied by inhalation with hilarious gas, a relaxing gas that is inhaled for 30 minutes before starting surgery. For the anxious there are methods of intravenous and general sedation in which the patient is put to sleep by an injection into a vein, respectively intubation.

La clinica de implantologie Dr. Nassar poti beneficia de 4 optiuni de anestezie: inhalosedare cu gaz ilariant, anestezie locala, intravenoasa si hipnoza medicala. Dupa caz, putem folosi fiecare anestezie in mod separat sau combinat, astfel incat vei fi relaxat/a in timpul procedurii de implant si nu vei simti deloc durere.

Durata operatiei

The completion time of the operation is proportional to:

• number of implants to be inserted;
• the number and complexity of possible related procedures (extractions, bone additions, sinus lift, etc.);
• type of prosthesis / crowns.

With Dr. Lorelei Nassar, surgeon and implantologist since 1992, with over 10,000 implants inserted, the dental implant procedure is extremely precise and fast. The operation takes an average of 7 minutes / tooth.

Durerea dupa implant

Imediat dupa implant locul in care s-a efectuat incizia se va simti amortit, apoi la cateva ore durerea va aparea. Intesitatea durerii poate fi mai mare sau mai mica, de la caz la caz. Pentru a stopa durerea, medicul va recomanda analgezice la cateva ore dupa operatie. Totusi, este de mentionat ca pacientii cu un grad de suportabilitate mai mare la durere renunta la analgezice – operatia de implant dentar nu este atat de durereoasa pe cat se crede.

Riscurile operatiei

Like any surgery or dental treatment, the implant is no exception to the rule and has the following risks:

1. IMPLICATION NON-INTEGRATION AND LOSS

Non-integration of the implant means that it does not weld completely to the bone, begins to shake and eventually falls. The causes of implant loss are:

• wrong insertion;
• smoking and excessive alcohol consumption;
• poor dental hygiene;
• non-compliance with post-operative medical indications.

2. EDEM

Swelling of the area where the implant was inserted is often a normal symptom that goes away on its own within a few days. The causes of swelling are:

• the body reacts properly to the introduction of a foreign body;
• post-operative instructions on hygiene and medication are not followed.

3. NERVE INJURY AND PARTIAL PARALYSIS

When the inserted implant touches the nerves, a numbness / paralysis of the respective area occurs. The patient may have symptoms of pain, tingling, numbness or desensitization. If the symptoms do not disappear within 2-3 days of surgery, it means that the nerves have been affected by the implant. This risk is avoided by:

• clinical and radiological / tomographic examination performed properly by the doctor;
• inserting the fixed implant in the right place, without any deviation.

4. INFECTION AND INFLAMMATION OF THE OPERATED AREA

Inflammation of the area where the implant was inserted actually means infection of the gingival and / or bone tissue. The infection results from:

• non-sterile dental equipment and instruments;
• non-compliance with hygiene instructions may be operative.

5. SINUS WASHING

Patients who have lost teeth in the area of the maxillary sinuses and who have not performed the implant surgery at the right time, need a procedure called sinus lifting and subsequently by implant surgery. If the length of the implant is chosen incorrectly by the doctor, the sinus may be perforated at the insertion.

To choose the right clinic, first of all analyze the doctor's profile. In order to reduce the risks of the operation, you should have answered favorably to the following 3 questions: “What is the specialization of the doctor who will operate on me? ”, „How many implant surgeries did he perform during his career? ”, „What do other patients say about him? ”

contraindications

Contraindicatiile se refera la boli ce au ca rezultat imposibilitatea de a recurge TEMPORARY the implant operation. To insert the implant, the dentist will work with the patient's attending physician and together will determine the optimal time of the procedure. Patients with one of the following diseases should be closely monitored throughout preoperative as well as postoperative.

• ACUTE AND CHRONIC DISEASES: insulin-dependent diabetes, polyarticular rheumatism, infections, leukemia, heart or other organ disorders;
• ENDOCRINE DISEASES: acromegaly, hyper and hypothyroidism, obesity;
• NEUROLOGICAL PSYCHOLOGICAL DISEASES OR ANXIETY: parkinson's, multiple sclerosis, epilepsy, paralysis, etc .;
• INFECTIONS: syphilis, tuberculosis, AIDS, other infectious hematological diseases;
• BONE SYSTEM DISEASES: psteoporosis, acute rheumatoid arthritis, other bone diseases;

THERE ARE NO ABSOLUTE CONTRAINDICATIONS. Regardless of the disease you suffer from, the dental implant can be inserted. The only necessary conditions are your medical balance and the mandatory minimum age of 17 years.

In aproape 30 de ani de chirurgie – implantologie dentara, Dr. Lorelei Nassar a tratat sute de cazuri cu contraindicatii la implant. Atata timp cat se supun unei monitorizari riguroase, pacientii cu osteoporoza, diabet, cancer sau alte afectiuni grave pot beneficia de implanturi dentare.

Lifetime of a dental implant

There is a short and comprehensive answer to this question: The implant lasts as long as you have a natural tooth. The implant failure / non-integration rate is below 1% - the rate calculated over a 10-year period in patients with a healthy lifestyle.

• If you take good care of the implant, then it can last a lifetime. Otherwise, the duration of a dental implant will be shortened according to the degree of oral hygiene; the more deficient it is, the shorter the implant will last.
• Implant duration is shortened in smoking patients (14% failure rate) and those suffering from alcoholism or chronic diseases. Diabetes, cancer, osteoporosis and other conditions are not completely banned from the implant, but only temporarily.