DENTAL IMPLANT: EVERYTHING YOU DIDN'T KNOW ABOUT IMPLANTS

WHAT IS A DENTAL IMPLANT?

The dental implant is a device made of a resistant and biocompatible material - pure titanium in a proportion of at least 99.5%. The implant is most often in the form of a screw, its role being a replacement for the root of a fallen tooth.

Overview

• 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.

Advantages and disadvantages

The dental implant is currently the most modern solution for replacing fallen teeth. The indisputable advantages unequivocally outweigh the disadvantages. In fact, we can say that the implant has no disadvantages, but only temporary bans for certain patients.

Benefits

• It mimics and feels like a natural tooth. The implant mimics a natural root, and the zirconium / ceramic crowns applied on the abutment look and feel exactly like natural teeth. A few days after insertion, you forget that you have artificial teeth in your mouth.
• Preserves the health of neighboring teeth. Compared to replacing teeth with pivots and bridges, the implant does not involve grinding neighboring teeth. These teeth still live; they remain intact, unpolished and healthy.
• Stops bone retraction. After a tooth falls out due to a lack of stimulus, the bone gradually begins to resorb (melts). When you chew, the implant stimulates the jaw bone and prevents it from retracting, just like a natural tooth with a root.
• Protects all teeth. Even without a tooth, the bone and gums begin to degrade, and neighboring teeth begin to become unstable, to move. The implant simulates the natural root and prevents adjacent teeth from migrating and eventually falling out.
• Improves facial aesthetics. Without one or more teeth, the expression on the face changes: the face begins to "fall", to age. With the help of the implant, the maxillary bones maintain their volume and the facial appearance remains unchanged.
• Eliminates bad breath. Compared to the pivot dental bridge (which is quite difficult to maintain), the implant is brushed exactly like a regular tooth. Under the crowns you will no longer have leftover food that rots and makes your mouth smell bad.
• Restores normal speech. Implants offer normal communication, without being embarrassed; pronunciation problems or splashing with saliva during a discussion no longer exist.
• Cheaper than any other tooth restoration solution. Compared to the pivot and dental bridge, the implant is not only cheaper, but also extremely efficient. Inserting an implant costs less than inserting a pivot, grinding teeth and adding dental bridges. You pay less and it is healthier to buy an implant than to install a pivot and kill neighboring teeth by grinding to add dental bridges.

disadvantages

Although dental implant is the most effective choice, it is not an ideal solution for everyone. An implant, regardless of the brand or the doctor who inserts it, also has disadvantages. Thus, the success of implant integration correlates not only with the skill of the doctor or the type of implant, but especially with the lifestyle and general health status of the patient.

• Not suitable for smokers. The higher the number of cigarettes, the lower the implant integration rate. According to studies, smokers have a success rate of 86%, while non-smokers can be proud of an integration rate of 99%.
• Not suitable for patients with bruxism. Brussels patients (those who grit their teeth at night, in their sleep) have a low rate of integration. For them, there is the solution of wearing a personalized splint that is made at the clinic, according to the dental impression. Without the use of the gutter, the integration rate decreases significantly.
• Not recommended for people with diabetes, polyarticular rheumatism, major infections, leukemia and heart disease. Patients with such conditions must follow a strict treatment, monitored by the implantologist, before they can benefit from dental implants.

Implant vs. pivot bridge

Due to its advantages and durability, the dental implant is by far the best choice compared to any other tooth replacement option. The implant is superior to the classic solution - pivot bridge, both in terms of price paid and invasiveness.

invasiveness

• In the old version, a missing tooth is restored by a dental bridge on 2 adjacent teeth. This involves canal treatment, insertion of pivots and grinding of neighboring teeth, which led to their deterioration and ultimately to their devitalization (death).
• In the modern version, the implant allows the preservation of neighboring teeth. They do not grind, they remain perfectly intact and healthy.

PRICE DIFFERENCE

As can be seen in the tables below, the cost of a dental implant is lower than that of the classic solution in which we use the dental bridge with pivots.

NOTE: The amounts used in the above calculation represent the average prices charged by the dental clinics in Bucharest.

Types of implants

The type of implant determines depending on the dental situation you are in, whether or not you have bone resorption in place of the fallen tooth. If the jaw bone is thin and narrow, a small diameter implant type will be used. Conversely, if the bone is generous, a robust implant is usually chosen.

Solutions for missing teeth

• If only one tooth fell out. Your situation is not serious, the bone has probably not resorbed yet. You can resort to implant surgery and benefit from all the advantages of maintaining healthy teeth. The type of implant (conical, cylindrical trapezoidal, short, long, with or without striations) will be chosen by the implantologist.
• If more teeth have fallen out. Your situation requires action; you probably need bone reconstruction as well. The insertion of implants will stop the migration of neighboring teeth: it will prevent them from degrading and falling. The choice of the implant type will be made according to the status of the gum and bone in the area of the fallen teeth. In one place you may need a certain type of implant, and in another part another.
• If all your teeth fell out. Your situation is serious, you need either a prosthesis fixed on 4 or 6 implants (FIX-IT ON 4 / FIX-IT ON 6 system), or the replacement of each fallen tooth with one implant. If the budget is limited, you can choose as a solution a mobile prosthesis fixed by staples on 2 or 4 implants.

At the Dr. Nassar Bucharest implantology clinic, you benefit from AB technology, a world leader that offers the widest range of premium implants in the world. Regardless of the situation you are in, if you have one, more or all teeth to replace, the clinic offers you AB implants made with the latest 3D nanotechnology. Each patient receives a personalized solution, according to their dental status.

Lifespan: how long does an implant last?

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.

The candidate for surgery

The ideal candidate is the one with a favorable medical status and history. To benefit from the implant, you must meet the following conditions:

• 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.

Duration of the intervention

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.

Associated risks

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

Yes. Contraindications refer to diseases that result in the impossibility of resorting 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 almost 30 years of dental implantology surgery, Dr. Lorelei Nassar has treated hundreds of cases with apparent contraindications to implants. As long as they are rigorously monitored, patients with osteoporosis, diabetes, cancer or other serious conditions can benefit from implants at Dr. Nassar's clinic.

Stages of the journey

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

Pain: Does the dental implant hurt?

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.

At the Dr. Nassar implantology clinic you can benefit from 4 anesthesia options: hilarious gas inhalation, local anesthesia, intravenous and medical hypnosis. Depending on the case, we can use each anesthesia separately or in combination, so that you will be relaxed during the implant procedure and you will not feel any pain.