What are dental implants?

Intraosseous implants are installed directly in the jaw bone, they are the most widespread and durable (under the right conditions of implantation and use, they serve a person for a lifetime), and subperiosteal implants are used extremely rarely, mostly as a temporary option. For example, if the patient needs to leave the hospital immediately with teeth, a subperiosteal implant is placed on the intraosseous implant, and a temporary crown structure is placed on it, in turn. This multi-unit construction will remain as long as the intraosseous implant takes root. The problem with subperiosteal implants is that they are short-lived: they are fixed not inside the bone, but in the mucous membrane or periosteum and, accordingly, do not grow into the jaw, which causes a feeling of discomfort. Usually, after 2-3 years, it is necessary to get rid of them and put intraosseous ones.

What is a dental implant?

An implant is a substitute for a tooth root. The crown part that we see visually is only a third of the tooth, and 2/3 is the root, which is inside the jaw. If a tooth is missing and needs to be replaced, we can install a bridge that will attach to the adjacent teeth, but we must grind those teeth and prepare them for the bridge. Or we can install an implant — an artificial root implanted in bone tissue, to which a crown is attached from above. Thus, we completely replace the visible and invisible parts of the tooth and at the same time completely preserve those teeth that are located next to each other.

Types of dental implants

We can classify dental implants by the material they are made of. Currently, the most practical and affordable are titanium implants – 99 out of 100 implants installed worldwide are just like this. In addition, zirconium dioxide implants are used, and earlier they were also made of gold and platinum.

Intraosseous implants are also distinguished by shape. This classification stems from the main problem of dental implantation: the lack of sufficient volume of bone tissue. Mathematically and engineering calculated the minimum dimensions of a dental implant capable of withstanding the chewing load — 4 by 8 mm. If the doctor sees that the amount of bone tissue left in the patient is not enough to install an implant of this size, and at the same time, for some reason, it is not possible to regenerate tissues, he can suggest experimenting with the shape of the implant. Currently, there are many manufacturers that make implants of non-standard shape: plate, vertical, ultra-thin, etc.

However, it should be considered that this is a compromise solution. In medical practice, there is a long-established understanding of what an implant should be. And in the case of a lack of bone tissue, the optimal option is to increase the volume of the bone and after that – implantation. The problem of implant integration has been solved today: they successfully take root, and the number of disintegrations in the Sirius-Dent clinic is 0.8-1%.

Another way to classify dental implants is by price. In our line, we offer options for any wallet: premium, mid-priced (made in Germany and Italy) and some of the best budget implants on the market, made in South Korea. You can choose any dental implant, it will be a good decision and quality work.

Service life of a dental implant

Since the human body does not perceive titanium as a foreign body, the service life of a dental implant is virtually unlimited. This discovery was made in 1952 by the Swedish research professor Per-Ingvar Branemark, known today as the father of dental implantology and one of the founders of the Nobel Biocare company.

Therefore, chemical bonds are formed between the bone cells and the oxide layer of the surface of the titanium implant, that is, the titanium implant grows into the jaw and will always be in it, if all the conditions of correct installation are followed. Disintegration usually occurs in cases of non-compliance with the principles of implantation:

• when the crown protrudes above the other teeth and takes all the load upon compression, this can lead to the destruction of the structure (fracture of the crown or connection, including the disintegration of the implant);
• if the crown is made incorrectly or oral hygiene is insufficient, food residues can get under the gums, which leads to the development of pathogenic microflora, inflammatory processes and eventually the destruction (reabsorption) of bone tissue;
• the implant is installed incorrectly, that is, it is not completely inside the bone, and its parts fall into the maxillary canal, maxillary sinuses, or nasal cavity. It can also lead to disintegration.

If the implant is installed correctly, is completely inside the bone, the crown does not protrude and is adjusted to the height of the tooth row, then these are the optimal conditions under which it can be in the oral cavity and perform its functions throughout life. Even when, as a result of periodontal changes and receding gums, part of the implant becomes visible, only the aesthetic appearance suffers, and the implant remains functional and continues to serve.

Methods of installing dental implants

There is one correct way to install a dental implant. For this, it is necessary to make a bed for the implant in the bone tissue and place it in this bed. This is done under anesthesia using a drill whose diameter and length correspond to the size of the implant. After that, the implant, which has a thread, is screwed into the bed and securely fixed.

The optimal initial stabilization of the implant is 30-35 N/cm — this is the force with which the implant is screwed into the bone tissue. At the end, a special plug or gum former is installed, and the implant remains in this form during the healing period.

If it is possible to install an implant with a higher load (50-60 N/cm), such primary stabilization allows you to immediately install an abutment (the element that connects the implant and the crown) instead of a plug or gum former and wear a temporary crown. It is removed from the bite so as not to load the implant immediately. That is, if the primary stabilization is sufficient, the patient can leave the operating room with a tooth.

After completion of osseointegration (3 months for the lower jaw and 6 months for the upper jaw), the temporary crown is replaced with a permanent one.

Pros and cons of dental implants

The main advantage of dental implantation is that it is a tooth-saving technology. For example, if we install a bridge prosthesis, we have to grind the adjacent teeth and put crowns on them, on which it will be attached. In the case of implantation, this is not necessary: ​​we work directly in the area of ​​the missing tooth and do not touch the adjacent teeth at all.

Even if there are no teeth or only a small number of them remain and the patient is forced to wear a removable prosthesis, implantation can help. First, the implant will allow you to securely fasten the removable prosthesis, secondly, you can install as many implants as there are missing teeth, and thus make a permanent prosthesis. A person will be able to smile again, instead of suffering limitations and discomfort.

And this is not to mention the possibility to leave the operating room already with a temporary crown, which is definitely a pleasant bonus.

The disadvantage can only be considered the fact that dental implantation requires a highly qualified doctor, which requires years of training and practice. A novice doctor spends 35-40 minutes installing one implant and risks facing a more difficult postoperative period, while a professional needs 8-10 minutes and his patients have no problems with regeneration.

Rehabilitation and rejection after dental implant placement

Rehabilitation after the installation of a dental implant depends on the traumatic nature of the operation, which, in turn, depends on the density of the patient’s bone tissue, which is determined by anatomical features. So, if the bone tissue is sparse or of low density, implantation is easy and fast, and the postoperative recovery process is almost not felt. But for patients with a high density of bone tissue, the drilling process is more traumatic, because even the smallest volumes of fluid will create high local pressure that causes pain.

On average, rehabilitation lasts 7 days, which correspond to the classic pathological signs of inflammation: 3 days — swelling growth with moderate pain at the peak, the next 4 days — stabilization and resolution. The drugs that we prescribe in the postoperative period make it possible to significantly improve the patient’s quality of life and reduce swelling and pain. A week after implantation, the jaw will still show signs of swelling (redness, increased volume), but it will heal quite successfully.

In the best scenario (30% of cases), the patient feels pain and discomfort 2-3 hours after the operation, when the effect of anesthesia wears off, but in the future he feels well and has almost no swelling. In the worst case scenario (about 20% of cases), when it comes to patients with high bone density, the pain lasts a whole week or even longer.

If the installation of the implant is accompanied by additional surgical interventions aimed at increasing bone tissue or mucosa, the postoperative period may be more difficult and accompanied by more intense pain and swelling. However, no matter how traumatic the implant surgery with one-stage bone grafting is, the postoperative period rarely lasts longer than a week.

The percentage of implant rejection is 0.8-1%. The implant does not take root, as a rule, in cases where surgical intervention is performed against the background of an inflammatory process. Then implantation is the final operation, and before that interventions may be required to remove teeth, cysts, granulation tissues, fight against inflammatory processes in the oral cavity. Unfortunately, in such cases, it is not always possible to extend the treatment for a year and a half and wait for complete regeneration, you have to take risks. If the patient agrees to take a risk with us, we install the implant in the area where the inflammatory process has not been completely eliminated. They usually take root, but in the worst case, you have to try again when the tissues have completely healed.

Contraindications to the installation of dental implants

Contraindications for dental implantation are currently cancer and undergoing chemotherapy. After all, the task of chemotherapy is to slow down or stop cell division, so regeneration is extremely poor, and there is no point in getting implants installed.

Things like smoking, diabetes, hypertension used to be contraindications, but as we learned to understand the nature of diabetes and the pathogenesis of smoking, we learned to work with it. Moreover, patients with diabetes are the most disciplined, because they are used to controlling their diet, sugar level, and taking medications according to the schedule.

It is not advisable to perform dental implantation on pregnant and breastfeeding women, because this is an operation that requires anesthesia.